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271 Response
Eligibility Response Detail
CIN: VG80230K
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:20 PM
Payload ID: 1c487945-4b05-433b-9b3b-f7f0bf29e46e
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: SENIOR WHOLE HEALTH OF NY PARTIAL
Received: Aug. 13, 2026 3:20 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 | 2027-02-28 | 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 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260813*1920*|*00501*648829184*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1920*829184*X*005010X279A1~ST*270*9184*005010X279A1~BHT*0022*13*202608131920000001*20260813*1920~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*202608131920000001*00000000ND~NM1*IL*1******MI*VG80230K~EQ*30~DTP*291*D8*20260814~SE*13*9184~GE*1*829184~IEA*1*648829184~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1520*^*00501*538788130*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*152024*538788130*X*005010X279A1~ST*271*538788130*005010X279A1~BHT*0022*11*202608131920000001*20260813*152024~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*202608131920000001*00000000ND~NM1*IL*1*FINKEL*ALLA****MI*VG80230K~N3*711A SEAGRIT AVE 5K~N4*FAR ROCKAWAY*NY*11691~DMG*D8*19461101*F~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20251001~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*PD~MSG*S1~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=02~LS*2120~NM1*Y2*2*SENIOR WHOLE HEALTH OF NY PARTIAL*****PI*SW~N3*15 METROTECH CTR FL~N4*BROOKLYN*NY*112013826~PER*IC*PROVIDER SERVICES*TE*8773530185~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~EB*R*IND*30~REF*18*2V36FM5RY61~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*37*538788130~GE*1*538788130~IEA*1*538788130~