Import › 271 Response

Eligibility Response Detail

CIN: KN48434P
Date of Service: Sept. 14, 2026
Submitted: Sept. 14, 2026 7:18 AM
Payload ID: cbb9daee-920a-48f0-a6ef-3c79d78c023a
Response Type: X12 271
Response Status: Eligible
Member Found: Yes
Coverage: Sept. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: NORTH SHORE UNIVERSITY HOSPITAL
Received: Sept. 14, 2026 7:18 AM
Parser Version: 1.0

Eligibility Indicators

Type Code Value Segment Element Description
Recertification RECERT 2026-10-31 MSG Recertification required by this date

Benefit Records (EB)

EB01 Service Type Description Amount Period Message
U 30 ELIGIBLE PCP — —
B 30 — — —
1 82 — — —
W CQ — — —
W CQ — — —
R 30 — — —
R 30 — — —

Raw 270 Request

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260914*1118*|*00501*384705929*1*P*:~GS*HS*00ND*EMEDNYREL*20260914*1118*705929*X*005010X279A1~ST*270*5929*005010X279A1~BHT*0022*13*202609141118000001*20260914*1118~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*202609141118000001*00000000ND~NM1*IL*1******MI*KN48434P~EQ*30~DTP*291*D8*20260914~SE*13*5929~GE*1*705929~IEA*1*384705929~

Raw 271 Response

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260914*0718*^*00501*244069330*0*P*|~GS*HB*EMEDNYREL*00ND*20260914*071826*244069330*X*005010X279A1~ST*271*244069330*005010X279A1~BHT*0022*11*202609141118000001*20260914*071826~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*202609141118000001*00000000ND~NM1*IL*1*RUIZ*INES****MI*KN48434P~N3*37-21    80TH STREET          1D~N4*JACKSON HEIGHTS*NY*11372~DMG*D8*19460515*F~DTP*472*D8*20260914~DTP*346*D8*20260901~DTP*102*D8*20260601~EB*U*IND*30**ELIGIBLE PCP~MSG*A1~MSG*A2~MSG*H9~MSG*CNTY CD=66 5H9~MSG*RECERT MONTH=10~LS*2120~NM1*Y2*2*HEALTHFIRST HEALTH PLAN, INC*****PI*MH~N3*100 CHURCH ST FL 18~N4*NEW YORK*NY*100072601~PER*IC*PROVIDER SERVICES*TE*8888011660~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*W*IND*CQ~LS*2120~NM1*Y2*2*NORTH SHORE UNIVERSITY HOSPITAL*****XX*1932472107~LE*2120~EB*W*IND*CQ~LS*2120~NM1*Y2*2*NORTH SHORE UNIVERSITY HOSPITAL*****XX*1932472107~LE*2120~EB*R*IND*30~REF*6P*H3359~LS*2120~NM1*P4*2*HEALTHFIRST MEDICARE PLAN*****PI*H3359~N3*HEALTHFIRST MEDICARE PLAN  PO BOX 5165~N4*NEW YORK*NY*10274~PER*IC*PROVIDER SERVICES*TE*8882601010~LE*2120~EB*R*IND*30~REF*18*3M59AU0AQ16~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*52*244069330~GE*1*244069330~IEA*1*244069330~