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Eligibility & benefits

Reliably determine eligibility and coordination of benefits, even when patients can’t provide accurate insurance information.

Send eligibility checks

Submit 270/271 eligibility checks through the Stedi portal or API in either JSON or X12 EDI.

Check coordination of benefits

Identify coverage overlap and determine payer responsibility for claims (primacy).

Find patient coverage

Find active health plans using the patient’s demographic data.

API Docs

Full reference for our Eligibility, Coordination of Benefits, and Insurance Discovery APIs.

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Claims processing

Submit 837P professional, 837I institutional, and 837D dental claims and 276/277 real-time claim status checks in both JSON and X12 EDI.

Submit claims

Send claims to payers through the API, an SFTP connection, or the Stedi portal.

Retrieve claim responses

Retrieve processed 277CA claim acknowledgments and 835 ERAs from Stedi.

Check claim status

Determine the processing status of existing claims in real time.

API Docs

Full reference for our Claims, Claim Status, and Reports (277CA and ERA) APIs.