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