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271 Response
Eligibility Response Detail
CIN: WP20152H
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:14 PM
Payload ID: d722d5c4-71f7-44d0-b6df-f561320c532d
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ELDERPLAN INC HOMEFIRST PARTIAL LTC
Received: Aug. 13, 2026 3:14 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 *260813*1914*|*00501*648492042*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1914*492042*X*005010X279A1~ST*270*2042*005010X279A1~BHT*0022*13*202608131914000001*20260813*1914~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*202608131914000001*00000000ND~NM1*IL*1******MI*WP20152H~EQ*30~DTP*291*D8*20260814~SE*13*2042~GE*1*492042~IEA*1*648492042~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1514*^*00501*537019830*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*151447*537019830*X*005010X279A1~ST*271*537019830*005010X279A1~BHT*0022*11*202608131914000001*20260813*151447~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*202608131914000001*00000000ND~NM1*IL*1*SANTONIVELAZQUEZ*ANIBAL****MI*WP20152H~N3*1349 GATES AVE 5L~N4*BROOKLYN*NY*11221~DMG*D8*19410629*M~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20251201~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*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*R*IND*30~REF*6P*H3359~LS*2120~NM1*P4*2*HEALTHFIRST MEDICARE PLAN*****PI*H3359~N3*HEALTHFIRST MEDICARE PLAN PO BOX 5165~N4*NEW YORK*NY*10274~PER*IC*PROVIDER SERVICES*TE*8882601010~LE*2120~EB*R*IND*30~REF*18*5RM9P49PV24~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*45*537019830~GE*1*537019830~IEA*1*537019830~