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271 Response
Eligibility Response Detail
CIN: NE61033M
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:23 PM
Payload ID: 2efdc076-e75e-40ab-9505-2b7ae7063c87
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 | 2027-05-31 | 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 | — | — | — |
Raw 270 Request
ISA*00* *00* *ZZ*00ND *ZZ*EMEDNYREL *260813*1923*|*00501*648988987*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1923*988987*X*005010X279A1~ST*270*8987*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*NE61033M~EQ*30~DTP*291*D8*20260814~SE*13*8987~GE*1*988987~IEA*1*648988987~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1523*^*00501*541760530*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*152304*541760530*X*005010X279A1~ST*271*541760530*005010X279A1~BHT*0022*11*202608131923000001*20260813*152304~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*REYES*JORGE****MI*NE61033M~N3*225 EAST 149TH STREET~N4*BRONX*NY*10451~DMG*D8*19390801*M~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20260201~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*C2~MSG*S1~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=05~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*K4011087101~REF*6P*1102367~LS*2120~NM1*P4*2*MONTEFIORE*****PI*MONT~N3*200 CORPORATE DRIVE~N4*YONKERS*NY*107016806~LE*2120~EB*R*IND*30~REF*6P*H3330~LS*2120~NM1*P4*2*HIP MEDICARE HMO*****PI*H3330~N3*55 WATER STREET 55 WATER STREET~N4*NEW YORK CITY*NY*10041~PER*IC*PROVIDER SERVICES*TE*8004478255~LE*2120~EB*R*IND*30~REF*18*5CN1KE4WD91~LS*2120~NM1*P4*2*MEDICARE AB~LE*2120~SE*53*541760530~GE*1*541760530~IEA*1*541760530~