Eligibility workflows
Here’s an overview of the eligibility workflows you can automate with Stedi APIs:- Eligibility checks: Verify a patient’s coverage with a specific payer. Eligibility checks return full benefits information from the payer, so they’re helpful when you need to determine a patient’s financial responsibilities for medical services, such as co-payments, deductibles, and out-of-pocket maximums.
- Insurance discovery: Find a patient’s active health plans using their demographic information, such as their name and date of birth. Insurance discovery checks return the same benefits information as a standard eligibility check, making them a great backup for verifying coverage when eligibility checks fail or aren’t possible.
- Coordination of benefits: Determine whether a patient has multiple, overlapping coverages and if so, which plan is primarily responsible for payment (primacy). COB checks help you submit claims to the correct payer and avoid claim denials.