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271 Response
Eligibility Response Detail
CIN: RJ44875S
Date of Service: Aug. 14, 2026
Submitted: Aug. 13, 2026 3:26 PM
Payload ID: fe91c5db-2d49-4514-b41f-a4707030100f
Response Type: X12 271
Response Status:
Eligible
Member Found: Yes
Coverage: Aug. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: ELDERPLAN INC HOMEFIRST PARTIAL LTC
Received: Aug. 13, 2026 3:26 PM
Parser Version: 1.0
Eligibility Indicators
| Type | Code | Value | Segment | Element | Description |
|---|---|---|---|---|---|
| Recertification | RECERT | 2026-11-30 | 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*1926*|*00501*649178953*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1926*178953*X*005010X279A1~ST*270*8953*005010X279A1~BHT*0022*13*202608131926000001*20260813*1926~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*202608131926000001*00000000ND~NM1*IL*1******MI*RJ44875S~EQ*30~DTP*291*D8*20260814~SE*13*8953~GE*1*178953~IEA*1*649178953~
Raw 271 Response
ISA*00* *00* *ZZ*EMEDNYREL *ZZ*00ND *260813*1526*^*00501*542554730*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*152614*542554730*X*005010X279A1~ST*271*542554730*005010X279A1~BHT*0022*11*202608131926000001*20260813*152614~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*202608131926000001*00000000ND~NM1*IL*1*VALENTINPENA*JUVENAL****MI*RJ44875S~N3*545 WEST 125TH STREET 10~N4*NEW YORK*NY*10027~DMG*D8*19550907*M~DTP*472*D8*20260813~DTP*346*D8*20260801~DTP*102*D8*20260801~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=11~LS*2120~NM1*Y2*2*ELDERPLAN INC HOMEFIRST PARTIAL LTC*****PI*ED~N3*55 WATER ST FL 46~N4*NEW YORK*NY*100413211~PER*IC*PROVIDER SERVICES*TE*8777711119~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*1V09HC5FY20~LS*2120~NM1*P4*2*MEDICARE ABD~LE*2120~SE*43*542554730~GE*1*542554730~IEA*1*542554730~