What are 270 and 271 in the eligibility workflow?

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Multiple Choice

What are 270 and 271 in the eligibility workflow?

HIPAA electronic checks of a member’s eligibility before services. A request is sent to the payer asking if the patient is eligible on a specific date and what benefits apply. The payer returns a response that includes coverage status, plan details, benefits, and patient responsibility such as copay, coinsurance, deductible, and any preauthorization requirements. This exchange helps verify coverage before services and guides whether the service is covered and what the patient will owe, reducing the risk of claim issues. It’s not about claim status or remittance advice, which are separate transactions.

HIPAA electronic checks of a member’s eligibility before services. A request is sent to the payer asking if the patient is eligible on a specific date and what benefits apply. The payer returns a response that includes coverage status, plan details, benefits, and patient responsibility such as copay, coinsurance, deductible, and any preauthorization requirements. This exchange helps verify coverage before services and guides whether the service is covered and what the patient will owe, reducing the risk of claim issues. It’s not about claim status or remittance advice, which are separate transactions.

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