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271 Response
Eligibility Response Detail
CIN: WB80289C
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:20 PM
Payload ID: 6008b46b-4c98-4e5d-a587-b82ea773da75
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 |
|---|---|---|---|---|---|
| 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 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260813*1920*|*00501*648852194*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1920*852194*X*005010X279A1~ST*270*2194*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*WB80289C~EQ*30~DTP*291*D8*20260814~SE*13*2194~GE*1*852194~IEA*1*648852194~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1520*^*00501*540283030*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*152047*540283030*X*005010X279A1~ST*271*540283030*005010X279A1~BHT*0022*11*202608131920000001*20260813*152047~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*MESSINA*BERTHA****MI*WB80289C~N3*1843 78TH STREET~N4*BROOKLYN*NY*11214~DMG*D8*19490721*F~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20260501~EB*U*IND*30**ELIGIBLE PCP~MSG*C2~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*237090614~REF*6P*1025128~LS*2120~NM1*P4*2*EYE MED VISION PLAN*****PI*GL~N3*PO BOX 631563~N4*CINCINNATI*OH*45242~PER*IC*PROVIDER SERVICES*TE*8005213605~LE*2120~EB*R*IND*30~REF*6P*H5522~LS*2120~NM1*P4*2*AETNA MEDICARE*****PI*H5522~N3*PO BOX 7405~N4*LONDON*KY*40742~PER*IC*PROVIDER SERVICES*TE*8887594415~LE*2120~EB*R*IND*30~REF*18*W231898406~REF*6P*061935601000025~LS*2120~NM1*P4*2*AETNA (DENTAL)*****PI*ACD~N3*PO BOX 14094~N4*LEXINGTON*KY*405124094~PER*IC*PROVIDER SERVICES*TE*8772386200~LE*2120~EB*R*IND*30~REF*18*8V73YW2QE99~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*61*540283030~GE*1*540283030~IEA*1*540283030~