MedCost Benefit Services’ e-verification process uses Eligibility and Benefit Inquiry (270) and Eligibility and Benefit Response (271) transactions for health care eligibility and benefits inquiries and responses associated with a member. Historically, MedCost has returned a group number on these e-verifications that includes a suffix. Due to recent enhancements requiring a correct employer group number to be filed on provider claims, we are simplifying the data providers receive through the e-verification process.
Beginning June 1, 2021, the data verified through your 270/271 with MedCost Benefit Services will return the member’s group number without a suffix included. Since the group number is printed on the member’s benefit ID card, this change will align better with the verification process. Member-level benefits and eligibility information will continue to be verified through our secure provider portal just as is it is today.
Please ensure that the member’s group number is included on any claim submitted to MedCost. In addition, the member ID number from either the member’s ID card or the 271 response is necessary to ensure the claim can be validated, accepted, and processed. This will aid the efficiency of claims processing and result in quicker turnaround times.
You can setup the transaction through your EDI clearinghouse.
If you have any further questions, please contact MedCost Customer Service at 1-800-795-1023 or via MedCost Webchat.