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Spotlight PEPPOL BIS Billing 3.0 The EU e-invoicing mandate is here — France Sept 2026, Belgium Jan 2026, Germany 2025.

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Foundations

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Standards

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Flagship messages

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Tools

X12 271 — Eligibility, Coverage or Benefit Information

Payer response to a 270 eligibility request: contract status, active coverages, patient responsibility, and any matching errors.

Purpose

The 271 carries the coverage information returned by the payer: plan type (HMO, PPO, HDHP), eligibility periods, covered services, deductible met, out-of-pocket maximum, copays… It can also report a matching error (member not found, mismatched date of birth, terminated plan…) via the AAA segment.

Envelope and structure

The 271 uses the same TR3 as the 270 (005010X279A1) and the same four-level hierarchical structure. The functional group identifier switches from HS (Eligibility Source) to HB (Eligibility Benefit Information). A positive response with deductible and copay:

x12 minimal-271.x12 
ISA*00*          *00*          *ZZ*PAYER99        *ZZ*PROVIDER01     *260513*0816*U*00501*000000271*0*P*>~
GS*HB*PAYER99*PROVIDER01*20260513*0816*1*X*005010X279A1~
ST*271*0001*005010X279A1~
BHT*0022*11*REQ-0001*20260513*0816~
HL*1**20*1~
NM1*PR*2*PAYER99*****PI*PAYER99~
HL*2*1*21*1~
NM1*1P*2*ACME CLINIC*****XX*1234567890~
HL*3*2*22*0~
TRN*2*TRACE-0001*9PROVIDER01~
NM1*IL*1*DOE*JANE****MI*MEMBER12345~
DMG*D8*19850412*F~
DTP*346*D8*20260101~
EB*1*IND*30**HMO GOLD~
EB*C*FAM*30**HMO GOLD*23*1500.00***Y~
EB*B*IND*98*HMO GOLD****25.00~
SE*15*0001~
GE*1*1~
IEA*1*000000271~

Common segments (concept)

  • Header — BHT with a purpose code 11 (response), followed by the same HL loops 2000A/B/C/D as the 270. TRN Trace Number ties the response back to the original request.
  • Detail — the heart of the 271 is the repeating EB Eligibility or Benefit Information segment. Each EB carries: the eligibility code (1 Active, 6 Inactive, V Cannot Process…), the coverage level (IND, FAM, SPC), the service type, the plan name, the kind of monetary amount (deductible, copay, coinsurance), and the value. Companion segments DTP (eligibility dates), MSG (free-text payer message), and AAA Request Validation (error cases) round out the answer.
  • Summary — a single SE.

When you'll see it

The 271 is consumed in real time by PMS (Practice Management Systems) and EHR systems to surface a patient's coverage to the front-desk before the appointment. Typical integrations: Epic Tapestry, Cerner Revenue Cycle, athenaCollector, NextGen Healthcare, eClinicalWorks. Clearinghouses (Availity, Change Healthcare, Waystar) often normalise 271s into JSON / FHIR CoverageEligibilityResponse before delivering them upstream.

Documentation