Import › 271 Response

Eligibility Response Detail

CIN: TY19507D
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:22 PM
Payload ID: 54f2291a-c027-4045-8117-4b17eb5440f6
Response Type: X12 271
Response Status: Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: VILLAGE SENIOR SVC CORP PARTIAL LTC
Received: Aug. 13, 2026 3:22 PM
Parser Version: 1.0

Eligibility Indicators

Type Code Value Segment Element Description
Recertification RECERT 2027-06-30 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*1922*|*00501*648953298*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1922*953298*X*005010X279A1~ST*270*3298*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*TY19507D~EQ*30~DTP*291*D8*20260814~SE*13*3298~GE*1*953298~IEA*1*648953298~

Raw 271 Response

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260813*1522*^*00501*541608130*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*152228*541608130*X*005010X279A1~ST*271*541608130*005010X279A1~BHT*0022*11*202608131922000001*20260813*152228~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*LAGOS*MARLON*A***MI*TY19507D~N3*325      EAST 198TH STREET    C302~N4*BRONX*NY*10458~DMG*D8*19620214*M~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20260801~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*PD~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=06~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*R*IND*30~REF*6P*H5549~LS*2120~NM1*P4*2*VNS CHOICE MEDICARE*****PI*H5549~N3*1250 BROADWAY  3RD FLOOR~N4*NEW YORK*NY*10001~PER*IC*PROVIDER SERVICES*TE*8665976674~LE*2120~EB*R*IND*30~REF*18*8PW9YU7VN36~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*44*541608130~GE*1*541608130~IEA*1*541608130~