Changelog

Stedi now rejects 837I institutional claims that are missing a required admission source code.

In an institutional claim, the admission source code tells you where the patient came from, such as the emergency room (ER), a doctor’s referral, or another facility.

Most institutional claims require this code. Without it, the payer can’t adjudicate the claim. The one exception is non-patient lab services, where no patient is present.

If the code is missing when required, the payer may reject the claim, which can cause payment delays.

This edit – the industry’s term for an automated validation rule – catches the issue before the claim reaches the payer.

When this edit applies
An institutional claim will fail this edit in the following cases:

• JSON API
  If you’re using Stedi’s JSON institutional claim submission API endpoint, the edit fails if:

  • The admissionSourceCode field is missing or empty.
    AND

  • The placeOfServiceCode field does not contain 14 (Non-Patient Laboratory).
    
    

• Raw X12
  If you’re using raw X12, the edit fails if:

  • CL1-02 (Admission Source Code) of Loop 2300 (Claim Information) is missing or empty.
    AND

  • C023-01 (Facility Type Code) of Loop 2300 is NOT 14 (Non-Patient Laboratory).

Rejection errors
If you submit a claim that fails the edit using Stedi’s institutional claim submission API endpoints, you’ll get back an error message in real time. If you’re using the JSON API endpoint, the response includes error details in the errors array:

{
  "errors": [
    {
      "code": "33",
      "description": "Missing admission source code. This code is required on all institutional claims with the exception of non-patient laboratory claims (Type of Bill 014x). Correct and resubmit.",
      "followupAction": "Please Correct and Resubmit"
    }
  ]
}

If you submit a claim that fails the edit using SFTP, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will contain a related claim status category code, claim status code, and error message. You can use the error message to correct and resubmit the claim.

Stedi app developers can now configure their apps to automatically add one or more support users – called members – to accounts that install their app. 

App developers can use the support users to provide support or help with implementation.

This new feature is optional. The support user has the Developer role.

What is a Stedi app?
A Stedi app is a prebuilt integration between Stedi and a third-party platform. 

Stedi accounts on the Basic plan can install Stedi apps to quickly connect their account to a third-party Revenue Cycle Management (RCM) system, Practice Management System (PMS), Electronic Health Record (EHR) platform, or other Stedi Platform Partners. 

For example, a practice or provider on Stedi’s free Basic plan can install a Stedi app to connect their Stedi account to their EHR.

As an app developer, you can choose to offer your app for free on the Basic plan or require a paid upgrade.

Get started with Stedi apps
To discuss publishing or configuring a Stedi app, contact us. You can also check out Publish your app in our developer docs.

To install a Stedi app, log in the Stedi portal and go to the Apps page. You can also check out our related docs.

Priority Health (Payer ID: PRHTH) now supports one-click transaction enrollment for Electronic Remittance Advice (ERAs).

What is transaction enrollment?
Transaction enrollment is the process of registering a provider to exchange specific healthcare transactions with a payer. Payers always require transaction enrollments for ERAs.

You can submit and track enrollments using Stedi's transaction enrollment API, the Stedi portal, or a bulk CSV.

One-click enrollment
Enrollment requirements vary by payer. Some payers may require the submitter to sign PDFs or complete tasks in the payer's portal.

If a payer supports one-click enrollment, you only need to submit the enrollment request. There are no follow-up steps. Stedi handles everything else.

You can check whether a payer requires enrollment – and supports one-click enrollment – for ERAs and other transaction types using the Stedi Payer Network or the Payer APIs.

For details, see our transaction enrollment docs.

Highmark Western and Northeastern New York (Payer ID: 55204) now supports one-click transaction enrollment for Electronic Remittance Advice (ERAs).

What is transaction enrollment?
Transaction enrollment is the process of registering a provider to exchange specific healthcare transactions with a payer. Payers always require transaction enrollments for ERAs.

You can submit and track enrollments using Stedi's transaction enrollment API, the Stedi portal, or a bulk CSV.

One-click enrollment
Enrollment requirements vary by payer. Some payers may require the submitter to sign PDFs or complete tasks in the payer's portal.

If a payer supports one-click enrollment, you only need to submit the enrollment request. There are no follow-up steps. Stedi handles everything else.

You can check whether a payer requires enrollment – and supports one-click enrollment – for ERAs and other transaction types using the Stedi Payer Network or the Payer APIs.

For details, see our transaction enrollment docs.