Frequently Asked Questions (FAQs)

Purpose of the 270/271 Health Care Eligibility Benefit Inquiry and Response

The purpose of generating a 270 Inquiry is to allow providers to determine if, and what, benefits and coverage for a specific period of time. The following information is required to run an eligibility inquiry:

  • Patient’s Medicare Number (Health Insurance Claim Number [HICN] or Medicare Beneficiary Identifier [MBI])
  • Patient's Full First and Last Name
  • Patient’s Date of Birth
  • Date of Service: 12 Months Prior & 4 Months after Today
  • Additional Service & Coverage Types are Available upon Request

The 271 response contains information such as eligibility, eligibility dates, copays, coinsurance, deductibles, out of pocket maximums, visit limits, benefit limits, and more. The 271 document typically includes the followings:

  • Details of the sender of the inquiry (name and contact information of the information receiver)
  • Name of the recipient of the inquiry (the information source)
  • Details of the plan subscriber about to the inquiry is referring
  • Description of eligibility or benefit information requested

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