The Payers API from Stedi — 4 operation(s) for payers.
components:
schemas:
AccessDeniedExceptionResponseContent:
description: The server response for authorization failure.
properties:
code:
description: Error classification code
type: string
message:
description: Human-readable error message
type: string
required:
- message
type: object
ClaimPaymentEnrollmentProcess:
description: Details about the enrollment process for Electronic Remittance Advice (ERAs).
properties:
requestedEffectiveDate:
$ref: '#/components/schemas/RequestedEffectiveDate'
description: "Whether this payer supports specifying a requested effective date for transaction enrollments.\n\
\ - If set to `SUPPORTED`, Stedi will process [transaction enrollment requests](https://www.stedi.com/docs/healthcare/api-reference/post-enrollment-create-enrollment)\
\ for this payer according to their specified `requestedEffectiveDate`.\n - This property is only returned\
\ when Stedi can determine whether the payer supports requested effective dates."
supportedAggregationPreferences:
description: "Aggregation types this payer supports for 835 Electronic Remittance Advice (ERA) transactions.\
\ Payers can aggregate by the provider's NPI, tax ID (TIN), or both.\n - You can use this information\
\ to specify an `aggregationPreference` when submitting ERA enrollment requests.\n - This property\
\ is only returned when Stedi can determine the payer's supported aggregation types."
items:
$ref: '#/components/schemas/SupportedAggregationType'
type: array
timeframe:
$ref: '#/components/schemas/EnrollmentProcessTimeframe'
type:
$ref: '#/components/schemas/EnrollmentProcessType'
type: object
ClaimStatusInquiryEnrollmentProcess:
description: Details about the enrollment process for real-time claim status requests.
properties:
requestedEffectiveDate:
$ref: '#/components/schemas/RequestedEffectiveDate'
description: "Whether this payer supports specifying a requested effective date for transaction enrollments.\n\
\ - If set to `SUPPORTED`, Stedi will process [transaction enrollment requests](https://www.stedi.com/docs/healthcare/api-reference/post-enrollment-create-enrollment)\
\ for this payer according to their specified `requestedEffectiveDate`.\n - This property is only returned\
\ when Stedi can determine whether the payer supports requested effective dates."
timeframe:
$ref: '#/components/schemas/EnrollmentProcessTimeframe'
type:
$ref: '#/components/schemas/EnrollmentProcessType'
type: object
CoordinationOfBenefitsEnrollmentProcess:
description: Details about the enrollment process for coordination of benefits (COB) checks.
properties:
requestedEffectiveDate:
$ref: '#/components/schemas/RequestedEffectiveDate'
description: "Whether this payer supports specifying a requested effective date for transaction enrollments.\n\
\ - If set to `SUPPORTED`, Stedi will process [transaction enrollment requests](https://www.stedi.com/docs/healthcare/api-reference/post-enrollment-create-enrollment)\
\ for this payer according to their specified `requestedEffectiveDate`.\n - This property is only returned\
\ when Stedi can determine whether the payer supports requested effective dates."
timeframe:
$ref: '#/components/schemas/EnrollmentProcessTimeframe'
type:
$ref: '#/components/schemas/EnrollmentProcessType'
type: object
CoverageType:
description: The types of insurance coverage that a payer can provide. Used to indicate whether a payer supports
transactions for medical coverage, dental coverage, vision coverage, or a combination of these.
enum:
- medical
- dental
- vision
type: string
DentalClaimEnrollmentProcess:
description: Details about the enrollment process for dental claim submission.
properties:
requestedEffectiveDate:
$ref: '#/components/schemas/RequestedEffectiveDate'
description: "Whether this payer supports specifying a requested effective date for transaction enrollments.\n\
\ - If set to `SUPPORTED`, Stedi will process [transaction enrollment requests](https://www.stedi.com/docs/healthcare/api-reference/post-enrollment-create-enrollment)\
\ for this payer according to their specified `requestedEffectiveDate`.\n - This property is only returned\
\ when Stedi can determine whether the payer supports requested effective dates."
timeframe:
$ref: '#/components/schemas/EnrollmentProcessTimeframe'
type:
$ref: '#/components/schemas/EnrollmentProcessType'
type: object
EligibilityInquiryEnrollmentProcess:
description: Details about the enrollment process for eligibility checks.
