How to evaluate Stedi for eligibility checks

Most eligibility checks are real-time and happen in front of patients.

If you’re building a tool that runs eligibility checks and something goes wrong, your users feel it immediately.

It's one reason why switching healthcare clearinghouses isn't something most teams do casually. It's also why Stedi designed our Eligibility Check APIs to make switching as easy and painless as possible.

You can try Stedi's eligibility checks in production for free. Start with just a few payers, get comfortable, and expand at your own pace.

Why switch to Stedi

Most healthcare clearinghouses were built before REST APIs or the Internet even existed. They were designed for batch processing and manual workflows, not automation at today’s scale.

Stedi is the modern healthcare clearinghouse. We offer:

• An API-first developer experience
  Stedi’s Real-Time Eligibility Check APIs are fast, JSON-native, and well-documented. If you’re building an AI agent, you can connect with them using the Stedi MCP server or use our OpenAPI spec to build integrations quickly. Many teams integrate in less than a day.
  
  If you already use X12, we also offer X12 and SOAP API endpoints.
  
  

• Lossless eligibility responses
  Some healthcare clearinghouses drop or truncate data in payer responses. Stedi doesn’t. We send you everything the payer sends back.
  
  

• The broadest payer coverage
  Stedi connects to virtually every payer who processes electronic transactions – 1,250+ for eligibility checks, including Medicare and all state Medicaid programs. You can see the payers we support using the Stedi Payer Network site or our Payers API.
  
  

• Cloud-based scalability
  Stedi is built on AWS’s cloud-based infrastructure and scales to any workload.
  
  

• Real-time support
  Every Stedi customer gets a dedicated Slack or Microsoft Teams channel. Our average response time is less than 10 minutes. We don’t use bots or auto-replies to deflect customer requests.

How to start an evaluation

1. Create a Stedi account.
   You can sign up for our Basic plan for free in under two minutes. No credit card is required.
   
   

2. Request a free trial.
   After you create an account, our team will get in touch. When they do, ask for a free trial to evaluate Stedi. You can also reach out using our contact form.
   
   

3. Run Stedi alongside your current clearinghouse.
   Start by routing eligibility checks for your top 10-20 payers by volume to Stedi while keeping the rest on your current clearinghouse.

   You can set up the routing so that if a Stedi eligibility request fails, the fallback logic sends it to your current clearinghouse automatically. This limits risk while you build confidence.

   And you can use your existing payer IDs with Stedi. We support payer ID aliases from other clearinghouses. No mapping is required.

   Here's what the routing logic looks like:

   // Start with your top 10-20 payers by volume.
   // Use your existing payer IDs.
   const STEDI_PAYER_LIST = [
     "87726",    // UnitedHealthcare
     "60054",    // Aetna
     "CMS",      // Medicare (CMS)
     ...
   ];
   
   function checkEligibility(request):
     if request.payerId in STEDI_PAYER_LIST:
       response = stedi.checkEligibility(request)
   
       if response.status == "success":
         return response
       else:
         // Fallback to existing clearinghouse on failure
         return existingClearinghouse.checkEligibility(request)
     else:
       return existingClearinghouse.checkEligibility(request)

   // Start with your top 10-20 payers by volume.
   // Use your existing payer IDs.
   const STEDI_PAYER_LIST = [
     "87726",    // UnitedHealthcare
     "60054",    // Aetna
     "CMS",      // Medicare (CMS)
     ...
   ];
   
   function checkEligibility(request):
     if request.payerId in STEDI_PAYER_LIST:
       response = stedi.checkEligibility(request)
   
       if response.status == "success":
         return response
       else:
         // Fallback to existing clearinghouse on failure
         return existingClearinghouse.checkEligibility(request)
     else:
       return existingClearinghouse.checkEligibility(request)

