Introducing the Search Payers API

You can now use the Search Payers API to programmatically search for payers in the Stedi Payer Network. We’ve also updated the Payer Network UI to use the new API. You now get consistent search results across the UI and API.

Why payer IDs matter

When you send a healthcare transaction, such as a dental claim (837D) or eligibility check (270/271), you need a payer ID. The payer ID tells your clearinghouse where to send the transaction. If the ID is wrong, the transaction might fail or be rejected.

That sounds simple. It’s not.

Primary payer IDs often change. They can vary between clearinghouses, sometimes even between transaction types. Most clearinghouses send out their IDs in CSV payer lists that are updated once a month at best. These CSVs can grow stale quickly. Worse, they often have duplicate names, typos, and other errors.

For developers building healthcare billing applications, CSV-based payer lists create a recurring pain. Every month, you need to update payer name-to-ID mappings or lookup tables. You end up writing logic to normalize names, match aliases, and handle edge cases – just to get the right payer ID.

So we built something better.

We created the Stedi Payer Network and Payers API to provide accurate, up-to-date data on thousands of medical and dental payers. You can get the right payer ID without digging through CSVs.

Now, with the Search Payers API, it’s faster to find the right payer and build tools that scale. For example, you can use the API to create an application that lets patients search for and select their insurance provider in a patient intake form.

Find payer IDs with the Search Payers API

The Search Payers API does one thing well: find the payer you're looking for.

You can search by the payer’s name, alias, or payer ID. The search supports fuzzy matching, so it returns close matches even if the provided payer name isn’t exact.

Stedi weights results based on text match relevance and additional factors, such as payer size, market share, and transaction volume, to present the most likely matches first.

You can further filter the results by supported transaction types, like dental claims (837D) or eligibility checks (270/271).

For example, the following request searches for the “Blue Cross” payer name and filters for payers that support eligibility checks and real-time claim status.

curl --request GET \
  --url https://healthcare.us.stedi.com/2024-04-01/payers/search?query=Blue%20Cross&eligibilityCheck=SUPPORTED&claimStatus=SUPPORTED \
  --header 'Authorization: <api-key>'

The response returns a list of matching payers. Each result includes:

• The payer’s immutable Stedi Payer ID

• Their name, primary payer ID, and known aliases

• Supported transaction types

• Whether transaction enrollment is required

• A score indicating how relevant the payer is to the search query.

{
 "items": [
   {
     "payer": {
       "stediId": "QDTRP",
       "displayName": "Blue Cross Blue Shield of Texas",
       "primaryPayerId": "G84980",
       "aliases": [
         "1406",
         "84980",
         "CB900",
         "G84980",
         "SB900",
         "TXBCBS",
         "TXBLS"
       ],
       "names": [
         "Blue Cross Blue Shield Texas Medicaid STAR CHIP",
         "Blue Cross Blue Shield Texas Medicaid STAR Children's Health Insurance Program",
         "Blue Cross Blue Shield of Texas",
         "Bryan Independent School",
         "Federal Employee Program Texas (FEP)",
         "Health Maintenance Organization Blue",
         "Health Maintenance Organization Blue Texas",
         "Healthcare Benefits",
         "Rio Grande",
         "Walmart (BlueCard Carriers)"
       ],
       "transactionSupport": {
         "eligibilityCheck": "SUPPORTED",
         "claimStatus": "SUPPORTED",
         "claimPayment": "ENROLLMENT_REQUIRED",
         "dentalClaimSubmission": "SUPPORTED",
         "professionalClaimSubmission": "SUPPORTED",
         "institutionalClaimSubmission": "SUPPORTED",
         "coordinationOfBenefits": "SUPPORTED",
         "unsolicitedClaimAttachment": "NOT_SUPPORTED"
       }
     },
     "score": 14.517873
   },
   ...
 ],
 ...
}

Get started with Stedi

At Stedi, we’re working to eliminate the toil in healthcare transactions. Programmatic access to accurate payer data is just one part.

The Search Payers API is free on all paid Stedi plans. Try it for yourself: Schedule a demo today.