Stedi and payer workflows
Planning a Stedi 270/271 eligibility integration
What to define before connecting eligibility checks: payer coverage, enrollment, request data, response handling, and operational ownership.
By Globalesm
Stedi accepts eligibility requests through its API or portal. For a JSON API request, Stedi translates the request into an X12 270 transaction and returns the payer's eligibility response. The implementation work is connecting that exchange to the decisions your team needs to make.
Confirm the payer and workflow first
Check the current payer list for your intended transaction and review any enrollment requirements. Define when your application should run a check: scheduling, preregistration, or another agreed point. Document which provider identifiers and patient or subscriber fields your workflow can supply.
Map the data your team needs
Our recommended discovery checklist covers:
- Where member identifiers, demographic details, and provider information originate.
- Which service types and dates your workflow needs to check.
- Which response fields the user needs to see and how missing or ambiguous values should appear.
- Who can correct a request and how that correction is recorded.
Treat exceptions as part of the product
Build explicit paths for invalid input, payer unavailability, and responses that need review. Separate technical success from a useful business result. Show staff what happened and the next action available. Before adding automatic retries, review the API behavior and agree how to avoid unnecessary repeat requests.
Validate before expanding
We recommend starting with a defined set of payers and test scenarios, then reconciling the displayed result with the source response. Keep credentials server-side, restrict access to sensitive data, and agree a retention policy for operational records. At handoff, identify who owns enrollment issues, response interpretation, and production alerts.
Put the plan into practice
Tell us which systems you need to connect and where you need help.