properties:
requestedEffectiveDate:
$ref: '#/components/schemas/RequestedEffectiveDate'
description: "Whether this payer supports specifying a requested effective date for transaction enrollments.\n\
\ - If set to `SUPPORTED`, Stedi will process [transaction enrollment requests](https://www.stedi.com/docs/healthcare/api-reference/post-enrollment-create-enrollment)\
\ for this payer according to their specified `requestedEffectiveDate`.\n - This property is only returned\
\ when Stedi can determine whether the payer supports requested effective dates."
timeframe:
$ref: '#/components/schemas/EnrollmentProcessTimeframe'
type:
$ref: '#/components/schemas/EnrollmentProcessType'
type: object
EnrollmentInfo:
description: Information about enrollment requirements for the payer
properties:
ptanRequired:
description: 'Whether a PTAN (Provider Transaction Access Number) is required for transaction enrollment.
The Provider Transaction Access Number (PTAN) is a Medicare-issued number given to providers upon enrollment
with Medicare. This number is usually six digits and is assigned based on the type of service and the
location of the provider. Upon enrollment, Medicare Administrating Contracting (MAC) providers should
receive their assigned PTAN number in their approval letter.'
type: boolean
transactionEnrollmentProcesses:
$ref: '#/components/schemas/TransactionEnrollmentProcesses'
description: 'Enrollment details for specific transaction types.
Stedi only returns this object when information about the enrollment process is available for one or
more transaction types. When this object isn''t included in the response, it **doesn''t** mean no transaction
types require enrollment. Refer to the `transactionSupport` object for details about which transaction
types require enrollment.'
type: object
EnrollmentProcessTimeframe:
description: Stedi's expected timeframe for completing the transaction enrollment process. `INSTANT` indicates
that the enrollment will be in `LIVE` status within minutes of submitting the request.
enum:
- INSTANT
- HOURS
- DAYS
- WEEKS
type: string
EnrollmentProcessType:
description: "Whether transaction enrollment is single or multi-step.\n - `ONE_CLICK` indicates that once\
\ you submit the transaction enrollment request, Stedi can complete the rest of the enrollment process without\
\ any further action from you.\n - `MULTI_STEP` indicates that you must complete additional steps to finish\
\ the enrollment process. Customer support will reach out with clear instructions explaining how to complete\
\ any remaining steps."
enum:
- ONE_CLICK
- MULTI_STEP
type: string
GatewayTimeoutExceptionResponseContent:
description: The server response for a gateway timeout error.
properties:
code:
description: Classification of the exception type.
type: string
message:
description: Human readable exception message.
type: string
required:
- message
type: object
GetPayerRecordResponseContent:
properties:
payer:
$ref: '#/components/schemas/PayerRecord'
description: The payer record matching the provided Stedi payer ID. The record includes the payer's display
name and aliases as well as supported transaction types and details about the payer's [transaction enrollment](https://www.stedi.com/docs/healthcare/transaction-enrollment)
process.
required:
- payer
type: object
InstitutionalClaimEnrollmentProcess:
description: Details about the enrollment process for institutional claim submission.
properties:
requestedEffectiveDate:
$ref: '#/components/schemas/RequestedEffectiveDate'
description: "Whether this payer supports specifying a requested effective date for transaction enrollments.\n\
\ - If set to `SUPPORTED`, Stedi will process [transaction enrollment requests](https://www.stedi.com/docs/healthcare/api-reference/post-enrollment-create-enrollment)\
\ for this payer according to their specified `requestedEffectiveDate`.\n - This property is only returned\
\ when Stedi can determine whether the payer supports requested effective dates."
timeframe:
$ref: '#/components/schemas/EnrollmentProcessTimeframe'
type:
$ref: '#/components/schemas/EnrollmentProcessType'
type: object
InternalFailureExceptionResponseContent:
description: The server response when an unexpected error occurred while processing request.
properties:
code:
description: Error classification code
type: string
message:
description: Human-readable error message
type: string
required:
- message
type: object
ListPayerRecordsCsvOutputPayload:
description: 'All supported payer records in CSV format. The first row contains the header with field names,
and subsequent rows contain the payer data.
