Issue Corrected: 270/271 Eligibility Inquiry Response Transactions, TR 40133

March 31, 2014

Trading Partners submitting a 270 request for a specific services type code rather than the generic services type code ‘30’ will no longer receive confirmation of eligibility for members with unmet spenddown amounts when the eligibility should have been excluded.

Below, is the original message we sent on February 21, 2014, explaining the issue that has now been corrected:

270/271 Eligibility Inquiry/Response Transactions TR 40133

Trading Partners submitting a 270 request for a specific service type code rather than with the generic service type code ‘30’ could have received a confirmation of eligibility for members with unmet spenddown when that eligibility should have been excluded. Omitting the specific service type code will not report this member as eligible. We are working to correct this issue and will notify you once it is resolved. Contact the EDI Helpdesk at (866) 690-5585 (TTY: 711) for questions.