EDI 271 Segments and Elements for the Eligibility, Coverage Or Benefit Information Standard


AgencySet IDFGTransaction DescriptionSubcommitteeStandard
ANSI271HBEligibility, Coverage Or Benefit Information InsuranceDownload


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Research and Development:
See the list of EDI 271 segments and elements in below data grid. The Jobisez.com site has an online translation tool that converts the EDI 271 (Eligibility, Coverage Or Benefit Information) document into a CSV file. For more detailed information, you can view a sample EDI 271 document by analyzing a transaction set example. If you are researching the 271s, you can view other trading partner's mapping specifications. You can also gain knowledge by researching all EDI document types. Jobisez LLC can also provide assistance if you need additional help.

Solutions:
Are you looking to trade the EDI 271 transaction with one of your trading partners? Do you need an EDI VAN Savings solution to exchange the 271? Or perhaps you would like to use a Cloud-Based application, so you can plug your 271 transaction directly into your ERP and TMS systems. Even small companies have the ability to trade the EDI 271 by using the EDI Mobile Device solution.


The EDI 271 Segments and Elements

SegmentDescriptionSectReqMax LoopMax UsagePos
BHTBeginning Of Hierarchical TransactionHM011
HLHierarchical LevelDM99999912
TRNTraceDO093
AAARequest ValidationDO094
NM1Individual Or Organizational NameDO99999915
REFReference InformationDO096
N2Additional Name InformationDO017
N3Party LocationDO018
N4Geographic LocationDO019
PERAdministrative Communications ContactDO0310
AAARequest ValidationDO0911
PRVProvider InformationDO0112
DMGDemographic InformationDO0113
INSInsured BenefitDO0114
HIHealth Care Information CodesDO0115
DTPDate Or Time Or PeriodDO0916
LUILanguage UseDO0917
MPIMilitary Personnel InformationDO0918
EBEligibility Or Benefit InformationDO999999119
HSDHealth Care Services DeliveryDO0920
REFReference InformationDO0921
DTPDate Or Time Or PeriodDO02022
AAARequest ValidationDO0923
VEHVehicle InformationDO0124
PIDProduct/Item DescriptionDO0125
PDRProperty Description - RealDO0126
PDPProperty Description - PersonalDO0127
LINItem IdentificationDO0128
EMEquipment CharacteristicsDO0129
SD1Safety DataDO0130
PKDPackaging DescriptionDO0131
MSGMessage TextDO01032
IIIInformationDO999999133
DTPDate Or Time Or PeriodDO0534
AMTMonetary Amount InformationDO0535
PCTPercent AmountsDO0536
LQIndustry Code IdentificationDO999999137
AMTMonetary Amount InformationDO0538
PCTPercent AmountsDO0539
LSLoop HeaderDO0140
NM1Individual Or Organizational NameDO999999141
N2Additional Name InformationDO0142
N3Party LocationDO0143
N4Geographic LocationDO0144
PERAdministrative Communications ContactDO0345
PRVProvider InformationDO0146
LELoop TrailerDO0147


SegmentElementDescriptionReqMin LengthMax LengthType
BHT1Hierarchical Structure CodeM44ID
BHT2Transaction Set Purpose CodeM22ID
BHT3Reference IdentificationO150AN
BHT4DateO88DT
BHT5TimeO48TM
BHT6Transaction Type CodeO22ID
HL1Hierarchical Id NumberM112AN
HL2Hierarchical Parent Id NumberO112AN
HL3Hierarchical Level CodeM12ID
HL4Hierarchical Child CodeO11ID
TRN1Trace Type CodeM12ID
