The Batch Eligibility Check API from Stedi — 4 operation(s) for submitting and polling asynchronous batches of X12 270 eligibility checks.
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openapi: 3.2.0
info:
contact:
email: healthcare@stedi.com
license:
name: Proprietary
url: https://stedi.com
title: Stedi Manager Batch eligibility check API
version: '2024-04-01'
servers:
- description: Production
url: https://manager.us.stedi.com/2024-04-01
security:
- httpApiKeyAuth: []
tags:
- name: Batch eligibility check
paths:
/eligibility-manager/batch-eligibility:
post:
description: Submit multiple eligibility checks for Stedi to process asynchronously
externalDocs:
description: Developer guide
url: https://www.stedi.com/docs/healthcare/batch-refresh-eligibility-checks
operationId: BatchEligibilityChecks
parameters:
- in: header
name: X-Forwarded-For
schema:
description: '**(CMS requests only):** Starting November 8, 2025, the Centers for Medicare & Medicaid Services (CMS) requires submitters to include network IP addresses from an eligibility request''s point of origin through receipt by the HETS system. To comply with this requirement, you may need to include this header in requests to CMS.
When present, this header should contain a comma-separated list of upstream IP addresses, starting with the originating system and continuing through every intermediary. You can exclude your IP address from the list. Note that Stedi blocks eligibility requests to CMS when any IP address in the chain – the originating IP address or any in the X-Forwarded-For header – is located outside the United States.
Visit [CMS traceability requirements](https://www.stedi.com/docs/healthcare/batch-refresh-eligibility-checks#cms-traceability-requirements) for details and examples.'
type: string
requestBody:
content:
application/json:
examples:
BatchEligibilityChecks_example1:
description: ''
summary: Batch eligibility checks
value:
items:
- encounter:
serviceTypeCodes:
- MH
provider:
npi: '1234567891'
organizationName: ACME Health Services
submitterTransactionIdentifier: ABC123456789
subscriber:
dateOfBirth: '19750101'
firstName: Jane
lastName: Doe
memberId: '1234567890'
tradingPartnerServiceId: AHS
- encounter:
serviceTypeCodes:
- '78'
provider:
npi: '1234567891'
organizationName: ACME Health Services
submitterTransactionIdentifier: DEF123456799
subscriber:
dateOfBirth: '19750101'
firstName: John
lastName: Doe
memberId: '1234567892'
tradingPartnerServiceId: AHS
name: march-2024-eligibility-batch
schema:
$ref: '#/components/schemas/BatchEligibilityChecksRequestContent'
required: true
responses:
'200':
content:
application/json:
examples:
BatchEligibilityChecks_example1:
description: ''
summary: Batch eligibility checks
value:
batchId: 01928d19-df25-76c0-8d51-f5351260fa05
submittedAt: '2023-11-07T05:31:56Z'
schema:
$ref: '#/components/schemas/BatchEligibilityChecksResponseContent'
description: BatchEligibilityChecks 200 response
'400':
content:
application/json:
schema:
$ref: '#/components/schemas/ValidationExceptionResponseContent'
description: ValidationException 400 response
'401':
content:
application/json:
schema:
$ref: '#/components/schemas/UnauthorizedExceptionResponseContent'
description: UnauthorizedException 401 response
'403':
content:
application/json:
schema:
$ref: '#/components/schemas/AccessDeniedExceptionResponseContent'
description: AccessDeniedException 403 response
'404':
content:
application/json:
schema:
$ref: '#/components/schemas/ResourceNotFoundExceptionResponseContent'
description: ResourceNotFoundException 404 response
'409':
content:
application/json:
schema:
$ref: '#/components/schemas/ResourceConflictExceptionResponseContent'
description: ResourceConflictException 409 response
'500':
content:
application/json:
schema:
$ref: '#/components/schemas/InternalFailureExceptionResponseContent'
description: InternalFailureException 500 response
tags:
- Batch eligibility check
/eligibility-manager/batch/{batchId}:
get:
description: Retrieve the status of an eligibility check batch submitted through the API or CSV upload
externalDocs:
description: Developer guide
url: https://www.stedi.com/docs/healthcare/batch-refresh-eligibility-checks#retrieve-batch-results
operationId: GetBatch
parameters:
- description: The unique identifier for the batch. This is the `batchId` returned in the Batch Eligibility Check endpoint response. It's also listed as the **Batch ID** in the Stedi portal.