To render this data as a CSV file, you must save it to a file with a `.csv` extension.'
type: string
ListPayerRecordsResponseContent:
description: Common output structure for list operations with pagination support.
properties:
items:
description: Payers that Stedi supports for each transaction type. Results are returned in alphabetical
order of the Stedi ID.
items:
$ref: '#/components/schemas/PayerRecord'
type: array
nextPageToken:
description: Token that you can supply in subsequent requests to retrieve the next page of results. If
not returned, there are no more results.
maxLength: 1024
minLength: 1
type: string
required:
- items
type: object
Matches:
description: 'Shows which properties in the payer record match the search query. This information helps you
understand why Stedi returned this payer and which parts of the payer record matched the search terms. It''s
also especially useful for debugging search queries and building user interfaces that display matching text.
- Matching text is wrapped in `<b>` HTML tags for highlighting.
- This object only contains properties with matching text. For example, if none of the payer''s aliases
matched the search query, this object will not include the `aliases` property.'
properties:
aliases:
description: 'The parts of the payer''s aliases that match the search query. Each alias that contains
matching text is included as a separate entry, with matching portions wrapped in `<b>` tags. For example,
searching for `XYZ` might return: [`<b>XYZ</b>123`, `ABC<b>XYZ</b>`].'
items:
type: string
type: array
displayName:
description: 'The part of the payer''s display name that matched the search query. For example, searching
for `Blue` might return: `Blue Cross <b>Blue</b> Shield`.'
type: string
names:
description: 'The parts of the payer''s other names that match the search query. Each name that contains
matching text is included as a separate entry, with matching portions wrapped in `<b>` tags. For example,
searching for `Health` might return: [`Community <b>Health</b> Plan`, `<b>Health</b> Partners`].'
items:
type: string
type: array
primaryPayerId:
description: 'The part of the primary payer ID that matched the search query. For example, if you search
for ''12345'', the results for a payer with primary payer ID `12345ABC` would return: `<b>12345</b>ABC`.'
type: string
stediId:
description: 'The part of the payer''s Stedi payer ID that matched the search query. Stedi payer IDs only
support exact substring matching (no prefix or fuzzy matching). For example, if you search for `KRP`,
the results for a payer with Stedi payer ID ''KRPCH'' would be: `<b>KRP</b>CH`.'
type: string
type: object
NotSupportedBreakdown:
properties:
total:
description: Total number of matching payers that don't support this transaction type.
minimum: 0
type: integer
required:
- total
type: object
OperatingStateCode:
description: US state codes, territories, or `NATIONAL` indicating the geographic regions where a payer operates.
When set to `NATIONAL`, the payer operates throughout the entire United States.
enum:
- AL
- AK
- AZ
- AR
- CA
- CO
- CT
- DE
- FL
- GA
- HI
- ID
- IL
- IN
- IA
- KS
- KY
- LA
- ME
- MD
- MA
- MI
- MN
- MS
- MO
- MT
- NE
- NV
- NH
- NJ
- NM
- NY
- NC
- ND
- OH
- OK
- OR
- PA
- RI
- SC
- SD
- TN
- TX
- UT
- VT
- VA
- WA
- WV
- WI
- WY
- DC
- PR
- VI
- GU
- AS
- MP
- NATIONAL
type: string
PayerRecord:
properties:
aliases:
description: Alternative IDs associated with a payer. If a payer changes their `primaryPayerId`, aliases
allow you to continue sending transactions to the payer using the old ID uninterrupted.
items:
type: string
type: array
avatarUrl:
description: 'A URL pointing to an image file (`.png`, `.jpeg`, or `.jpg`) with the payer''s logo. This
is the same logo Stedi displays in the [Payer Network](https://www.stedi.com/healthcare/network). You
can use this property to display payer logos in your system or application.
This property is only returned when a payer logo is available.'
type: string
coverageTypes:
description: 'A list of insurance coverage types that indicates whether this payer supports transactions
for medical coverage, dental coverage, vision coverage, or a combination of these. For example: `["medical"]`
or `["medical", "dental"]`.
