Real-time eligibility checks

Verify patient benefits in seconds across thousands of payers

Active Coverage

Jane S Doe

Complete Care Management

Services

Hospital

Eye

Orthopedic

54 more

Deductibles

Limitations

Jane S Doe

Complete Care Management

Services

Hospital

Eye

Orthopedic

54 more

Deductibles

Limitations

Quickly determine coverage

Get into production quickly with hands-on engineering support, a dedicated Slack channel, and clear documentation.

Estimate patient responsibility

Create cost estimates for patient care, including co-pays and co-insurance.

Eliminate manual tasks

Replace web scraping and phone-call based workflows with a simple to use API that covers thousands of payers.

Keep patients informed

Communicate patients’ day-of-appointment responsibilities and maintain compliance with the No Surprises Act.

How it works

Integrate with a modern, developer-friendly API

Submit

Route

Deliver

Submit a JSON request

Submit a JSON request to Stedi’s Eligibility Check API with provider and patient details.

checkEligibility.js

fetch(
  "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3",
  {
    controlNumber: "123456789",
    tradingPartnerServiceId: "CIGNA",
    provider: { organizationName: "Doctors LLC", npi: "7921017274" },
    subscriber: {
      firstName: "John",
      lastName: "Doe",
      dateOfBirth: "19870521",
      memberId: "0000000000",
    },
    encounter: {
      dateOfService: "20240322",
      serviceTypeCodes: ["30"],
    },
  }
).then((response) => response.json())

Submit

Route

Deliver

Submit a JSON request

Submit a JSON request to Stedi’s Eligibility Check API with provider and patient details.

checkEligibility.js

fetch(
  "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3",
  {
    controlNumber: "123456789",
    tradingPartnerServiceId: "CIGNA",
    provider: { organizationName: "Doctors LLC", npi: "7921017274" },
    subscriber: {
      firstName: "John",
      lastName: "Doe",
      dateOfBirth: "19870521",
      memberId: "0000000000",
    },
    encounter: {
      dateOfService: "20240322",
      serviceTypeCodes: ["30"],
    },
  }
).then((response) => response.json())

Submit

Route

Deliver

Submit a JSON request

Submit a JSON request to Stedi’s Eligibility Check API with provider and patient details.

checkEligibility.js

fetch(
  "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3",
  {
    controlNumber: "123456789",
    tradingPartnerServiceId: "CIGNA",
    provider: { organizationName: "Doctors LLC", npi: "7921017274" },
    subscriber: {
      firstName: "John",
      lastName: "Doe",
      dateOfBirth: "19870521",
      memberId: "0000000000",
    },
    encounter: {
      dateOfService: "20240322",
      serviceTypeCodes: ["30"],
    },
  }
).then((response) => response.json())

Submit a JSON request

Submit a JSON request to Stedi’s Eligibility Check API with provider and patient details.

checkEligibility.js

fetch(
  "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3",
  {
    controlNumber: "123456789",
    tradingPartnerServiceId: "CIGNA",
    provider: { organizationName: "Doctors LLC", npi: "7921017274" },
    subscriber: {
      firstName: "John",
      lastName: "Doe",
      dateOfBirth: "19870521",
      memberId: "0000000000",
    },
    encounter: {
      dateOfService: "20240322",
      serviceTypeCodes: ["30"],
    },
  }
).then((response) => response.json())

Stedi routes the request

Stedi routes the request to the payer through the most reliable connection automatically.

checkEligibility.js

fetch(
  "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3",
  {
    controlNumber: "123456789",
    tradingPartnerServiceId: "CIGNA",
    provider: { organizationName: "Doctors LLC", npi: "7921017274" },
    subscriber: {
      firstName: "John",
      lastName: "Doe",
      dateOfBirth: "19870521",
      memberId: "0000000000",
    },
    encounter: {
      dateOfService: "20240322",
      serviceTypeCodes: ["30"],
    },
  }
).then((response) => response.json())

Stedi routes the request

Stedi routes the request to the payer through the most reliable connection automatically.

checkEligibility.js

fetch(
  "https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3",
  {
    controlNumber: "123456789",
    tradingPartnerServiceId: "CIGNA",
    provider: { organizationName: "Doctors LLC", npi: "7921017274" },
    subscriber: {
      firstName: "John",
      lastName: "Doe",
      dateOfBirth: "19870521",
      memberId: "0000000000",
    },
    encounter: {
      dateOfService: "20240322",
      serviceTypeCodes: ["30"],
    },
  }
).then((response) => response.json())

Stedi delivers the response

Stedi delivers the response payload from the payer in an easily digestible JSON format.

benefitResponse.json

"benefitsInformation": [
{
      "code": "C",
      "name": "Deductible",
      "coverageLevelCode": "FAM",
      "coverageLevel": "Family",
      "serviceTypeCodes": [
        "30"
      ],
      "serviceTypes": [
        "Health Benefit Plan Coverage"
      ],
      "timeQualifierCode": "23",
      "timeQualifier": "Calendar Year",
      "benefitAmount": "500",
      "inPlanNetworkIndicatorCode": "Y",
      "inPlanNetworkIndicator": "Yes",
      "additionalInformation": [
        {
          "description": "Includes services provided by Client Specific Network"
        }
      ]
    }

Stedi delivers the response

Stedi delivers the response payload from the payer in an easily digestible JSON format.

benefitResponse.json

"benefitsInformation": [
{
      "code": "C",
      "name": "Deductible",
      "coverageLevelCode": "FAM",
      "coverageLevel": "Family",
      "serviceTypeCodes": [
        "30"
      ],
      "serviceTypes": [
        "Health Benefit Plan Coverage"
      ],
      "timeQualifierCode": "23",
      "timeQualifier": "Calendar Year",
      "benefitAmount": "500",
      "inPlanNetworkIndicatorCode": "Y",
      "inPlanNetworkIndicator": "Yes",
      "additionalInformation": [
        {
          "description": "Includes services provided by Client Specific Network"
        }
      ]
    }

Broad, reliable connectivity

Connect to thousands of payers with automatic failover

Our growing set of payers is covered by redundant connections. Stedi dynamically routes traffic to the most reliable connection, eliminating single points of failure.

Browse our network

View payer status dashboard

“We made the switch over to Stedi and were live in a day.”

— Keaton Bedell

CEO & Founder of Bridge

“We made the switch over to Stedi and were live in a day.”

— Keaton Bedell

CEO & Founder of Bridge

“We made the switch over to Stedi and were live in a day.”

— Keaton Bedell

CEO & Founder of Bridge

Manual eligibility checks

Test new integrations and easily understand what’s covered

Search and filter for specific benefit types, coverage dates, and more in the Stedi app.