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271 Response
Eligibility Response Detail
CIN: TG37452K
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:22 PM
Payload ID: 9922f2f7-579e-455a-8c42-b136d39beae1
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: COMMUNITY CARE MANAGEMENT PARTNERS
Received: Aug. 13, 2026 3:22 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 | — | — | — | |
| W | CQ | — | — | — | |
| W | CQ | — | — | — | |
| R | 30 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260813*1922*|*00501*648941287*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1922*941287*X*005010X279A1~ST*270*1287*005010X279A1~BHT*0022*13*202608131922000001*20260813*1922~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*202608131922000001*00000000ND~NM1*IL*1******MI*TG37452K~EQ*30~DTP*291*D8*20260814~SE*13*1287~GE*1*941287~IEA*1*648941287~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1522*^*00501*541559930*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*152216*541559930*X*005010X279A1~ST*271*541559930*005010X279A1~BHT*0022*11*202608131922000001*20260813*152216~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*202608131922000001*00000000ND~NM1*IL*1*GUILLEN*CARLITA****MI*TG37452K~N3*42-42 80TH ST 6E~N4*ELMHURST*NY*11373~DMG*D8*19361010*F~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20260401~EB*U*IND*30**ELIGIBLE PCP~MSG*A1~MSG*A2~MSG*CF~MSG*PD~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=02~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*W*IND*CQ~LS*2120~NM1*Y2*2*DIRECT CARE MANAGEMENT LLC*****XX*1427718972~LE*2120~EB*W*IND*CQ~LS*2120~NM1*Y2*2*COMMUNITY CARE MANAGEMENT PARTNERS*****XX*1366780850~LE*2120~EB*R*IND*30~REF*18*1GW2U45VP87~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*46*541559930~GE*1*541559930~IEA*1*541559930~