When this array isn''t in the response, it means Stedi hasn''t classified the payer''s coverage types
yet, **not** that the payer doesn''t support any coverage types.'
items:
$ref: '#/components/schemas/CoverageType'
type: array
displayName:
description: The payer's business name, such as Cigna or Aetna. This is the name most commonly used to
identify the payer.
type: string
employerIdentificationNumbers:
description: Employer Identification Numbers (EINs) associated with this payer.
items:
description: A valid Employer Identification Number (EIN) in the format XX-XXXXXXX
pattern: ^[0-9]{2}-[0-9]{7}$
type: string
type: array
enrollment:
$ref: '#/components/schemas/EnrollmentInfo'
description: Details about the [transaction enrollment process](https://www.stedi.com/docs/healthcare/transaction-enrollment)
for this payer, if available. This object may not be returned for some payers.
names:
description: Alternative names associated with a payer. These additional names help you search for and
identify payers using the name most familiar to your organization.
items:
type: string
type: array
operatingStates:
description: 'A list of US state codes, territories, or `NATIONAL` that indicates the geographic regions
where this payer operates. For example: `["CA", "OR"]` for a regional payer, or `["NATIONAL"]` for a
payer that operates throughout the entire United States.
When this array isn''t in the response, it means Stedi hasn''t classified the payer''s operating states
yet.'
items:
$ref: '#/components/schemas/OperatingStateCode'
type: array
parentPayerGroupId:
description: The payer's parent payer group entity. This is metadata Stedi uses internally. It doesn't
necessarily relate to the payer's enrollment process or other capabilities.
type: string
primaryPayerId:
description: The most commonly used ID for a payer. This value often corresponds to the name the payer
uses internally and provides to patients on member ID cards.
type: string
stediId:
description: A unique ID that Stedi assigned to this payer and uses internally for routing requests. This
ID will not change even if the `primaryPayerId` is updated.
type: string
transactionSupport:
$ref: '#/components/schemas/TransactionSupport'
urls:
$ref: '#/components/schemas/PayerUrls'
description: URLs associated with this payer, such as their website. This object is only returned when
URL information is available for the payer.
required:
- aliases
- displayName
- names
- primaryPayerId
- stediId
- transactionSupport
type: object
PayerUrls:
description: URLs associated with a payer.
properties:
website:
description: The payer's website URL.
type: string
type: object
ProfessionalClaimEnrollmentProcess:
description: Details about the enrollment process for professional claim submission.
properties:
requestedEffectiveDate:
$ref: '#/components/schemas/RequestedEffectiveDate'
description: "Whether this payer supports specifying a requested effective date for transaction enrollments.\n\
\ - If set to `SUPPORTED`, Stedi will process [transaction enrollment requests](https://www.stedi.com/docs/healthcare/api-reference/post-enrollment-create-enrollment)\
\ for this payer according to their specified `requestedEffectiveDate`.\n - This property is only returned\
\ when Stedi can determine whether the payer supports requested effective dates."
timeframe:
$ref: '#/components/schemas/EnrollmentProcessTimeframe'
type:
$ref: '#/components/schemas/EnrollmentProcessType'
type: object
RequestedEffectiveDate:
description: Whether a payer supports specifying a requested effective date for transaction enrollments.
enum:
- SUPPORTED
- NOT_SUPPORTED
type: string
ResourceNotFoundExceptionResponseContent:
description: The server response when the specified resource cannot be found after an API request passes authentication
and authorization.
properties:
code:
description: Error classification code
type: string
message:
description: Human-readable error message
type: string
required:
- message
type: object
SearchPayerRecord:
properties:
aliases:
description: Alternative IDs associated with a payer. If a payer changes their `primaryPayerId`, aliases
allow you to continue sending transactions to the payer using the old ID uninterrupted.
items:
type: string
type: array
avatarUrl:
description: 'A URL pointing to an image file (`.png`, `.jpeg`, or `.jpg`) with the payer''s logo. This
is the same logo Stedi displays in the [Payer Network](https://www.stedi.com/healthcare/network). You
can use this property to display payer logos in your system or application.
This property is only returned when a payer logo is available.'
type: string
coverageTypes:
description: 'A list of insurance coverage types that indicates whether this payer supports transactions
for medical coverage, dental coverage, vision coverage, or a combination of these. For example: `["medical"]`
or `["medical", "dental", "vision"]`.