examples:
GetBatch_example1:
description: ''
summary: CSV Batch
value: 01976b18-6d90-71d1-b27b-2556a9fbf837
GetBatch_example2:
description: ''
summary: API Batch
value: 01976a49-05f4-7421-bc33-aed86f1fccc6
in: path
name: batchId
required: true
schema:
description: The unique identifier for the batch. This is the `batchId` returned in the Batch Eligibility Check endpoint response. It's also listed as the **Batch ID** in the Stedi portal.
type: string
responses:
'200':
content:
application/json:
examples:
GetBatch_example1:
description: ''
summary: CSV Batch
value:
batchType: ELIGIBILITY
createdAt: '2025-06-13T21:00:52.496Z'
errorCount: 5
id: 01976b18-6d90-71d1-b27b-2556a9fbf837
importUrl: https://s3.amazonaws.com/bucket/key
inProgressCount: 0
name: test_CSV_upload
source: CSV_IMPORT
status: COMPLETED_WITH_ERRORS
successCount: 245
totalCount: 250
updatedAt: '2025-06-16T15:59:20.312Z'
GetBatch_example2:
description: ''
summary: API Batch
value:
batchType: ELIGIBILITY
createdAt: '2025-06-13T17:14:20.02Z'
errorCount: 0
id: 01976a49-05f4-7421-bc33-aed86f1fccc6
inProgressCount: 0
name: 01976a49-05f4-7421-bc33-aed86f1fccc6
source: API
status: COMPLETED
successCount: 9000
totalCount: 9000
updatedAt: '2025-06-13T17:14:24.872Z'
validatedCount: 0
validationFailedCount: 0
schema:
$ref: '#/components/schemas/GetBatchResponseContent'
description: GetBatch 200 response
'400':
content:
application/json:
schema:
$ref: '#/components/schemas/ValidationExceptionResponseContent'
description: ValidationException 400 response
'401':
content:
application/json:
schema:
$ref: '#/components/schemas/UnauthorizedExceptionResponseContent'
description: UnauthorizedException 401 response
'403':
content:
application/json:
schema:
$ref: '#/components/schemas/AccessDeniedExceptionResponseContent'
description: AccessDeniedException 403 response
'404':
content:
application/json:
schema:
$ref: '#/components/schemas/ResourceNotFoundExceptionResponseContent'
description: ResourceNotFoundException 404 response
'500':
content:
application/json:
schema:
$ref: '#/components/schemas/InternalFailureExceptionResponseContent'
description: InternalFailureException 500 response
tags:
- Batch eligibility check
/eligibility-manager/batch/{batchId}/items:
get:
description: Retrieve status information for all eligibility checks within a batch, regardless of processing status
externalDocs:
description: Developer guide
url: https://www.stedi.com/docs/healthcare/batch-refresh-eligibility-checks#retrieve-batch-results
operationId: GetBatchItems
parameters:
- description: The unique identifier for the batch. This is the `batchId` returned in the Batch Eligibility Check endpoint response. It's also listed as the **Batch ID** in the Stedi portal.
examples:
GetBatchItems_example1:
description: ''
summary: Get Batch Items
value: 01932c61-2d4f-7d22-85fa-c7db2e13e771
in: path
name: batchId
required: true
schema:
description: The unique identifier for the batch. This is the `batchId` returned in the Batch Eligibility Check endpoint response. It's also listed as the **Batch ID** in the Stedi portal.
type: string
- description: The maximum number of elements to return in a page. If not specified, the default is 100.
in: query
name: pageSize
schema:
description: The maximum number of elements to return in a page. If not specified, the default is 100.
maximum: 1000
minimum: 1
type: integer
- description: A token returned by a previous call to this operation in the `nextPageToken` property. If not specified, Stedi returns the first page of results.
in: query
name: pageToken
schema:
description: A token returned by a previous call to this operation in the `nextPageToken` property. If not specified, Stedi returns the first page of results.
maxLength: 1024
minLength: 1
type: string
- description: "Filter for batch items in the specified states. Can be set to one or more of the following states:\n - `PENDING`: Stedi hasn't begun processing the eligibility check.\n - `VALIDATED`: Stedi finished validating the eligibility check and is ready to execute it.\n - `VALIDATION_FAILED`: Stedi found errors in the eligibility check that you need to fix before processing can continue.\n - `STARTED`: Stedi has begun processing the eligibility check.\n - `RETRYING`: Stedi is retrying the eligibility check. Stedi retries eligibility checks that fail due to payer connectivity issues for up to 8 hours.\n - `COMPLETED`: Stedi successfully processed the eligibility check and received a response from the payer. This doesn't indicate that the payer has active coverage, only that Stedi was able to get a response.\n - `COMPLETED_WITH_ERRORS`: Stedi finished processing the eligibility check, but couldn't get a response from the payer."
