How to evaluate Stedi for eligibility checks

Most eligibility checks are real-time and happen in front of patients, like at the front desk of a provider’s office.

If you’re building a tool that runs eligibility checks and something goes wrong, your users – the providers – feel it immediately.

Switching healthcare clearinghouses for eligibility isn't something most teams do casually. That's why we designed Stedi to make switching as easy, safe, and predictable as possible.

You can try Stedi in production for free. Start with just a few payers, get comfortable, and expand at your own pace.

Why switch to Stedi for eligibility

Most healthcare clearinghouses were built before REST APIs – or the Internet – existed. They were designed for batch processing and manual workflows, not modern development workflows or automation at today’s scale.

Stedi is the modern healthcare clearinghouse. We offer:

• Well-documented REST APIs
  Stedi’s Real-Time Eligibility APIs are fast, JSON-native, and well-documented. If you’re building an AI agent, you can connect using the Stedi MCP server or use our OpenAPI spec to build integrations quickly.

  Many teams integrate in less than a day.If you already use X12, we offer X12 and SOAP API endpoints. We also support batch eligibility checks.
  
  

• Lossless eligibility responses
  Not all clearinghouses are the same. Some drop or truncate data from payer responses. Stedi doesn’t. We send you everything the payer sends back. Nothing is dropped.
  
  

• The broadest payer coverage
  Stedi connects to virtually every payer who processes electronic transactions – 1,250+ for eligibility checks, including Medicare and all state Medicaid programs. You can see them using the Stedi Payer Network site or our Payers API.
  
  

• Cloud-based scalability

  Stedi is built on AWS’s cloud-based infrastructure. You can scale us infinitely. We have a 99.9% uptime SLA.
  
  

• Real-time support
  Every Stedi customer gets a dedicated Slack or Microsoft Teams channel. Our average response time is less than 10 minutes – from real humans. We don’t use bots or auto-replies. See our support page.

How to start an evaluation

1. Create a Stedi account.
   You can sign up for our Basic plan for free in under two minutes. No credit card required.
   
   

2. Request a free trial.
   After you create an account, our team will get in touch. When they do, ask for a free trial to evaluate Stedi. You can also reach out using our contact form.
   
   

3. Run Stedi alongside your current clearinghouse.
   Start by routing eligibility checks for your top 10-20 payers by volume to Stedi while keeping the rest on your current clearinghouse.

   Stedi supports payer ID aliases – you can use your existing payer IDs with Stedi. No mapping is required.The pseudocode for routing would look something like this:

   // Start with your top 10-20 payers by volume.
   // Use your existing payer IDs.
   const STEDI_PAYER_LIST = [
     "87726",    // UnitedHealthcare
     "60054",    // Aetna
     "CMS",      // Medicare (CMS)
     ...
   ];
   
   function checkEligibility(request):
     if request.payerId in STEDI_PAYER_LIST:
       response = stedi.checkEligibility(request)
   
       if response.status == "success":
         return response
       else:
         // Fallback to existing clearinghouse on failure
         return existingClearinghouse.checkEligibility(request)
     else:
       return existingClearinghouse.checkEligibility(reques

   // Start with your top 10-20 payers by volume.
   // Use your existing payer IDs.
   const STEDI_PAYER_LIST = [
     "87726",    // UnitedHealthcare
     "60054",    // Aetna
     "CMS",      // Medicare (CMS)
     ...
   ];
   
   function checkEligibility(request):
     if request.payerId in STEDI_PAYER_LIST:
       response = stedi.checkEligibility(request)
   
       if response.status == "success":
         return response
       else:
         // Fallback to existing clearinghouse on failure
         return existingClearinghouse.checkEligibility(request)
     else:
       return existingClearinghouse.checkEligibility(reques

   // Start with your top 10-20 payers by volume.
   // Use your existing payer IDs.
   const STEDI_PAYER_LIST = [
     "87726",    // UnitedHealthcare
     "60054",    // Aetna
     "CMS",      // Medicare (CMS)
     ...
   ];
   
   function checkEligibility(request):
     if request.payerId in STEDI_PAYER_LIST:
       response = stedi.checkEligibility(request)
   
       if response.status == "success":
         return response
       else:
         // Fallback to existing clearinghouse on failure
         return existingClearinghouse.checkEligibility(request)
     else:
       return existingClearinghouse.checkEligibility(reques

   If a Stedi eligibility request fails, the fallback logic sends it to your current clearinghouse automatically. This limits risk while you build confidence with Stedi.

What to look for during your trial

Once you're routing eligibility checks through Stedi, compare our responses to those from your current clearinghouse.

Stedi returns lossless responses. If your current clearinghouse is truncating or dropping data, you'll see it here.

How to compare eligibility responses

All clearinghouses exchange eligibility checks using X12 EDI -- it's required by HIPAA. Stedi's JSON API handles the translation from X12 to JSON for you. Stedi's JSON responses include an x12 field with the raw X12 response if you need to inspect it directly.

If you'd rather not deal with X12, you can use Stedi's JSON eligibility responses – they contain the same data. You'll just need to map the response shapes between clearinghouses.

Tip: You can also feed our OpenAPI spec to an LLM-enabled coding tool, like Codex or Claude Code, to have them map Stedi's JSON responses to those from your current clearinghouse.

Migrate at your own pace

When you’re ready to move fully to Stedi, continue routing more payers until all your traffic is moved over. Then, you can remove the above routing logic – and your old clearinghouse – entirely.

FAQ

Do I need to complete transaction enrollment for eligibility checks?

Not usually. Most payers don't require transaction enrollment for eligibility checks. A notable exception is CMS, the government payer used for Medicare eligibility checks.

To check enrollment requirements, use the Stedi Payer Network or Payers API. If enrollment is required, use Stedi’s Transaction Enrollment API or the Stedi portal to track and manage enrollment requests. We handle the enrollment paperwork for you wherever possible.

How long does it take to integrate with Stedi for eligibility checks?

Most teams integrate in a day or less. The evaluation period -- testing payer coverage, enrolling providers where needed, and building confidence -- is what takes longer.

Do I need to move my ERA transaction enrollments to switch my eligibility checks to Stedi?

No. You can run eligibility checks with Stedi independently of enrollments for ERAs (Electronic Remittance Advice) or other transactions.

Can I test without real patient data?

Yes. All Stedi plans include a test mode with predefined mock eligibility checks and realistic responses. But mock checks won’t reveal whether your current clearinghouse drops or truncates data. For a real comparison, request a free production trial.

What if Stedi doesn't cover all my payers?

Stedi connects to 1,250+ payers for eligibility checks – virtually every payer who supports real-time eligibility, including Medicare and all state Medicaid payers.

If there's a specific payer giving you trouble or that you’re concerned about, reach out.

Do I need to update my payer IDs to switch to Stedi?

No. Stedi accepts payer IDs from other clearinghouses. Your existing payer IDs will work as is. See our Payer ID aliases docs.