TRN2Reference IdentificationM150AN
TRN3Originating Company IdentifierO1010AN
TRN4Reference IdentificationO150AN
AAA1Yes/No Condition Or Response CodeM11ID
AAA2Agency Qualifier CodeO22ID
AAA3Reject Reason CodeO22ID
AAA4Follow-Up Action CodeO11ID
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
N21NameM160AN
N22NameO160AN
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
AAA1Yes/No Condition Or Response CodeM11ID
AAA2Agency Qualifier CodeO22ID
AAA3Reject Reason CodeO22ID
AAA4Follow-Up Action CodeO11ID
PRV1Provider CodeM13ID
PRV2Reference Identification QualifierC23ID
PRV3Reference IdentificationC150AN
PRV4State Or Province CodeO22ID
PRV5Provider Specialty CodeO13AN
PRV6Agency Qualifier CodeO22ID
PRV7Yes/No Condition Or Response CodeO11ID
PRV8Provider Organization CodeO33ID
DMG1Date Time Period Format QualifierC23ID
DMG2Date Time PeriodC135AN
DMG3Gender CodeO11ID
DMG4Marital Status CodeO11ID
DMG5Race Or Ethnicity CodeC11ID
DMG6Code List Qualifier CodeC13ID
DMG7Industry CodeC130AN
DMG8Citizenship Status CodeO12ID
DMG9Country CodeO23ID
DMG10Basis Of Verification CodeO12ID
DMG11QuantityO115R
DMG12Code List Qualifier CodeC13ID
DMG13Industry CodeC130AN
INS1Yes/No Condition Or Response CodeM11ID
INS2Individual Relationship CodeM22ID
INS3Maintenance Type CodeO33ID
INS4Maintenance Reason CodeO23ID
INS5Benefit Status CodeO11ID
INS6Medicare Plan CodeO11ID
INS7Eligibility Reason CodeO11ID
INS8Eligibility Reason CodeO11ID
INS9Eligibility Reason CodeO11ID
INS10Consolidated Omnibus Budget Reconciliation Act (Cobra) QualifyingO12ID
INS11Employment Status CodeO22ID
INS12Student Status CodeO11ID
INS13Yes/No Condition Or Response CodeO11ID
INS14Date Time Period Format QualifierC23ID
INS15Date Time PeriodC135AN
INS16Confidentiality CodeO11ID
INS17City NameO230AN
INS18State Or Province CodeO22ID
INS19Country CodeO23ID
INS20NumberO19N0
HI1Code List Qualifier CodeM13ID
HI2Industry CodeM130AN
HI3Date Time Period Format QualifierM23ID
HI4Date Time PeriodM135AN
HI5Monetary AmountM118R
HI6QuantityM115R
HI7Version IdentifierM130AN
HI8Industry CodeM130AN
HI9Yes/No Condition Or Response CodeM11ID
HI10Code List Qualifier CodeO13ID
HI11Industry CodeO130AN
HI12Date Time Period Format QualifierO23ID
HI13Date Time PeriodO135AN
HI14Monetary AmountO118R
HI15QuantityO115R
HI16Version IdentifierO130AN
HI17Industry CodeO130AN
HI18Yes/No Condition Or Response CodeO11ID
HI19Code List Qualifier CodeO13ID
HI20Industry CodeO130AN
HI21Date Time Period Format QualifierO23ID
HI22Date Time PeriodO135AN
HI23Monetary AmountO118R
HI24QuantityO115R
HI25Version IdentifierO130AN
HI26Industry CodeO130AN
HI27Yes/No Condition Or Response CodeO11ID
HI28Code List Qualifier CodeO13ID
HI29Industry CodeO130AN
HI30Date Time Period Format QualifierO23ID
HI31Date Time PeriodO135AN
HI32Monetary AmountO118R
HI33QuantityO115R
HI34Version IdentifierO130AN
HI35Industry CodeO130AN
HI36Yes/No Condition Or Response CodeO11ID
HI37Code List Qualifier CodeO13ID
HI38Industry CodeO130AN
HI39Date Time Period Format QualifierO23ID
HI40Date Time PeriodO135AN
HI41Monetary AmountO118R
HI42QuantityO115R
HI43Version IdentifierO130AN
HI44Industry CodeO130AN
HI45Yes/No Condition Or Response CodeO11ID
HI46Code List Qualifier CodeO13ID
HI47Industry CodeO130AN
