Test API key
When submitting these mock requests to the API, you must use a test Stedi API key for authentication. When using a test API key, you can only send the following mock requests to the endpoint. Stedi returns an error if you try to send production data with a test API key.API clients
You may want to use an API client to make testing and debugging easier. We don’t recommend using Postman for requests containing Protected Health Information (PHI) because Postman defaults to storing request history - including full request payloads - on its cloud servers. You can’t turn this feature off without impractical workarounds. Visit API clients for a list of recommended clients you can use instead.Medical - Active coverage
Request notes:encounter
: Only service type code30
is supported.provider
: You can use any organization name and any NPI, as long as it passes check digit validation. To generate a dummy NPI, you can use this free tool.subscriber
: You must use the exact values in the test request. Other birth dates, first names, last names, member IDs, and Social Security Numbers return errors.
Dependent
Each of these examples represent an eligibility check for a dependent. An individual qualifies as a dependent for eligibility checks when they are listed as a dependent on the subscriber’s insurance plan AND the payer cannot uniquely identify them through information outside the subscriber’s policy. These example requests follow best practices for structuring eligibility checks. Specifically, all requests include the dependent’s information, including their date of birth, in thedependents
array. Some payers may allow different structures, such as sending the dependent’s information in the subscriber
object with the subscriber’s member ID. However, we recommend following the guidance outlined in the Real-Time Eligibility Check endpoint documentation for the most reliable results across all payers.
The way dependent information is included in the response varies by payer. Some contain the dependent’s information in the subscriber
object. Some include the actual subscriber’s information in the subscriber
object and the dependent’s information in the dependents
array.
Aetna
In this example, the dependent Jordan is the subscriber John’s child. Jordan’s information is returned in the dependents
array in the response.
Aetna - Mock request 1
Aetna - Mock request 1
dependents
array in the response.
Anthem BCBSCA - Mock request 1
Anthem BCBSCA - Mock request 1
dependents
array in the response.
BCBSTX - Mock request 1
BCBSTX - Mock request 1
subscriber
object with no dependents
array, even though they are a dependent.
Cigna - Mock request 1
Cigna - Mock request 1
dependents
array in the response.
Oscar Health - Mock request 1
Oscar Health - Mock request 1
dependents
array in the response.
UnitedHealthcare - Mock request 1
UnitedHealthcare - Mock request 1
Subscriber only
The following examples request benefits information for the subscriber only. The subscriber’s information is sent in thesubscriber
object in the request. The payer’s response contains the subscriber’s information in the subscriber
object and doesn’t include any dependent information.
Aetna
Aetna - Mock request 1
Aetna - Mock request 1
Ambetter - Mock request 1
Ambetter - Mock request 1
CIGNA - Mock request 1
CIGNA - Mock request 1
CIGNA - Mock request 2
CIGNA - Mock request 2
CIGNA - Mock request 3
CIGNA - Mock request 3
CIGNA - Mock request 4
CIGNA - Mock request 4
CIGNA - Mock request 5
CIGNA - Mock request 5
CIGNA - Mock request 6
CIGNA - Mock request 6
CIGNA - Mock request 7
CIGNA - Mock request 7
Humana - Mock request 1
Humana - Mock request 1
Kaiser Permanente - Mock request 1
Kaiser Permanente - Mock request 1
CMS - Mock request 1
CMS - Mock request 1
UHC - Mock request 1
UHC - Mock request 1
MBI lookup for CMS checks
You must include the patient’s Medicare Beneficiary Identifier (MBI) in every eligibility check you submit to the Centers for Medicare and Medicaid Services (Payer ID: CMS). When patients don’t know their MBI, you can use Stedi’s eligibility APIs to perform an MBI lookup using their Social Security Number instead. Visit MBI lookup for more information.MBI lookup mock request
MBI lookup mock request
Medical - Inactive coverage
The following example requests benefits information for the subscriber. UnitedHealthcareUHC - Mock request 1
UHC - Mock request 1
Dental
The following example requests benefits information for the subscriber. Request notes:encounter
: Only service type code35
is supported.provider
: You can use any organization name and any NPI, as long as it passes check digit validation. To generate a dummy NPI, you can use this free tool.subscriber
: You must use the exact values in the test request. Other birthdates, first names, last names, and member IDs return errors.
Ameritas - Mock request
Ameritas - Mock request
BCBSCA - Mock request
BCBSCA - Mock request
Cigna - Mock request
Cigna - Mock request
Metlife - Mock request
Metlife - Mock request
UnitedHealthcare - Mock request
UnitedHealthcare - Mock request
Common AAA errors
The following requests return mock data for the most common PayerAAA
errors. Visit Eligibility troubleshooting for a complete list of AAA error codes, other common eligibility check issues, and recommended resolution steps.
42 - Unable to respond at current time
The following example request returns a42
AAA error code, indicating that the payer is unable to respond at the current time. This is typically a temporary issue with the payer’s system, but it can also be an extended outage or the payer throttling your requests.
42 - AAA Error - Mock request
42 - AAA Error - Mock request
43 - Invalid/Missing Provider Identification
The following example request returns a43
AAA error code. This error can occur if provider’s NPI is not registered with the payer, the provider’s NPI is not registered correctly with the payer, or the payer requires an agreement.
43 - AAA Error - Mock request
43 - AAA Error - Mock request
72 - Invalid/Missing Subscriber/Insured ID
The following example request returns a72
AAA error code. This error can occur if the subscriber member ID was incorrect in the request, the request does not meet the payer’s requirements for the subscriber ID, or there is another unidentified error in the request data.
72 - AAA Error - Mock request
72 - AAA Error - Mock request
73 - Invalid/Missing Subscriber/Insured Name
The following example request returns a73
AAA error code. This error can occur if an incorrect subscriber name was submitted, the subscriber name was missing, the subscriber name was spelled incorrectly, or the request doesn’t meet the payer’s requirements for the subscriber’s name.
73 - AAA Error - Mock request
73 - AAA Error - Mock request
75 - Subscriber/Insured Not Found
The following example request returns a75
AAA error code. This error occurs when the payer can’t find the subscriber in their database. You should verify the subscriber details and try sending different combinations of firstName
, lastName
, dateOfBirth
, and memberId
. Note that not all search combinations are supported by all payers.
75 - AAA Error - Mock request
75 - AAA Error - Mock request
79 - Invalid Participant Identification
The following example request returns a79
AAA error code. This error occurs when there is a problem connecting with the payer. You should contact Stedi support for assistance.
79 - AAA Error - Mock request
79 - AAA Error - Mock request