270/271 Eligibility Verification Change

June 18, 2020
270/271 Eligibility Verification Change

Beginning in July, 270/271 eligibility verification for QualChoice members will be provided by Availity.

The 270/271 Transaction Set is the electronic data interchange (EDI) function that requests eligibility and benefit information from a patient’s insurance company and the response to the inquiry. Effective starting in July, Optum™ Intelligent EDI Eligibility will no longer provide QualChoice eligibility verification.

Enrollment information for Availity 270/271 eligibility request and response will be available soon on the Electronic Transactions page at QualChoice.com.

An eligibility and benefits request should be completed for every patient at every visit to confirm membership, verify coverage and determine other important information such as co-pay, coinsurance and deductible amounts.

Eligibility inquiries can also be made by signing in to the My Account portal at QualChoice.com or by calling Customer Service at 501.228.7111 or 1.800.235.7111.