Review the requirements for Availity 270/271 eligibility processing.
The 270/271 Transaction Set is the electronic data interchange (EDI) function that requests eligibility and benefit information from a patient’s insurance company and the response to the inquiry. Effective December 15, 2020, QualChoice eligibility verification is being provided by Availity.
To protect member information, the following elements are now required for all 270 requests:
- Member ID Number
- Member Date of Birth
- Member First Name and Last Name
An eligibility and benefits request should be completed for every patient at every visit to confirm membership, verify coverage and determine other important information such as copay, coinsurance and deductible amounts. Be sure to include all the information specified above for a successful eligibility check.
Learn about Availity portal registration. View or download the Availity Portal Registration Quick Reference Guide. Eligibility inquiries can also be made by signing in to the My Account portal at QualChoice.com or by calling Customer Service at 501.228.7111 or 1.800.235.7111.
