What a 271 response is

An X12 271 is a response transaction that reports the result of a health care eligibility and benefit inquiry. It answers a preceding 270 request defined by the 005010 X279 product.

The terms in the name

X12 is the standards organization and data format family used for structured business transactions. A transaction is a message with a defined purpose. In this guide, a response is the message returned after a sender’s inquiry reaches the responding organization.

A payer is the organization that administers or pays for coverage. A clearinghouse is an intermediary that can transport, validate, translate, or route transactions between a sender and a payer. A payer’s companion guide is its local trading-partner documentation. An implementation guide is the licensed standard that defines the transaction’s full requirements. A public example or cross-reference, such as X12’s 005010 X279 examples, helps explain the format. The implementation guide contains the complete requirements.

What a 271 can communicate

A 271 can contain eligibility and benefit information, such as an active coverage statement, a service type, or a qualified amount. It can also contain request-level error information. X12’s RFI 2821 interpretation explains when a response reports benefit information and when it reports a validation problem with AAA.

An EB segment reports a qualified statement. Its meaning depends on the person, service, coverage, and time information around it, so read it with the surrounding hierarchy and related segments.

Outcomes outside the 271

Transport failures, a TA1 interchange acknowledgment, and a 999 functional acknowledgment are separate outcomes. They describe delivery or structural processing. A 271 carries the eligibility and benefit response. A payer or clearinghouse can also apply route-specific rules documented in its companion guide.

X279A1 defines the complete transaction. Payer and clearinghouse documents add instructions for a named connection.