Introducing the redesigned eligibility check view

You can now review an eligibility check's result, summary, and benefits on one page in the Stedi portal's checks view.

Previously, each check had separate Overview and Benefits tabs. Plan details and benefit-related entities were on the Overview tab, apart from the benefits they applied to.

Now, the benefits table is part of the Overview tab. The redesign includes:

• Status banner and summary – A banner at the top of the page shows the check's result, above a summary of the check's details.
• Plan details – Plan names, group numbers, plan numbers, and plan dates appear in the benefits table.
• Coverage statuses – Each status has its own Statuses row in the benefits table.
• Related entities column – Benefit-related entities have their own column in the benefits table.
• Benefits filters – The benefits table has 15 filters, up from 7.

Status banner and summary

The top of the Overview tab shows the check's result in a status banner. When the payer returns errors, they appear directly under the banner.

Under the banner, the summary now groups the check's details into Subscriber, Dependent, Provider, Payer, and Encounter sections.

Name and address fields also show a sub-label for each part, such as First, Last, or City.

Plan details

The table includes the patient's plan details when the payer's response has them. These include the plan name, group number, plan number, and the plan's begin and end dates.

Coverage statuses

Coverage statuses for a Service Type Code (STC) or procedure code appear in rows with the Type column set to Statuses. The Coverage column lists the status, such as Active coverage or Inactive.

Related entities column

Benefit-related entities appear in a Related entities column, in the same row as the benefit they apply to. Payers commonly use these entities to identify the patient's primary care provider (PCP), a carveout organization, or another health plan.

Benefits filters

We've added eight filters to the benefits table:

• Authorization – Whether the benefit requires prior authorization.
• Limit applies – Whether the payer applies a limit to the benefit, such as a visit or dollar cap.
• Time period – The period the benefit applies to, such as Calendar Year or Remaining.
• Has dates – Benefits that contain dates, such as plan or eligibility dates.
• Has related entities – Benefits that name a related entity, such as a PCP or a carveout organization.
• Has plan information – Benefits that contain plan details, such as the plan name or number.
• Has group information – Benefits that contain group details, such as the group number.
• Has additional information – Benefits that contain other details from the payer.

The filter bar shows three filters, and a button such as 12 more holds the rest. The three filters on the bar depend on the payer's response, so they change from check to check.

Payers often send more benefits than you need. You can use the filters to find the benefits for a specific task. For example, you can check coverage for a service, estimate patient responsibility, or confirm prior authorization requirements.

Get started

To get started with Stedi, sign up for a free sandbox account. It takes less than two minutes. No credit card is required.

When you're ready to run real eligibility checks, upgrade to production on our pay-as-you-go plan. There are no monthly minimums or setup fees. You only pay for the transactions you use.