Eligibility Verification (E1) Transaction
Pharmacies use this transaction to determine a client's program-specific eligibility, prescription benefits, and managed care enrollment status when applicable. The following payer sheets are available:
- Eligibility Verification (E1) Transaction Payer Sheet
- Eligibility Request
- Programs: Medicaid, CHIP*, CSHCN, HTW, KHC
- Accepted Response
- Rejected Response
- Eligibility Request
* E1 transactions submitted to HHSC for clients enrolled in CHIP will return a response identifying the name of the client's MCO. Pharmacy providers should contact the client's specific MCO for details.