Import ›
271 Response
Eligibility Response Detail
CIN: WQ88191A
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:13 PM
Payload ID: 60916aca-b00d-40b1-95b6-216f4255cd79
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ELDERPLAN INC MAP
Received: Aug. 13, 2026 3:13 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| 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 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260813*1913*|*00501*648436008*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1913*436008*X*005010X279A1~ST*270*6008*005010X279A1~BHT*0022*13*202608131913000001*20260813*1913~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*202608131913000001*00000000ND~NM1*IL*1******MI*WQ88191A~EQ*30~DTP*291*D8*20260814~SE*13*6008~GE*1*436008~IEA*1*648436008~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1513*^*00501*536786030*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*151351*536786030*X*005010X279A1~ST*271*536786030*005010X279A1~BHT*0022*11*202608131913000001*20260813*151351~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*202608131913000001*00000000ND~NM1*IL*1*GEORGE*ALEXIS*S***MI*WQ88191A~N3*9708 BOSTON RD 2J~N4*BRONX*NY*10456~DMG*D8*19510303*F~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20260201~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=01~LS*2120~NM1*Y2*2*ELDERPLAN INC MAP*****PI*YL~N3*55 WATER ST FL 46~N4*NEW YORK*NY*100413211~PER*IC*PROVIDER SERVICES*TE*8778916447~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*R*IND*30~REF*6P*H3347~LS*2120~NM1*P4*2*ELDERPLAN*****PI*H3347~N3*ELDERPLAN INC 745 64TH STREET~N4*BROOKLYN*NY*11220~PER*IC*PROVIDER SERVICES*TE*8003533765~LE*2120~EB*R*IND*30~REF*18*8Y08TC3UK37~LS*2120~NM1*P4*2*MEDICARE ABD~LE*2120~SE*42*536786030~GE*1*536786030~IEA*1*536786030~