Introducing Insurance Discovery: Find active coverage with a patient's demographic data

Eligibility checks verify a patient's coverage with a specific payer. But what if you don't know the patient's insurance details or you're not sure whether they have coverage at all? Now, you can run an insurance discovery check to find a patient's active coverage using only their demographic data.

You may need to run an insurance discovery check when a patient provides outdated insurance details, doesn’t have their insurance card, or can’t provide insurance details in an urgent care situation. You may also want to use insurance discovery checks to simplify patient onboarding.  

Here's how insurance discovery checks work:

1. Submit a request to the Insurance Discovery API with as much patient demographic information as possible to increase the chances of finding matching coverage. You'll also include information like the provider's NPI and the date of service, similar to an eligibility check.

2. Stedi uses the demographic information you provide to determine if the patient has active coverage with one or more payers. This process involves submitting real-time eligibility checks to supported payers to find a match. 

3. When the insurance discovery check is complete, Stedi returns an array of potential active coverages along with subscriber details and complete benefits information.

There is no cost for limited insurance discovery checks while the API is in beta. If you are interested in pricing when the product is generally available, please contact us.

Visit our Insurance Discovery docs for complete instructions, example requests and responses, and more.