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Basic Eligibility
Allows the submission of an eligibility request based on a data set and returns a 271.
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Input Details
Output Details
Payer-Generated 271
Payer AAA Response Codes
Quadax-Generated 271
Error Handling
Input Details
Upon submission of the request model below, basic validation will be done to ensure all required fields are completed. If any of the required fields are omitted, an error will be returned with a list of missing fields.
Attributes
Note:
While most of the fields within the request model are optional due to variations by payer, it is recommended that as much information as possible be sent in the request in order to increase the likelihood of receiving a successful response from the payer. For more information on fields required by payer, see Quadax Eligibility Payers.
If the dependent has his or her own unique member ID, then the dependent should be treated as the subscriber within the request.
Output Details
Attributes
Payer-Generated 271
The expected result for the API response will be an ANSI X12 271 response from the payer. The 271 response will either contain the requested details based on the provided input data, or contain an AAA error response, indicating that the request made it to the payer but the payer is returning an error.
Example Response
ISA*00*XXXXXXXXXX*01*XXXXXXXXXX*ZZ*XXXXXXXXXXXXXXX*ZZ*XXXXXXXXXXXXXXX*181219*0946*^*00501*183357221*0*P*:~GS*HB*MTEXE*XXXXXXXXXX*20181219*0845*183357221*X*005010X279A1~ST*271*183357221*005010X279A1~BHT*0022*11*QDX19034537*20181219*0845~HL*1**20*1~NM1*PR*2*MEDICAL MUTUAL*****PI*MMO~HL*2*1*21*1~NM1*1P*2*ZZZ HEALTHCARE*****XX*1265714091~HL*3*2*22*1~NM1*IL*1*TIGER*JANET*L***MI*456321987~N3*122 ANY RD APT~N4*ANYTOWN*OH*44444~DMG*D8*19460709*F~INS*Y*18*001*25~HL*4*3*23*0~TRN*1*JPVAGUK3RN*9MEDMUTUAL~TRN*2*19034537*9 QUADAX*WARP~TRN*1*183357221*9EMDEON999~NM1*03*1*TIGER*JOHN~REF*6P*228275101*LOCAL 880CLEVELANDPLAN 19~REF*N6*3-01*SUPERMED PLUS~N3*122 ANY RD APT~N4*ANYTOWN*OH*44444~DMG*D8*19590215*M~INS*N*01*001*25~DTP*346*D8*20180201~DTP*356*D8*20180201~EB*1**30**SUPERMED CLASSIC - HOSPITAL ONLY~EB*U**30~LS*2120~NM1*2B*2*UFCW LOCAL 880~PER*IC**TE*8002412828~LE*2120~SE*32*183357221~GE*1*183357221~IEA*1*183357221~
Example AAA Response
ISA*00*XXXXXXXXXX*01*XXXXXXXXXX*ZZ*XXXXXXXXXXXXXXX*ZZ*XXXXXXXXXXXXXXX*181218*1010*^*00501*888216406*0*P*:~GS*HB*MTEXE*XXXXXXXXXX*20181218*0908*888216406*X*005010X279A1~ST*271*888216406*005010X279A1~BHT*0022*11*QDX19014150*20181218*0908~HL*1**20*1~NM1*PR*2*SELECT HEALTH OF SOUTH CAROLINA*****PI*SHSC~PER*IC*PROVIDER SERVICES*TE*8007416605~HL*2*1*21*1~NM1*1P*2*ZZZ HEALTHCARE*****XX*1215003603~HL*3*2*22*0~TRN*2*19014150*9 QUADAX~TRN*1*888216406*9EMDEON999~TRN*2*19014150*9 QUADAX~NM1*IL*1******MI*236598574~AAA*Y**75*C~DTP*291*RD8*20181201-20181218~SE*15*888216406~GE*1*888216406~IEA*1*888216406~
AAA Payer Response Codes
Quadax-Generated 271
The Quadax-generated 271 files look like 271 files returned from the payer, but they are generated by Quadax when an error occurs during processing before the request makes it to the payer. The Quadax-generated 271 will also have an AAA response code and will include a message describing the error that occurred, as well as “Quadax Message: Request was not sent to the payer.” This makes it clear that the 271 AAA error is from Quadax and not from the payer.
Error Handling
