Eligibility Response Detail

CIN: AB12345C

Date of Service: Aug. 14, 2026

Submitted: Aug. 13, 2026 3:26 PM

Payload ID: afab45c4-0fa9-481c-8ef3-1467d48f5a58

Response Type: X12 271

Response Status: Rejected

Member Found: Yes

Coverage: — — —

Plan: —

MCO: —

Received: Aug. 13, 2026 3:26 PM

Parser Version: 1.0

Raw 270 Request

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260813*1926*|*00501*649189963*1*P*:~GS*HS*00ND*EMEDNYREL*20260813*1926*189963*X*005010X279A1~ST*270*9963*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*AB12345C~EQ*30~DTP*291*D8*20260814~SE*13*9963~GE*1*189963~IEA*1*649189963~

Raw 271 Response

Full screen

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260813*1526*^*00501*542599830*0*P*|~GS*HB*EMEDNYREL*00ND*20260813*152625*542599830*X*005010X279A1~ST*271*542599830*005010X279A1~BHT*0022*11*202608131926000001*20260813*152625~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******MI*AB12345C~AAA*N**72*C~DTP*472*D8*20260813~SE*13*542599830~GE*1*542599830~IEA*1*542599830~