explode: true
in: query
name: state
schema:
description: "Filter for batch items in the specified states. Can be set to one or more of the following states:\n - `PENDING`: Stedi hasn't begun processing the eligibility check.\n - `VALIDATED`: Stedi finished validating the eligibility check and is ready to execute it.\n - `VALIDATION_FAILED`: Stedi found errors in the eligibility check that you need to fix before processing can continue.\n - `STARTED`: Stedi has begun processing the eligibility check.\n - `RETRYING`: Stedi is retrying the eligibility check. Stedi retries eligibility checks that fail due to payer connectivity issues for up to 8 hours.\n - `COMPLETED`: Stedi successfully processed the eligibility check and received a response from the payer. This doesn't indicate that the payer has active coverage, only that Stedi was able to get a response.\n - `COMPLETED_WITH_ERRORS`: Stedi finished processing the eligibility check, but couldn't get a response from the payer."
items:
$ref: '#/components/schemas/BatchItemState'
type: array
style: form
- description: "Filter for batch items with the specified eligibility check results. Can be set to one or more of the following results:\n - `ACTIVE`: The payer's response contains an active eligibility and benefit type. Visit [Eligibility and benefit type codes](https://www.stedi.com/docs/healthcare/supported-features/eligibility-and-benefit-type-codes) for a complete list of valid code values.\n - `INACTIVE`: The payer's response doesn't contain an active eligibility and benefit type.\n - `INVESTIGATE`: The payer returned an unexpected eligibility or benefit type code. Review the response and contact the payer if you have questions.\n - `FAILED`: The payer returned an error code in the response. Review the error code and retry the eligibility check."
explode: true
in: query
name: eligibilityCheckResult
schema:
description: "Filter for batch items with the specified eligibility check results. Can be set to one or more of the following results:\n - `ACTIVE`: The payer's response contains an active eligibility and benefit type. Visit [Eligibility and benefit type codes](https://www.stedi.com/docs/healthcare/supported-features/eligibility-and-benefit-type-codes) for a complete list of valid code values.\n - `INACTIVE`: The payer's response doesn't contain an active eligibility and benefit type.\n - `INVESTIGATE`: The payer returned an unexpected eligibility or benefit type code. Review the response and contact the payer if you have questions.\n - `FAILED`: The payer returned an error code in the response. Review the error code and retry the eligibility check."
items:
$ref: '#/components/schemas/EligibilityCheckResult'
type: array
style: form
responses:
'200':
content:
application/json:
examples:
GetBatchItems_example1:
description: ''
summary: Get Batch Items
value:
items:
- additionalInfo:
eligibility:
eligibilityCheckResult: ACTIVE
eligibilitySearchId: 01932c61-2d4f-7d22-85fa-c7db2e13e771
payerId: BCBS
submitterTransactionIdentifier: ABC123456789
subscriberFirstName: John
subscriberLastName: Doe
subscriberMemberId: '123456789'
batchId: 01932c61-2d4f-7d22-85fa-c7db2e13e771
createdAt: '2025-03-31T14:25:30Z'
requestId: req-01a2b3c4-d5e6-7f89-0123-456789abcdef
rowNumber: 1
state: COMPLETED
updatedAt: '2025-03-31T14:26:45Z'
- additionalInfo:
eligibility:
eligibilityCheckResult: FAILED
eligibilitySearchId: 01932c61-2d4f-7d22-85fa-c7db2e13e772
payerId: AETNA
submitterTransactionIdentifier: GHJ987654321
subscriberFirstName: Jane
subscriberLastName: Smith
subscriberMemberId: '987654321'
batchId: 01932c61-2d4f-7d22-85fa-c7db2e13e771
createdAt: '2025-03-31T14:25:30Z'
requestId: req-02a2b3c4-d5e6-7f89-0123-456789abcdef
rowNumber: 2
state: COMPLETED_WITH_ERRORS
updatedAt: '2025-03-31T14:27:15Z'
nextPageToken: 945ff6de213d3ef481d028065d4c12fb996a166a3a90ef98564318decfae50ce4b36d74b7e9d9bafa6e1d169
schema:
$ref: '#/components/schemas/GetBatchItemsResponseContent'
description: GetBatchItems 200 response
'400':
content:
application/json:
schema:
$ref: '#/components/schemas/ValidationExceptionResponseContent'
description: ValidationException 400 response
'401':
content:
application/json:
schema:
$ref: '#/components/schemas/UnauthorizedExceptionResponseContent'
description: UnauthorizedException 401 response
'403':
content:
application/json:
schema:
$ref: '#/components/schemas/AccessDeniedExceptionResponseContent'
description: AccessDeniedException 403 response
'404':
content:
application/json:
schema:
$ref: '#/components/schemas/ResourceNotFoundExceptionResponseContent'
description: ResourceNotFoundException 404 response
'500':
content:
application/json:
schema:
$ref: '#/components/schemas/InternalFailureExceptionResponseContent'
description: InternalFailureException 500 response
tags:
- Batch eligibility check
/eligibility-manager/polling/batch-eligibility:
get:
description: Retrieve batch eligibility check results
externalDocs:
description: Developer guide
url: https://www.stedi.com/docs/healthcare/batch-refresh-eligibility-checks#retrieve-batch-results
operationId: BatchEligibilityPolling
parameters:
- description: "The maximum number of check results to return in a page - each check is represented as one item in the `items` array. If not specified, the default is 10.\n - If you set the page size to a value > 20, Stedi returns the requested batch check results in `gzip` format to reduce the size. Many common HTTP clients accept `gzip` by default, but if not, you must add the `Accept-Encoding: gzip` header to your request and resubmit.\n - When check results are especially large, Stedi may return fewer than the requested number per page. In these cases, you can use the `nextPageToken` property to retrieve the rest of the requested results."