HI48Date Time Period Format QualifierO23ID
HI49Date Time PeriodO135AN
HI50Monetary AmountO118R
HI51QuantityO115R
HI52Version IdentifierO130AN
HI53Industry CodeO130AN
HI54Yes/No Condition Or Response CodeO11ID
HI55Code List Qualifier CodeO13ID
HI56Industry CodeO130AN
HI57Date Time Period Format QualifierO23ID
HI58Date Time PeriodO135AN
HI59Monetary AmountO118R
HI60QuantityO115R
HI61Version IdentifierO130AN
HI62Industry CodeO130AN
HI63Yes/No Condition Or Response CodeO11ID
HI64Code List Qualifier CodeO13ID
HI65Industry CodeO130AN
HI66Date Time Period Format QualifierO23ID
HI67Date Time PeriodO135AN
HI68Monetary AmountO118R
HI69QuantityO115R
HI70Version IdentifierO130AN
HI71Industry CodeO130AN
HI72Yes/No Condition Or Response CodeO11ID
HI73Code List Qualifier CodeO13ID
HI74Industry CodeO130AN
HI75Date Time Period Format QualifierO23ID
HI76Date Time PeriodO135AN
HI77Monetary AmountO118R
HI78QuantityO115R
HI79Version IdentifierO130AN
HI80Industry CodeO130AN
HI81Yes/No Condition Or Response CodeO11ID
HI82Code List Qualifier CodeO13ID
HI83Industry CodeO130AN
HI84Date Time Period Format QualifierO23ID
HI85Date Time PeriodO135AN
HI86Monetary AmountO118R
HI87QuantityO115R
HI88Version IdentifierO130AN
HI89Industry CodeO130AN
HI90Yes/No Condition Or Response CodeO11ID
HI91Code List Qualifier CodeO13ID
HI92Industry CodeO130AN
HI93Date Time Period Format QualifierO23ID
HI94Date Time PeriodO135AN
HI95Monetary AmountO118R
HI96QuantityO115R
HI97Version IdentifierO130AN
HI98Industry CodeO130AN
HI99Yes/No Condition Or Response CodeO11ID
HI100Code List Qualifier CodeO13ID
HI101Industry CodeO130AN
HI102Date Time Period Format QualifierO23ID
HI103Date Time PeriodO135AN
HI104Monetary AmountO118R
HI105QuantityO115R
HI106Version IdentifierO130AN
HI107Industry CodeO130AN
HI108Yes/No Condition Or Response CodeO11ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
LUI1Identification Code QualifierC12ID
LUI2Identification CodeC280AN
LUI3DescriptionC180AN
LUI4Use Of Language IndicatorO12ID
LUI5Language Proficiency IndicatorO11ID
MPI1Information Status CodeM11ID
MPI2Employment Status CodeM22ID
MPI3Government Service Affiliation CodeM11ID
MPI4DescriptionO180AN
MPI5Military Service Rank CodeO22ID
MPI6Date Time Period Format QualifierC23ID
MPI7Date Time PeriodC135AN
EB1Eligibility Or Benefit Information CodeM12ID
EB2Coverage Level CodeO33ID
EB3Service Type CodeO12ID
EB4Insurance Type CodeO13ID
EB5Plan Coverage DescriptionO150AN
EB6Time Period QualifierO12ID
EB7Monetary AmountO118R
EB8Percentage As DecimalO110R
EB9Quantity QualifierC22ID
EB10QuantityC115R
EB11Yes/No Condition Or Response CodeO11ID
EB12Yes/No Condition Or Response CodeO11ID
EB13Product/Service Id QualifierO22ID
EB14Product/Service IdO148AN
EB15Procedure ModifierO22AN
EB16Procedure ModifierO22AN
EB17Procedure ModifierO22AN
EB18Procedure ModifierO22AN
EB19DescriptionO180AN
EB20Product/Service IdO148AN
EB21Diagnosis Code PointerO12N0
EB22Diagnosis Code PointerO12N0
EB23Diagnosis Code PointerO12N0
EB24Diagnosis Code PointerO12N0
HSD1Quantity QualifierC22ID
HSD2QuantityC115R
HSD3Unit Or Basis For Measurement CodeO22ID
HSD4Sample Selection ModulusO16R6
HSD5Time Period QualifierC12ID
HSD6Number Of PeriodsO13N0
HSD7Ship/Delivery Or Calendar Pattern CodeO12ID
