Beginning May 7, 2026, providers can verify eligibility of ConnectiCare Marketplace and Medicare members in real time via the Availity Essential provider portal.
What’s new
We have launched a new real-time eligibility verification connection using the X12 270/271 transaction standard.
- Your practice management system submits an eligibility inquiry (270) with patient demographics and payer information.
- Our clearinghouse routes that request to us in real time and returns the eligibility response (271).
- Coverage details returned include active status, plan type, deductibles, copays, and benefit information.
What this means for you
Eligibility verification is one of the most time-sensitive steps in the revenue cycle. Our new connection makes that process faster and more reliable by enabling real-time 270/271 exchanges.
Member ID is now required
A Member ID is required to perform all eligibility searches through this connection. Submissions that do not include a member ID will not be processed. Please ensure that you have this information when submitting eligibility inquiries.