in: query
name: pageSize
schema:
description: "The maximum number of check results to return in a page - each check is represented as one item in the `items` array. If not specified, the default is 10.\n - If you set the page size to a value > 20, Stedi returns the requested batch check results in `gzip` format to reduce the size. Many common HTTP clients accept `gzip` by default, but if not, you must add the `Accept-Encoding: gzip` header to your request and resubmit.\n - When check results are especially large, Stedi may return fewer than the requested number per page. In these cases, you can use the `nextPageToken` property to retrieve the rest of the requested results."
maximum: 200
minimum: 1
type: integer
- description: A token returned by a previous call to this operation in the `nextPageToken` property. If not specified, Stedi returns the first page of results.
in: query
name: pageToken
schema:
description: A token returned by a previous call to this operation in the `nextPageToken` property. If not specified, Stedi returns the first page of results.
maxLength: 1024
minLength: 1
type: string
- description: An identifier for a batch of eligibility checks submitted through the [Batch Eligibility Check](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-batch-eligibility) endpoint. Use this to retrieve results for eligibility checks in the batch.
examples:
BatchEligibilityPolling_example1:
description: ''
summary: Poll for results
value: 01932c61-2d4f-7d22-85fa-c7db2e13e771
in: query
name: batchId
schema:
description: An identifier for a batch of eligibility checks submitted through the [Batch Eligibility Check](https://www.stedi.com/docs/healthcare/api-reference/post-healthcare-batch-eligibility) endpoint. Use this to retrieve results for eligibility checks in the batch.
type: string
- description: An ISO 8601 formatted string. For example `2023-08-28T00:00:00Z`. Stedi returns asynchronous eligibility checks that have completed processing after this time. Completed means that the payer has successfully returned a benefits response, the check has failed due to errors in the request, or that the payer has been unavailable for 8 hours and Stedi will no longer attempt to retry.
in: query
name: startDateTime
schema:
description: An ISO 8601 formatted string. For example `2023-08-28T00:00:00Z`. Stedi returns asynchronous eligibility checks that have completed processing after this time. Completed means that the payer has successfully returned a benefits response, the check has failed due to errors in the request, or that the payer has been unavailable for 8 hours and Stedi will no longer attempt to retry.
format: date-time
type: string
responses:
'200':
content:
application/json:
examples:
BatchEligibilityPolling_example1:
description: ''
summary: Poll for results
value:
items:
- batchId: 01932c61-2d4f-7d22-85fa-c7db2e13e771
controlNumber: '000022222'
eligibilitySearchId: 06956c88-a177-5252-b868-ju4974dd54gh
errors:
- code: '79'
description: Invalid Participant Identification
followupAction: Please Correct and Resubmit
location: 2100A
possibleResolutions: Payer TEST is not configured. Please check our published payer list or contact Stedi support to resolve.