HSD8Ship/Delivery Pattern Time CodeO11ID
REF1Reference Identification QualifierM23ID
REF2Reference IdentificationC150AN
REF3DescriptionC180AN
REF4Reference Identification QualifierO23ID
REF5Reference IdentificationO150AN
REF6Reference Identification QualifierO23ID
REF7Reference IdentificationO150AN
REF8Reference Identification QualifierO23ID
REF9Reference IdentificationO150AN
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
AAA1Yes/No Condition Or Response CodeM11ID
AAA2Agency Qualifier CodeO22ID
AAA3Reject Reason CodeO22ID
AAA4Follow-Up Action CodeO11ID
VEH1Assigned NumberO16N0
VEH2Vehicle Identification NumberO130AN
VEH3YearO44N0
VEH4Agency Qualifier CodeC22ID
VEH5Reference IdentificationC150AN
VEH6Reference IdentificationO150AN
VEH7Reference IdentificationC150AN
VEH8LengthO18R8
VEH9Reference IdentificationO150AN
VEH10State Or Province CodeO22ID
VEH11Location IdentifierO130AN
VEH12Yes/No Condition Or Response CodeO11ID
VEH13AmountO115N2
VEH14Yes/No Condition Or Response CodeO11ID
VEH15AmountO115N2
VEH16Action CodeO12ID
VEH17Country CodeO23ID
VEH18NameC160AN
VEH19Country CodeC23ID
PID1Item Description TypeM11ID
PID2Product/Process Characteristic CodeO23ID
PID3Agency Qualifier CodeC22ID
PID4Product Description CodeC112AN
PID5DescriptionC180AN
PID6Surface/Layer/Position CodeO22ID
PID7Source SubqualifierO115AN
PID8Yes/No Condition Or Response CodeO11ID
PID9Language CodeO23ID
PDR1Type Of Real Estate Asset CodeM22ID
PDR2Code List Qualifier CodeC13ID
PDR3Industry CodeC130AN
PDR4Occupancy CodeO22ID
PDP1Type Of Personal Or Business Asset CodeM22ID
PDP2Commodity Code QualifierC11ID
PDP3Commodity CodeC130AN
LIN1Assigned IdentificationO120AN
LIN2Product/Service Id QualifierM22ID
LIN3Product/Service IdM148AN
LIN4Product/Service Id QualifierC22ID
LIN5Product/Service IdC148AN
LIN6Product/Service Id QualifierC22ID
LIN7Product/Service IdC148AN
LIN8Product/Service Id QualifierC22ID
LIN9Product/Service IdC148AN
LIN10Product/Service Id QualifierC22ID
LIN11Product/Service IdC148AN
LIN12Product/Service Id QualifierC22ID
LIN13Product/Service IdC148AN
LIN14Product/Service Id QualifierC22ID
LIN15Product/Service IdC148AN
LIN16Product/Service Id QualifierC22ID
LIN17Product/Service IdC148AN
LIN18Product/Service Id QualifierC22ID
LIN19Product/Service IdC148AN
LIN20Product/Service Id QualifierC22ID
LIN21Product/Service IdC148AN
LIN22Product/Service Id QualifierC22ID
LIN23Product/Service IdC148AN
LIN24Product/Service Id QualifierC22ID
LIN25Product/Service IdC148AN
LIN26Product/Service Id QualifierC22ID
LIN27Product/Service IdC148AN
LIN28Product/Service Id QualifierC22ID
LIN29Product/Service IdC148AN
LIN30Product/Service Id QualifierC22ID
LIN31Product/Service IdC148AN
EM1Weight Unit CodeC11ID
EM2WeightO110R
EM3Volume Unit QualifierC11ID
EM4VolumeO18R8
EM5Country CodeO23ID
EM6Construction TypeO12ID
EM7DateO88DT
SD11Item Description TypeM11ID
SD12Safety Characteristic/Hazard CodeM33ID
SD13Agency Qualifier CodeC22ID
SD14Source SubqualifierO115AN
SD15Product Description CodeC112AN
SD16DescriptionC180AN
SD17State Or Province CodeO22ID
SD18Country CodeO23ID
PKD1Packaging CodeC35AN
PKD2Source SubqualifierC115AN
PKD3Agency Qualifier CodeO22ID
PKD4Packaging Description CodeO17AN
