Eligibility views
The Stedi portal provides two views for tracking eligibility checks. You can toggle between views using the tabs at the top of the Eligibility page.
- Checks - Shows individual eligibility check attempts. Every attempt appears as a separate row. If a check is retried, the retry appears as its own row.
- Searches - Groups all retry attempts for the same check into a single record, called an eligibility search.
Checks view
The checks view shows individual eligibility check attempts. For example, if you submit a check for patient Jane Doe that initially fails and then retry to get successful results, the initial attempt and the retry appear as separate checks in the list.
You can use the checks view to:
- Check the status of individual eligibility check attempts. For example, you may want to reference the results of an eligibility check that you ran earlier in the day.
- Identify patterns in check failures. For example, if you filter by a specific payer and find that checks for all patients within the last hour have failed, the payer may be experiencing an outage.
Eligibility checks are sorted by Processed date, with the most recent checks appearing first.
Filter
You can filter eligibility checks by the following criteria:
| Filter | Description |
|---|---|
| Processed date | A date range for when Stedi processed the eligibility check. |
| Results | By the check result status (Active, Inactive, Investigate, or Failed). |
| Member ID | By the patient's member ID. |
| Payer | By a Payer ID or alias in the Payer Network or a payer's business name (such as Cigna). |
| Provider NPI | By the National Provider Identifier (NPI) of the requesting provider. |
| Error code | By the AAA code returned by the payer. For example, 42 errors indicate a connectivity issue. |
| Search ID | By the ID of the eligibility search containing the check. |
Check statuses
Each eligibility check can have one of the following statuses:
| Status | Description |
|---|---|
| Active | The payer's response contains an active eligibility and benefit type. |
| Inactive | The payer's response doesn't contain an active eligibility and benefit type. |
| Investigate | The payer returned an unexpected eligibility or benefit type code. Review the response and contact Stedi support if you have questions. |
| Failed | The payer returned an error code in the response. Review the error code and retry the eligibility check. |
Check details
Click any check to view its details, including the check overview, benefits information (if present), and raw request and response data.
From an individual eligibility check's detail page, you can go to the associated eligibility search to review all related attempts. Click View search to open the search. If the search contains multiple checks, the button shows the count of related checks.
Searches view
The searches view displays a list of eligibility searches. An eligibility search is a container for retry attempts of a particular eligibility check.
When you submit an eligibility check through any method, Stedi creates a new eligibility search record. Every time you retry that eligibility check, Stedi stores the retry details within the existing eligibility search. This creates a clear timeline of troubleshooting efforts for failed requests.
You can use the searches view to:
- Track the full retry history for a specific patient's eligibility check. For example, you can see all troubleshooting attempts made to resolve a failed check for patient Jane Doe and track what you changed for each attempt.
- View the overall status of an eligibility check based on the highest-priority result. An eligibility search's status is based on the best outcome achieved across all retry attempts.
Eligibility searches are sorted by the date of the original eligibility check within the eligibility search, with the most recent listed first.
Filter
You can filter eligibility searches by the following criteria:
| Filter | Description |
|---|---|
| Error code | By the AAA code returned by the payer. For example, 42 errors indicate a connectivity issue. |
| Payer | By a Payer ID or alias in the Payer Network or a payer's business name (such as Cigna). |
| Status | By Active, Inactive, Investigate, and Failed. |
| Date | A date range for the submission of the initial eligibility check within a search. For example, a filter beginning on October 1st would only include eligibility searches with an initial submission on or after October 1st. It would not include an eligibility search with an initial submission on September 30th and a retry on October 1st. |
| Provider NPI | By the National Provider Identifier (NPI) of the requesting provider. |
Search statuses
The status of an eligibility search is determined by the highest-priority check among all checks in the search. Stedi uses the following priority order: Active → Inactive → Investigate → Failed. If multiple checks share the same priority status, the most recent check determines the search status.
Example: A search contains three sequential checks: first a Failed check, then an Active check, and finally another Failed check. The search status is Active because Active has the highest priority, even though it's not the most recent check.
This priority logic also applies to all search-level data displayed in the Eligibility searches view, including patient information, payer details, service type codes, and error metadata. All of this data comes from the highest-priority check, not necessarily the most recent check.
An eligibility search can have one of the following statuses:
| Status | Description |
|---|---|
| Active | The payer's response contains an active eligibility and benefit type. |
| Inactive | The payer's response doesn't contain an active eligibility and benefit type. |
| Investigate | The payer returned a response with errors that require investigation or additional action to resolve. |
| Failed | The payer returned an error code in the response. Review the error code and retry the eligibility check. |
Search details
Click any search to view its details, including the search overview and a complete history of all check attempts.
From a search detail page, you can view all individual checks within the search to see the progression of retry attempts. Click any check to see its full details, including benefits information (if present), and the raw request and response data.