id: ec_750e8400-e29b-41d4-a716-446655440002
meta:
outboundTraceId: 01JCP62EYY1N6PZABF9Q45EN5Y
status: ERROR
submitterTransactionIdentifier: ABC123456789
tradingPartnerServiceId: TEST
- batchId: 01932c61-2d4f-7d22-85fa-c7db2e13e771
benefitsInformation:
- additionalInformation:
- description: Complete Care Management
code: '1'
name: Active Coverage
planCoverage: Open Access Plus
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
- additionalInformation:
- description: Includes services provided by Client Specific Network
- description: Coinsurance does apply to member's out-of-pocket maximum
- description: Copay does apply to member's out-of-pocket maximum
- description: Deductible does apply to member's out-of-pocket maximum
benefitAmount: '6000'
code: G
coverageLevel: Family
coverageLevelCode: FAM
inPlanNetworkIndicator: 'Yes'
inPlanNetworkIndicatorCode: Y
name: Out of Pocket (Stop Loss)
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
timeQualifier: Calendar Year
timeQualifierCode: '23'
- additionalInformation:
- description: Includes services provided by Client Specific Network
benefitAmount: '500'
code: C
coverageLevel: Family
coverageLevelCode: FAM
inPlanNetworkIndicator: 'Yes'
inPlanNetworkIndicatorCode: Y
name: Deductible
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
timeQualifier: Calendar Year
timeQualifierCode: '23'
- additionalInformation:
- description: Includes services provided by Client Specific Network
- description: Copay does apply to member's out-of-pocket maximum
- description: Coinsurance does apply to member's out-of-pocket maximum
- description: Deductible does apply to member's out-of-pocket maximum
benefitAmount: '3000'
code: G
coverageLevel: Individual
coverageLevelCode: IND
inPlanNetworkIndicator: 'Yes'
inPlanNetworkIndicatorCode: Y
name: Out of Pocket (Stop Loss)
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
timeQualifier: Calendar Year
timeQualifierCode: '23'
- additionalInformation:
- description: Includes services provided by Client Specific Network
benefitAmount: '250'
code: C
coverageLevel: Individual
coverageLevelCode: IND
inPlanNetworkIndicator: 'Yes'
inPlanNetworkIndicatorCode: Y
name: Deductible
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
timeQualifier: Calendar Year
timeQualifierCode: '23'
- benefitAmount: '15000'
code: C
coverageLevel: Family
coverageLevelCode: FAM
inPlanNetworkIndicator: 'No'
inPlanNetworkIndicatorCode: N
name: Deductible
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
timeQualifier: Calendar Year
timeQualifierCode: '23'
- additionalInformation:
- description: Coinsurance does apply to member's out-of-pocket maximum
- description: Deductible does apply to member's out-of-pocket maximum
benefitAmount: '30000'
code: G
coverageLevel: Family
coverageLevelCode: FAM
inPlanNetworkIndicator: 'No'
inPlanNetworkIndicatorCode: N
name: Out of Pocket (Stop Loss)
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
timeQualifier: Calendar Year
timeQualifierCode: '23'
- benefitPercent: '0.1'
code: A
coverageLevel: Individual
coverageLevelCode: IND
inPlanNetworkIndicator: 'Yes'
inPlanNetworkIndicatorCode: Y
name: Co-Insurance
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
- benefitAmount: '7500'
code: C
coverageLevel: Individual
coverageLevelCode: IND
inPlanNetworkIndicator: 'No'
inPlanNetworkIndicatorCode: N
name: Deductible
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
timeQualifier: Calendar Year
timeQualifierCode: '23'
- additionalInformation:
- description: Deductible does apply to member's out-of-pocket maximum
- description: Coinsurance does apply to member's out-of-pocket maximum
benefitAmount: '15000'
code: G
coverageLevel: Individual
coverageLevelCode: IND
inPlanNetworkIndicator: 'No'
inPlanNetworkIndicatorCode: N
name: Out of Pocket (Stop Loss)
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
timeQualifier: Calendar Year
timeQualifierCode: '23'
- benefitPercent: '0.5'
code: A
coverageLevel: Individual
coverageLevelCode: IND
inPlanNetworkIndicator: 'No'
inPlanNetworkIndicatorCode: N
name: Co-Insurance
serviceTypeCodes:
- '30'
serviceTypes:
- Health Benefit Plan Coverage
- code: '1'
inPlanNetworkIndicator: Not Applicable
inPlanNetworkIndicatorCode: W
name: Active Coverage
serviceTypeCodes:
- A7
- BC
- A8
- A4
- A5
- A6
- '7'
- '4'
- BB
- '22'
serviceTypes:
- Psychiatric - Inpatient
- Day Care (Psychiatric)
- Psychiatric - Outpatient
- Psychiatric
- Psychiatric - Room and Board
- Psychotherapy
- Anesthesia
- Diagnostic X-Ray
- Partial Hospitalization (Psychiatric)
- Social Work
- additionalInformation:
- description: Includes services provided by Client Specific Network
authOrCertIndicator: N
benefitAmount: '0'
code: C
co
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# Full source: https://raw.githubusercontent.com/api-evangelist/stedi/refs/heads/main/openapi/stedi-batch-eligibility-check-api-openapi.yml