PKD5Ownership CodeO11ID
MSG1Free-Form Message TextM1264AN
MSG2Printer Carriage Control CodeC22ID
MSG3NumberO19N0
III1Code List Qualifier CodeC13ID
III2Industry CodeC130AN
III3Code CategoryO22ID
III4Free-Form Message TextC1264AN
III5QuantityC115R
III6Unit Or Basis For Measurement CodeO22ID
III7ExponentO115R
III8MultiplierO110R
III9Unit Or Basis For Measurement CodeO22ID
III10ExponentO115R
III11MultiplierO110R
III12Unit Or Basis For Measurement CodeO22ID
III13ExponentO115R
III14MultiplierO110R
III15Unit Or Basis For Measurement CodeO22ID
III16ExponentO115R
III17MultiplierO110R
III18Unit Or Basis For Measurement CodeO22ID
III19ExponentO115R
III20MultiplierO110R
III21Surface/Layer/Position CodeO22ID
III22Surface/Layer/Position CodeO22ID
III23Surface/Layer/Position CodeO22ID
DTP1Date/Time QualifierM33ID
DTP2Date Time Period Format QualifierM23ID
DTP3Date Time PeriodM135AN
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
PCT1Percent QualifierM12ID
PCT2Percentage As DecimalM110R
LQ1Code List Qualifier CodeO13ID
LQ2Industry CodeC130AN
AMT1Amount Qualifier CodeM13ID
AMT2Monetary AmountM118R
AMT3Credit/Debit Flag CodeO11ID
PCT1Percent QualifierM12ID
PCT2Percentage As DecimalM110R
LS1Loop Identifier CodeM14AN
NM11Entity Identifier CodeM23ID
NM12Entity Type QualifierM11ID
NM13Name Last Or Organization NameC160AN
NM14Name FirstO135AN
NM15Name MiddleO125AN
NM16Name PrefixO110AN
NM17Name SuffixO110AN
NM18Identification Code QualifierC12ID
NM19Identification CodeC280AN
NM110Entity Relationship CodeC22ID
NM111Entity Identifier CodeO23ID
NM112Name Last Or Organization NameO160AN
N21NameM160AN
N22NameO160AN
N31Address InformationM155AN
N32Address InformationO155AN
N41City NameO230AN
N42State Or Province CodeC22ID
N43Postal CodeO315ID
N44Country CodeC23ID
N45Location QualifierC12ID
N46Location IdentifierO130AN
N47Country Subdivision CodeC13ID
PER1Contact Function CodeM22ID
PER2NameO160AN
PER3Communication Number QualifierC22ID
PER4Communication NumberC1256AN
PER5Communication Number QualifierC22ID
PER6Communication NumberC1256AN
PER7Communication Number QualifierC22ID
PER8Communication NumberC1256AN
PER9Contact Inquiry ReferenceO120AN
PRV1Provider CodeM13ID
PRV2Reference Identification QualifierC23ID
PRV3Reference IdentificationC150AN
PRV4State Or Province CodeO22ID
PRV5Provider Specialty CodeO13AN
PRV6Agency Qualifier CodeO22ID
PRV7Yes/No Condition Or Response CodeO11ID
PRV8Provider Organization CodeO33ID
LE1Loop Identifier CodeM14AN


Official Definition:
Data contents of the Eligibility, Coverage or Benefit Information Transaction Set (271) for use within the context of an Electronic Data Interchange (EDI) environment. This transaction set can be used to communicate information about or changes to eligibility, coverage or benefits from information sources (such as - insurers, sponsors, payors) to information receivers (such as - physicians, hospitals, repair facilities, third party administrators, governmental agencies). This information includes but is not limited to: benefit status, explanation of benefits, coverages, dependent coverage level, effective dates, amounts for co-insurance, co-pays, deductibles, exclusions and limitations.



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