Eligibility Response Detail

CIN: CD67890D

Date of Service: July 1, 2026

Submitted: July 26, 2026 1:24 PM

Payload ID: 11e21628-ed19-448c-9eab-31fce77c0f74

Response Type: X12 271

Response Status: Rejected

Member Found: Yes

Coverage: — — —

Plan: —

MCO: —

Received: July 26, 2026 1:24 PM

Parser Version: 1.0

Raw 270 Request

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260726*1724*|*00501*086675323*1*P*:~GS*HS*00ND*EMEDNYREL*20260726*1724*675323*X*005010X279A1~ST*270*5323*005010X279A1~BHT*0022*13*202607261724000001*20260726*1724~HL*1**20*1~NM1*PR*2*NYSDOH*****PI*EMEDNY~HL*2*1*21*1~NM1*1P*2*MEDICAID PLANNING GROUP CORP*****SV*08046628~PRV*PE*PXC*251B00000X~HL*3*2*22*0~TRN*1*202607261724000001*00000000ND~NM1*IL*1******MI*CD67890D~EQ*30~DTP*291*D8*20260701~SE*13*5323~GE*1*675323~IEA*1*086675323~

Raw 271 Response

Full screen

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260726*1324*^*00501*270218630*0*P*|~GS*HB*EMEDNYREL*00ND*20260726*132431*270218630*X*005010X279A1~ST*271*270218630*005010X279A1~BHT*0022*11*202607261724000001*20260726*132431~HL*1**20*1~NM1*PR*2*NYSDOH*****FI*141797357~PER*IC*EMEDNY PROVIDER SERVICES*TE*8003439000*UR*www.emedny.org~HL*2*1*21*1~NM1*1P*2*MEDICAID PLANNING GROUP CORP*****SV*08046628~HL*3*2*22*0~TRN*2*202607261724000001*00000000ND~NM1*IL*1******MI*CD67890D~AAA*N**72*C~DTP*472*D8*20260726~SE*13*270218630~GE*1*270218630~IEA*1*270218630~