X12 270/271

X12N 270 and 271 Transaction Set pair, HIPAA eligibility verification.

Definition

The 270 (Eligibility/Benefit Inquiry) is sent by a provider to verify a member's coverage; the 271 (Response) returns active status, plans and benefit detail through EB segments. Often exchanged in real time.

Origin

Defined by ASC X12 and published as HIPAA TR3 005010X279 plus addendum A1 (Health Care Eligibility Benefit Inquiry and Response), maintained by X12N.

Example in context

EQ*30~ in the 270 requests general eligibility (Service Type 30); the 271 answers EB*1*IND*30~ (active coverage).

Related terms

• EB (X12) — Eligibility or Benefit Information segment in the 271.
• X12 271 NM1 — member identification segment.