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EDI Healthcare Interoperability Lab

ANSI X12 270/271 Eligibility Validator

Inspect, validate, and decode raw ANSI X12 271 real-time eligibility responses. Decode EB benefit segments, deductibles, copay amounts, and prevent CO-27 eligibility denials.

ANSI X12 270/271 Real-Time Parser

Select ANSI X12 271 Eligibility Transaction

271_BENEFIT_RESPONSE.X12

ANSI X12 271 Segment Dictionary:

NM1*PR = Payer ID & Name · NM1*IL = Insured Member · DTP*291 = Benefit Effective Date

EB*1 = Active Coverage · EB*6 = Inactive · EB*C = Deductible · EB*B = Copay · EB*A = Coinsurance

Payer Verified Status
Active In-Network Coverage
Payer ID: 60054Aetna Life Insurance Company
Subscriber / Patient:ELEANOR ROOSEVELT (ID: W19482751)
Group Number:GRP883019
Plan Description:Aetna Choice POS II (Open Access)
Coverage Window:2026-01-01

Patient Financial Responsibility Grid

Primary Copay$25.00 (Office Visit)
Deductible Remaining$450.00 remaining
Coinsurance Rate20% after deductible
Remaining Out-of-Pocket Maximum:$2,400.00 remaining

Automate 270/271 Real-Time Eligibility Verification

Eliminate front-end eligibility denials (CO-27, CO-197, CO-4) forever. Aethera automates real-time 270/271 batch verification sweeps 48 hours and 2 hours prior to every patient visit across 10,600+ payers.

Explore Eligibility Services

ANSI X12 270/271 Technical Architecture FAQ

What is an ANSI X12 270/271?

The 270 is an electronic health care eligibility inquiry sent by a provider to a payer. The 271 is the official HIPAA-mandated response returned by the clearinghouse containing active benefit and coverage details.

Decoding the EB (Eligibility Benefit) Segment

The EB segment is the core payload: EB01 defines benefit type (1=Active, B=Copay, C=Deductible, A=Coinsurance, G=OOP Max), EB03 defines service type (30=General Health, 98=Professional, 1=Medical), and EB07 defines dollar amounts.

Preventing Front-End Denials

Over 25% of all medical claim rejections stem from eligibility issues (CARC CO-26, CO-27, CO-31). Performing automated 270/271 checks pre-service guarantees patient identification numbers and active coverage.

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