Aetna SSI 270 271

Aetna SSI 270 271 Companion Guide Information

Aetna SSI (Senior Supplemental Insurance) is a division of Aetna that providers medical insurance to seniors. The Eligibility Enquiry 270 and the 271-eligibility response are a key component of their business process. These transactions allow members to receive co-pay, deductible and other important information about their plan when they visit the doctor.

Aetna SSI uses the standard HIPAA V5010X279A1 transaction. However, there are interesting business rules about Aetna SSI.

  • One fun fact is that they do not use the dependent loop. The subscriber is always the patient.
  • Aetna SSI uses Emdeon as their clearing house.
  • Payer ID is AESSI and this value will be populated in the NM109 element of the 2100A loop.
  • Aetna SSI owns and administers multiple Medicare supplement companies (e.g. Aetna Life Insurance and Washington National Insurance Company).
  • Tech such as SOAP, MIME/Multipart, and WSDL is used to exchange these transactions in real-time and comply with core operating rules.
  • If the trading partner (e.g. provider) does not submit a date of service, the current system date will be used as a date of service. If the trading partner submits a date range then only the first date will be used. (e.g. DTP*291*20190603-20190604) to determine member eligibility.
  • A 999 Acknowledgment will only be sent if there are failures in the 270.
  • The EQ01 data element has medical service type codes and Aetna SSI supports all CORE mandated codes.

Here we have simply provided some interesting facts about Aetna SSI’s 270_271 transactions. To view the full companion guide please visit this link:

Some day in the future the new version of the 270_271 transaction sets will be mandated. When that day comes we will have to start migrating from V5010X279 to 007030X347. EDI Academy will have gap analysis classes when this mandate is set.

To learn more about EDI and become a certified  EDI Professional please visit our course schedule page.

Leave a Reply

Your email address will not be published.

Post Navigation