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271 Response
Eligibility Response Detail
CIN: PT97740V
Date of Service: Aug. 13, 2026
Submitted: Aug. 12, 2026 3:51 PM
Payload ID: caa95c20-6a51-40c1-ac9c-92f89521ef90
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: COORDINATED BEHAVIORAL CARE INC
Received: Aug. 12, 2026 3:51 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| Recertification | RECERT | 2026-12-31 | MSG | Recertification required by this date |
Benefit Records (EB)
| EB01 | Service Type | Description | Amount | Period | Message |
|---|---|---|---|---|---|
| U | 30 | ELIGIBLE PCP | — | — | |
| B | 30 | — | — | — | |
| 1 | 82 | — | — | — | |
| 1 | 88 | — | — | — | |
| W | CQ | — | — | — | |
| W | CQ | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260812*1951*|*00501*564288855*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*1951*288855*X*005010X279A1~ST*270*8855*005010X279A1~BHT*0022*13*202608121951000001*20260812*1951~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*202608121951000001*00000000ND~NM1*IL*1******MI*PT97740V~EQ*30~DTP*291*D8*20260813~SE*13*8855~GE*1*288855~IEA*1*564288855~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260812*1551*^*00501*528771130*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*155124*528771130*X*005010X279A1~ST*271*528771130*005010X279A1~BHT*0022*11*202608121951000001*20260812*155124~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*202608121951000001*00000000ND~NM1*IL*1*AGORDOME*VERA****MI*PT97740V~N3*2110 WESTBURY CT 5e~N4*BROOKLYN*NY*11225~DMG*D8*19830131*F~DTP*472*D8*20260812~DTP*346*D8*20260801~DTP*102*D8*20260601~EB*U*IND*30**ELIGIBLE PCP~MSG*A1~MSG*A2~MSG*CF~MSG*H9~MSG*PD~MSG*CNTY CD=66 066~MSG*RECERT MONTH=12~LS*2120~NM1*Y2*2*ELDERPLAN INC HOMEFIRST PARTIAL LTC*****PI*ED~N3*55 WATER ST FL 46~N4*NEW YORK*NY*100413211~PER*IC*PROVIDER SERVICES*TE*8777711119~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~EB*W*IND*CQ~LS*2120~NM1*Y2*2*NATIONAL ASSOCIATION ON DRUG ABUSE*****XX*1295006526~LE*2120~EB*W*IND*CQ~LS*2120~NM1*Y2*2*COORDINATED BEHAVIORAL CARE INC*****XX*1730451071~LE*2120~SE*42*528771130~GE*1*528771130~IEA*1*528771130~