Import › 271 Response

Eligibility Response Detail

CIN: GS95652J
Date of Service: Sept. 14, 2026
Submitted: Sept. 14, 2026 7:19 AM
Payload ID: 9ace6345-831c-4760-a304-19dbce944402
Response Type: X12 271
Response Status: Eligible
Member Found: Yes
Coverage: Sept. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: VNS CHOICE PARTIAL LTC
Received: Sept. 14, 2026 7:19 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 — — —
1 88 — — —
R 30 — — —

Raw 270 Request

ISA*00*          *00*          *ZZ*00ND           *ZZ*EMEDNYREL      *260914*1119*|*00501*384746969*1*P*:~GS*HS*00ND*EMEDNYREL*20260914*1119*746969*X*005010X279A1~ST*270*6969*005010X279A1~BHT*0022*13*202609141119000001*20260914*1119~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*202609141119000001*00000000ND~NM1*IL*1******MI*GS95652J~EQ*30~DTP*291*D8*20260914~SE*13*6969~GE*1*746969~IEA*1*384746969~

Raw 271 Response

ISA*00*          *00*          *ZZ*EMEDNYREL      *ZZ*00ND           *260914*0719*^*00501*244124530*0*P*|~GS*HB*EMEDNYREL*00ND*20260914*071907*244124530*X*005010X279A1~ST*271*244124530*005010X279A1~BHT*0022*11*202609141119000001*20260914*071907~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*202609141119000001*00000000ND~NM1*IL*1*MAIEZZA*LINDA****MI*GS95652J~N3*171 HANSEN AVENUE~N4*PEARL RIVER*NY*10965~DMG*D8*19381216*F~DTP*472*D8*20260914~DTP*346*D8*20260901~DTP*102*D8*20251001~EB*U*IND*30**ELIGIBLE PCP~MSG*CF~MSG*PD~MSG*CNTY CD=39~MSG*RECERT MONTH=10~LS*2120~NM1*Y2*2*VNS CHOICE PARTIAL LTC*****PI*VC~N3*220 E 42ND ST FL 6~N4*NEW YORK*NY*100175831~PER*IC*PROVIDER SERVICES*TE*8667830222~LE*2120~EB*B*IND*30***29*0~EB*1*IND*82~EB*1*IND*88~EB*R*IND*30~REF*18*4Q53TA1TC15~LS*2120~NM1*P4*2*MEDICARE ABDQMB~LE*2120~SE*36*244124530~GE*1*244124530~IEA*1*244124530~