Member eligibility response (271) changes coming Sept. 1

On Sept. 1, 2026, we’ll update how we generate and return member eligibility responses (271) as part of our Provider Portal’s transition to Epic. The new responses will use Epic’s 271 output, which follows industry standard (X12) formatting.Epic’s 271 output includes more comprehensive benefit information and additional details beyond the specific date of service. As a result, what you’ll see in your system for eligibility and benefits may look different than it does today:

What changes can you expect to see?

Data elementCurrent 271 responseEpic 271 response
Benefits matchingMatched to the provider sending the 270 requestDisplays all benefits (Tier 1, Tier 2 and out of network benefits), regardless of the provider’s tier or network status relative to the member’s plan
Copay / coinsuranceShows $0 amounts for copay and coinsurance when applicableDoes not send “0” values. No benefit displayed = covered at $0. No copay or coinsurance listed = no copay or coinsurance apply.
Benefits by dateShows benefits only for the date eligibility was requestedDisplays all coverage, even benefits that are no longer active (with a flag noting they’re inactive).
The new 271 responses will include information that may not apply to a specific visit or service. When interpreting the data, be sure to focus on the benefit details that match the specific service or setting and review eligibility carefully before estimating a member’s financial responsibility

Where to get more information?

See Epic’s ANSI X12 Outgoing 271 Technical Specifications for more information.