   // Start with your top 10-20 payers by volume.
   // Use your existing payer IDs.
   const STEDI_PAYER_LIST = [
     "87726",    // UnitedHealthcare
     "60054",    // Aetna
     "CMS",      // Medicare (CMS)
     ...
   ];
   
   function checkEligibility(request):
     if request.payerId in STEDI_PAYER_LIST:
       response = stedi.checkEligibility(request)
   
       if response.status == "success":
         return response
       else:
         // Fallback to existing clearinghouse on failure
         return existingClearinghouse.checkEligibility(request)
     else:
       return existingClearinghouse.checkEligibility(request)

   // Start with your top 10-20 payers by volume.
   // Use your existing payer IDs.
   const STEDI_PAYER_LIST = [
     "87726",    // UnitedHealthcare
     "60054",    // Aetna
     "CMS",      // Medicare (CMS)
     ...
   ];
   
   function checkEligibility(request):
     if request.payerId in STEDI_PAYER_LIST:
       response = stedi.checkEligibility(request)
   
       if response.status == "success":
         return response
       else:
         // Fallback to existing clearinghouse on failure
         return existingClearinghouse.checkEligibility(request)
     else:
       return existingClearinghouse.checkEligibility(request)

   // Start with your top 10-20 payers by volume.
   // Use your existing payer IDs.
   const STEDI_PAYER_LIST = [
     "87726",    // UnitedHealthcare
     "60054",    // Aetna
     "CMS",      // Medicare (CMS)
     ...
   ];
   
   function checkEligibility(request):
     if request.payerId in STEDI_PAYER_LIST:
       response = stedi.checkEligibility(request)
   
       if response.status == "success":
         return response
       else:
         // Fallback to existing clearinghouse on failure
         return existingClearinghouse.checkEligibility(request)
     else:
       return existingClearinghouse.checkEligibility(request)

What to look for during your trial

Once you're routing eligibility checks through Stedi, compare our responses to those from your current clearinghouse. If your current clearinghouse is truncating or dropping data, you'll see it.

How to compare eligibility responses

All clearinghouses exchange eligibility checks with payers using X12 EDI – it's required by HIPAA. If you're already using X12, this makes it easy to compare Stedi's eligibility responses to those from your current clearinghouse one-to-one.

If you'd rather not deal with X12, you can use our JSON API responses – they contain the same data. You'll just need to map the response shapes between clearinghouses.

To map the JSON shapes, you can feed our OpenAPI spec to a coding agent like Claude Code or Codex and have them do the translation for you.

Migrate at your own pace

When you’re ready to move fully to Stedi, continue routing more payers until all your traffic is moved over. Then, you can remove the above routing logic – and your old clearinghouse – entirely.

FAQ

Do I need to complete transaction enrollment for eligibility checks?

Not usually. Most payers don't require transaction enrollment for eligibility checks. A notable exception is CMS, the government payer used for Medicare eligibility checks.

To check enrollment requirements, use the Stedi Payer Network or Payers API. If enrollment is required, use Stedi’s Transaction Enrollment API or the Stedi portal to track and manage enrollment requests. We handle the enrollment paperwork for you wherever possible.

How long does it take to integrate with Stedi for eligibility checks?

Most teams integrate in a day or less. The evaluation period – testing payer coverage, enrolling providers where needed, and building confidence – is what takes longer.

Do I need to move my ERA transaction enrollments to switch my eligibility checks to Stedi?

No. You can run eligibility checks with Stedi independently of enrollments for ERAs (Electronic Remittance Advice) or other transactions.

Can I test without real patient data?

Yes. All Stedi plans include a test mode with predefined mock eligibility checks and realistic responses. But mock checks won’t reveal whether your current clearinghouse drops or truncates data. For a real comparison, request a free production trial.

What if Stedi doesn't cover all my payers?

Stedi connects to 1,250+ payers for eligibility checks – virtually every payer who supports electronic transactions, including Medicare and all state Medicaid payers.

If there's a specific payer giving you trouble or that you’re concerned about, reach out.

Do I need to update my payer IDs to switch to Stedi?

No. Stedi accepts payer IDs from other clearinghouses. Your existing payer IDs will work as is. See our Payer ID aliases docs.