Resolving EDI Errors

Tips for Resolving Errors with 270/271 Eligibility and Benefits Transactions

UnitedHealthcare wants to help partners resolve errors to obtain member eligibility and benefits from their 270/271 Health Care Eligibility and Benefit Inquiry and Response transactions. Its current search logic allows you to enter different criteria related to the member or patient for the eligibility and benefits inquiry transaction (270). If the information given in the request doesn’t match the data in the system, you will receive an AAA code informing you of what information did not match in the eligibility and benefits transaction response (271).

UnitedHealthcare outlined suggestions to resolve errors for the most common reasons they unable to find a match. They recommend researching the information and resubmitting a 270 transaction to help ensure your records are accurate. Verify information is accurate from the member ID card, patient records or contacting the patient/member when receiving the following 271 responses:

  • If you receive: AAA*Y**73*C~AAA*Y**71*C~ (Invalid or missing name and DOB) Then verify name and DOB in your records and include member ID
  • If you receive: AAA*Y**75 (Subscriber/insured not found) Then member has no active coverage or may not be a UnitedHealthcare member
  • If you receive: AAA*Y**71 (Subscriber/insured DOB does not match patient database) Then check formatting of DOB — should be YYMMDD.

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

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