When to use batch eligibility checks

Real-time eligibility checks are built for real-time scenarios: A patient's on the phone. Someone's at the front desk. You need an answer in seconds.

But if you’re checking coverage for upcoming appointments or refreshing eligibility for entire patient panels, the timeline shifts. You don’t need answers in seconds. You need them in hours.

Stedi’s real-time eligibility API works for these bulk use cases until you’re running thousands or millions of checks at once. That’s when teams usually start writing separate logic for large batches, like queuing requests and handling long-running retries.

Stedi's batch eligibility API handles that for you. You can submit multiple checks in one request. Stedi queues and retries them automatically. And batch checks run in a separate pipeline, away from your real-time traffic.

When to use real-time vs. batch checks

Real-time checks are the default. Use them for:

• When a patient at the desk

• Verification before a visit

• Fast feedback loops while testing or debugging

• Smaller sets of bulk checks

• Any time-sensitive eligibility need

As your volume grows and you find yourself building custom logic to support it, use batch checks for bulk workflows that aren’t time sensitive:

• Monthly or weekly coverage refreshes

• Upcoming appointments

• Sets of thousands or millions of checks that can run in the background

• Any workflow where a timeline of minutes to hours works

Most teams start by using real-time checks for everything. They add batch checks when they start running several thousands of time-insensitive checks at once. Until then, using real-time checks is simpler.

Run a batch check

You submit batch checks using the Batch Eligibility Check API endpoint or a CSV upload. Each check in the batch uses the same fields as real-time requests. You can track individual checks in a batch using submitterTransactionIdentifier.

curl --request POST \
  --url "https://manager.us.stedi.com/2024-04-01/eligibility-manager/batch-eligibility" \
  --header "Authorization: <api_key>" \
  --header "Content-Type: application/json" \
  --data '{
    "name": "march-2024-eligibility-batch",
    "items": [
      {
        "submitterTransactionIdentifier": "ABC123456789",
        "controlNumber": "000022222",
        "tradingPartnerServiceId": "AHS",
        "encounter": {
          "serviceTypeCodes": [
            "MH"
          ]
        },
        "provider": {
          "organizationName": "ACME Health Services",
          "npi": "1234567891"
        },
        "subscriber": {
          "dateOfBirth": "19000101",
          "firstName": "Jane",
          "lastName": "Doe",
          "memberId": "1234567890"
        }
      },
      ...
    ]
  }'

The response includes a batchId you can use to check results:

{
  "batchId": "01928d19-df25-76c0-8d51-f5351260fa05",
  "submittedAt": "2023-11-07T05:31:56Z"
}

Get batch results

Use the Poll Batch Eligibility Checks API endpoint to poll the batchId:

curl --request GET \
  --url "https://manager.us.stedi.com/2024-04-01/eligibility-manager/polling/batch-eligibility?batchId=01928d19-df25-76c0-8d51-f5351260fa05" \
  --header "Authorization: <api_key>"

You can start polling immediately. After the initial poll, use exponential backoff with jitter. Start at 2 minutes and approximately double the wait between polls, up to 8 hours.

The endpoint returns results incrementally. The response's items array contains full 271 eligibility responses in the same JSON format as real-time checks. Failed checks appear alongside successful ones. You can debug failed checks using Stedi’s Eligibility Manager

You can track batch completion by counting returned results. You can also match submitterTransactionIdentifier values for each check.

Batch processing times

Most batches complete in 15-30 minutes. If a check in the batch fails due to payer connectivity, Stedi retries the check for up to 8 hours.

Pricing

A batch check costs the same as the equivalent number of real-time checks. For example, running a batch of 500 checks costs the same as running 500 real-time checks.

There’s no charge for non-billable checks in a batch. For details, see Billing for eligibility checks.

Get started

If you’re not currently using batch checks but are considering building logic for bulk eligibility, test the pattern with a small batch, then scale up.

Batch eligibility checks are available on all paid Stedi plans. If you don’t have a paid account, request a free trial.