You don’t need to do payer mapping

The big takeaway: You can use your existing payer IDs with Stedi – no mapping or updates required. Stedi’s payer ID aliases ensure your payer IDs keep working, even when payers change them.

Every clearinghouse transaction needs a payer ID. It’s used to route the transaction to the right payer.

But payer IDs aren’t standard. They can vary by clearinghouse, plan, and transaction type. And payers change their IDs all the time – like after a merger or a rebrand.

Most clearinghouses make this your problem. They adopt the latest IDs (or make up their own), then leave you to maintain mappings for old ones. Miss an update, and your transactions fail.

For example, you use payer ID 4500 to send a claim to Aetna. But your clearinghouse now uses 6400 for Aetna claims. They reject your claims until you update your mappings and use the new ID.

With Stedi, both IDs just work. You can use any existing payer ID – old or new, from any clearinghouse – and we’ll route your transaction to the right payer.

What is payer mapping?

A payer mapping is a lookup table for payer IDs. It translates the payer IDs your system uses into the ones your clearinghouse expects. Every transaction from your system must go through this table.

For example, a mapping table may look like this:

Problems with payer mapping

• You have to make updates on someone else’s schedule.
  Every time your clearinghouse or a payer changes a payer ID, you have to update your mapping table.
  
  

• Mistakes mean lost revenue.
  If you send an outdated payer ID, most clearinghouses will reject your transaction. That can mean lost or delayed revenue for your providers.
  
  

• Clearinghouse lock-in
  Different clearinghouses use different payer IDs for the same payer. Switching to another clearinghouse typically means rebuilding your mappings from scratch.

Stedi’s system of payer IDs avoids these issues.

How payer IDs work at Stedi

Stedi has three types of payer IDs:

• Primary payer ID
  This is the most commonly used ID for the payer. Usually, it’s a 3-5 character alphanumeric code and often (but not always) returned in responses and transactions from the payer, like eligibility responses or Electronic Remittance Advice (ERAs).
  
  It’s often found on the payer’s insurance cards or in the payer’s documentation.
  
  

• Payer ID aliases
  These are historical payer IDs and payer IDs from other clearinghouses. In some cases, these IDs are taken from the payer’s documentation.
  
  If a primary payer ID is removed by a payer, Stedi adds it as an alias and maintains it indefinitely. This ensures your existing payer IDs continue to work.
  
  

• Stedi payer IDs
  This is Stedi’s immutable ID for the payer. Use this if you need a stable ID that doesn’t change.

Using payer IDs with Stedi

Get a payer’s IDs
You can see a payer’s full set of payer IDs – including aliases – on the Payer Network site or using Stedi’s Payers API. For example, using the API:

{
  "payer": {
    "displayName": "Aetna",
    "primaryPayerId": "60054",	// Primary payer ID
    "aliases": [			// Payer ID aliases
      "4500",
      "60054",
      "60054MA",
      "6400",
      "953402799",
      "AETNA",
      "Z95668"
    ],
    "stediId": "HPQRS",		// Stedi payer ID
    ...
  }
}

To see if a specific payer ID is already supported, search for it using the Payer Network or the Search Payers endpoint.

Use a payer ID in transactions
If you’re using Stedi’s JSON APIs, put the payer ID in the request body’s tradingPartnerServiceId field for eligibility checks, claims submissions, and real-time claim status checks. You can use any payer ID type, including aliases.

For example, using the JSON eligibility check API:

{
  "tradingPartnerServiceId": "4500",  // A payer ID alias for Aetna
  "subscriber": { ... },
  ...
}

For the Transaction Enrollments API, specify a payer ID in the payer.idOrAlias field of the Create Enrollment or Update Enrollment endpoint’s request body. You can use any payer ID type. For example:

{
  "userEmail": "test@example.com",
  "payer": {
    "idOrAlias": "6400"  // A payer ID alias for Aetna
  },
  ...
}

Payer-related errors
Stedi returns an error if you use a payer ID we don’t recognize. For a list of errors and troubleshooting tips, see our Stedi payer errors docs.

Adding new payer ID aliases
Most known payer IDs are already mapped as aliases or primary IDs. If you need a new alias, contact us using your Slack or Microsoft Teams channel. We'll add it within 1-2 business days.

We typically only add publicly documented payer IDs as aliases. In your request, include documentation showing the ID was sent by the payer, is used by another clearinghouse, or was mentioned in the payer’s docs.

Try it out

Payer ID aliases make it easy to switch to Stedi. Sign up to get started. It’s free and takes less than two minutes.

If you only have payer names and not payer IDs, reach out. Our team can help with payer ID matching.