Search Payers

This endpoint queries Stedi’s Payer Network database and returns information about matching payers, including all of their possible names, aliases, and supported transaction types. It’s the same endpoint Stedi uses internally to power dynamic search on the Payer Network page.

The search supports fuzzy matching, which means that the results contain an array of exact (if available) and close matches. You can search by the payer’s name, alias, or Payer ID. You can further filter the results by supported transaction types, including 270/271 eligibility checks, 837 claims, 275 claim attachments, 835 ERAs (claim payments), coordination of benefits checks, and more.

This endpoint is especially useful when you want to embed dynamic payer search capabilities into your own system or application. For example, you could use it to allow patients to search for and select their insurance provider in a patient intake form.

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Results

When you specify multiple transaction filters, they are combined with AND logic, meaning payers must satisfy all specified transaction criteria to be included in results.

Stedi weights results based on text match relevance and additional factors, such as payer size, market share, and transaction volume in order to present the most likely matches first. Stedi also accounts for potential misspellings (a search for CEGNA still returns CIGNA) and transposed letters (a search for ICGNA still returns CIGNA) when searching the payer database.

Each payer record includes a score starting at 0 that indicates how relevant it is to the search query. Higher scores indicate a more relevant match.

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Examples

This page contains two examples of search results:

• Basic Search: The SearchPayers_example1 response shows the results of a basic search for the query string “Blue Cross”. The URL for this request is https://healthcare.us.stedi.com/2024-04-01/payers/search?query=Blue%20Cross.
• Complex Search: The SearchPayers_example2 response shows the results of a more advanced search that includes a query string for “Blue Cross”, plus additional query parameters that filter for payers supporting eligibility checks and real-time claim status. The URL for this request is https://healthcare.us.stedi.com/2024-04-01/payers/search?query=Blue%20Cross&eligibilityCheck=SUPPORTED&claimStatus=SUPPORTED. In the stats object, the summary counts of payers matching the search criteria are fewer than the summary counts for the basic search. This is because the advanced search only returns payers that support both eligibility checks and claim status, while the basic search returns all payers, regardless of the transaction types they support.

Both examples are truncated for brevity to show only one payer matching the results (Blue Cross Blue Shield of North Carolina). However, the full responses would contain multiple payers, such as Blue Cross Blue Shield of Illinois and Anthem Blue Cross Blue Shield of California.

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Spaces

You must represent spaces in the query string using either %20 or +. For example, you could use either query=Blue%20Cross or query=Blue+Cross to represent Blue Cross.

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Query parameters

To add the required query parameter (query) to the URL, append a ? character followed by the parameter name and value. For example, the URL https://healthcare.us.stedi.com/2024-04-01/payers/search?query=Blue%20Cross includes the parameter query with the value Blue%20Cross (equivalent to Blue Cross).

To add additional filters to the request, place the & character in front of each additional query parameter. For example, the URL https://healthcare.us.stedi.com/2024-04-01/payers/search?query=Blue%20Cross&eligibilityCheck=SUPPORTED&claimStatus=SUPPORTED combines three query parameters: query, eligibilityCheck, and claimStatus.