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271 Response
Eligibility Response Detail
CIN: RZ38607B
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:23 PM
Payload ID: 317e1325-2f6a-4f27-9c66-11acdd6d50f8
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 3:23 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 | 2026-09-30 | 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 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260813*1923*|*00501*648986332*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1923*986332*X*005010X279A1~ST*270*6332*005010X279A1~BHT*0022*13*202608131923000001*20260813*1923~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*202608131923000001*00000000ND~NM1*IL*1******MI*RZ38607B~EQ*30~DTP*291*D8*20260814~SE*13*6332~GE*1*986332~IEA*1*648986332~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1523*^*00501*541746630*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*152301*541746630*X*005010X279A1~ST*271*541746630*005010X279A1~BHT*0022*11*202608131923000001*20260813*152301~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*202608131923000001*00000000ND~NM1*IL*1*RAO*NICHOLAS****MI*RZ38607B~N3*1740 84TH STREET~N4*BKLYN*NY*11214~DMG*D8*19380725*M~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20260301~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*NH~MSG*S1~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=09~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*18*3A42QN5YA22~LS*2120~NM1*P4*2*MEDICARE ABD~LE*2120~SE*37*541746630~GE*1*541746630~IEA*1*541746630~