Stedi integration

Check Eligibility (270/271)

Perform Check Eligibility (270/271) through Stedi.

View as Markdown

stedi_check_eligibility

writestedi

Inputs

enabled
boolean
Enabled
Optional true-or-false value.
Default: true
payer_id
expressionrequired
Payer Id
Required literal value or workflow expression.
member_id
expression
Member Id
Optional literal value or workflow expression.
first_name
expression
First Name
Optional literal value or workflow expression.
last_name
expression
Last Name
Optional literal value or workflow expression.
date_of_birth
expression
Date Of Birth
Optional literal value or workflow expression.
dependent_first_name
expression
Dependent First Name
Optional literal value or workflow expression.
dependent_last_name
expression
Dependent Last Name
Optional literal value or workflow expression.
dependent_date_of_birth
expression
Dependent Date Of Birth
Optional literal value or workflow expression.
dependent_gender
expression
Dependent Gender
Optional literal value or workflow expression.
dependent_ssn
expression
Dependent Ssn
Optional literal value or workflow expression.
dependent_group_number
expression
Dependent Group Number
Optional literal value or workflow expression.
dependent_address1
expression
Dependent Address1
Optional literal value or workflow expression.
dependent_city
expression
Dependent City
Optional literal value or workflow expression.
dependent_state
expression
Dependent State
Optional literal value or workflow expression.
dependent_postal_code
expression
Dependent Postal Code
Optional literal value or workflow expression.
provider_npi
expression
Provider Npi
Optional literal value or workflow expression.
provider_organization_name
expression
Provider Organization Name
Optional literal value or workflow expression.
service_start_date
expression
Service Start Date
Optional literal value or workflow expression.
service_end_date
expression
Service End Date
Optional literal value or workflow expression.
service_type_codes
expression
Service Type Codes
Optional literal value or workflow expression.
skip_reason
expression
Skip Reason
Optional literal value or workflow expression.

Outputs

successSuccess
statusStatus
stedi_statusStedi Status
eligibility_check_idEligibility Check Id
warning_countWarning Count
warningsWarnings
is_eligibleIs Eligible
payer_namePayer Name
payer_idPayer Id
trading_partner_service_idTrading Partner Service Id
plan_namePlan Name
plan_numberPlan Number
group_numberGroup Number
plan_coverage_startPlan Coverage Start
plan_coverage_endPlan Coverage End
coverage_startCoverage Start
coverage_endCoverage End
insurance_typesInsurance Types
plan_coverage_descriptionsPlan Coverage Descriptions
benefit_codesBenefit Codes
related_entitiesRelated Entities
payer_errorsPayer Errors
retryableRetryable
errorError
skippedSkipped
skip_reasonSkip Reason

Output schema completeness: best_effort_declared

Safety

External effect: write
Confirmation recommended: No
Retry safe: No
Dry run supported: No

Schemas

These schemas are first-pass authoring guidance. Runtime validation remains authoritative.

Input schema

{
  "type": "object",
  "required": [
    "payer_id"
  ],
  "properties": {
    "enabled": {
      "type": "boolean",
      "default": true,
      "description": "Optional true-or-false value.",
      "x-workflow-field-type": "boolean"
    },
    "payer_id": {
      "description": "Required literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "last_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "member_id": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "first_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "skip_reason": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "provider_npi": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "date_of_birth": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_ssn": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_city": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_state": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_gender": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_end_date": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_address1": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_start_date": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "service_type_codes": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_last_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_first_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_postal_code": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_group_number": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "dependent_date_of_birth": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    },
    "provider_organization_name": {
      "description": "Optional literal value or workflow expression.",
      "x-workflow-field-type": "expression"
    }
  },
  "additionalProperties": false
}

Output schema

{
  "type": "object",
  "properties": {
    "error": {},
    "status": {},
    "skipped": {},
    "success": {},
    "payer_id": {},
    "warnings": {},
    "plan_name": {},
    "retryable": {},
    "payer_name": {},
    "is_eligible": {},
    "plan_number": {},
    "skip_reason": {},
    "coverage_end": {},
    "group_number": {},
    "payer_errors": {},
    "stedi_status": {},
    "benefit_codes": {},
    "warning_count": {},
    "coverage_start": {},
    "insurance_types": {},
    "related_entities": {},
    "plan_coverage_end": {},
    "plan_coverage_start": {},
    "eligibility_check_id": {},
    "plan_coverage_descriptions": {},
    "trading_partner_service_id": {}
  },
  "additionalProperties": true
}

View all Stedi actions