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271 Response
Eligibility Response Detail
CIN: WH67486X
Date of Service: Aug. 13, 2026
Submitted: Aug. 12, 2026 3:54 PM
Payload ID: e2911377-be1c-4f73-a39b-190f9bb62116
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: VILLAGE SENIOR SVC CORP PARTIAL LTC
Received: Aug. 12, 2026 3:54 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| S1 | S1 | S1 | MSG | MSG01 | S1 exemption code found in MSG segment |
| Recertification | RECERT | 2027-01-31 | 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 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260812*1954*|*00501*564476045*1*P*:~GS*HS*00ND*EMEDNYREL*20260812*1954*476045*X*005010X279A1~ST*270*6045*005010X279A1~BHT*0022*13*202608121954000001*20260812*1954~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*202608121954000001*00000000ND~NM1*IL*1******MI*WH67486X~EQ*30~DTP*291*D8*20260813~SE*13*6045~GE*1*476045~IEA*1*564476045~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260812*1554*^*00501*529568030*0*P*|~GS*HB*EMEDNYREL*00ND*20260812*155431*529568030*X*005010X279A1~ST*271*529568030*005010X279A1~BHT*0022*11*202608121954000001*20260812*155431~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*202608121954000001*00000000ND~NM1*IL*1*CUNNINGHAM*MAURICE****MI*WH67486X~N3*841 EAST 14TH STREET 3~N4*BROOKLYN*NY*11230~DMG*D8*19480911*M~DTP*472*D8*20260812~DTP*346*D8*20260801~DTP*102*D8*20260201~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*PD~MSG*S1~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=01~LS*2120~NM1*Y2*2*VILLAGE SENIOR SVC CORP PARTIAL LTC*****PI*VL~N3*112 CHARLES ST FL 2~N4*NEW YORK*NY*100142653~PER*IC*PROVIDER SERVICES*TE*8557692500~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~EB*R*IND*30~REF*6P*H3330~LS*2120~NM1*P4*2*HIP MEDICARE HMO*****PI*H3330~N3*55 WATER STREET 55 WATER STREET~N4*NEW YORK CITY*NY*10041~PER*IC*PROVIDER SERVICES*TE*8004478255~LE*2120~EB*R*IND*30~REF*18*2HG6EJ9AM53~LS*2120~NM1*P4*2*MEDICARE ABD~LE*2120~SE*45*529568030~GE*1*529568030~IEA*1*529568030~