When this array isn''t in the response, it means Stedi hasn''t classified the payer''s coverage types
yet, **not** that the payer doesn''t support any coverage types.'
items:
$ref: '#/components/schemas/CoverageType'
type: array
displayName:
description: The payer's business name, such as Cigna or Aetna. This is the name most commonly used to
identify the payer.
type: string
employerIdentificationNumbers:
description: Employer Identification Numbers (EINs) associated with this payer.
items:
description: A valid Employer Identification Number (EIN) in the format XX-XXXXXXX
pattern: ^[0-9]{2}-[0-9]{7}$
type: string
type: array
enrollment:
$ref: '#/components/schemas/EnrollmentInfo'
description: Information about the [transaction enrollment process](https://www.stedi.com/docs/healthcare/transaction-enrollment)
for this payer.
names:
description: Alternative names associated with a payer. These additional names help you search for and
identify payers using the name most familiar to your organization.
items:
type: string
type: array
operatingStates:
description: 'A list of US state codes, territories, or `NATIONAL` that indicates the geographic regions
where this payer operates. For example: `["CA", "OR"]` for a regional payer, or `["NATIONAL"]` for a
payer that operates throughout the entire United States.
When this array isn''t in the response, it means Stedi hasn''t classified the payer''s operating states
yet.'
items:
$ref: '#/components/schemas/OperatingStateCode'
type: array
parentPayerGroupId:
description: The parent payer group entity this payer belongs to. This is for metadata purposes and doesn't
necessarily relate to the payer's enrollment process or other capabilities.
type: string
primaryPayerId:
description: The most commonly used ID for a payer. This value often corresponds to the name the payer
uses internally and provides to patients on member ID cards.
type: string
stediId:
description: A unique ID that Stedi assigned to this payer and uses internally for routing requests. This
ID will not change even if the `primaryPayerId` is updated.
type: string
transactionSupport:
$ref: '#/components/schemas/SearchPayerTransactionSupport'
urls:
$ref: '#/components/schemas/PayerUrls'
description: URLs associated with this payer, such as their website. This object is only returned when
URL information is available for the payer.
required:
- aliases
- displayName
- names
- primaryPayerId
- stediId
- transactionSupport
type: object
SearchPayerTransactionSupport:
description: 'Whether the following transaction types are supported: 270 eligibility checks, 276/277 claim
status requests, 837 claims (professional, dental, institutional), 835 ERAs (claim payments), 275 unsolicited
claim attachments, and coordination of benefits checks.
If the value is `ENROLLMENT_REQUIRED`, Stedi supports the transaction type, but you must [enroll with the
payer](https://www.stedi.com/docs/healthcare/supported-payers#enrollment) first.'
properties:
claimPayment:
$ref: '#/components/schemas/TransactionSupportValue'
description: Whether you can receive 835 Electronic Remittance Advice (ERA) transactions from this payer.
claimStatus:
$ref: '#/components/schemas/TransactionSupportValue'
description: Whether you can send 276 claim status requests to this payer.
coordinationOfBenefits:
$ref: '#/components/schemas/TransactionSupportValue'
description: Coordination of Benefits (COB) support.
dentalClaimSubmission:
$ref: '#/components/schemas/TransactionSupportValue'
description: Whether you can send 837D dental claims to this payer.
eligibilityCheck:
$ref: '#/components/schemas/TransactionSupportValue'
description: Whether you can send 270 eligibility checks to this payer.
institutionalClaimSubmission:
$ref: '#/components/schemas/TransactionSupportValue'
description: Whether you can send 837I institutional claims to this payer.
professionalClaimSubmission:
$ref: '#/components/schemas/TransactionSupportValue'
description: Whether you can send 837P professional claims to this payer.
unsolicitedClaimAttachment:
$ref: '#/components/schemas/TransactionSupportValue'
description: Whether you can send unsolicited claim attachments to this payer.
required:
- claimPayment
- claimStatus
- coordinationOfBenefits
- dentalClaimSubmission
- eligibilityCheck
- institutionalClaimSubmission
- professionalClaimSubmission
- unsolicitedClaimAttachment
type: object
SearchPayersResponseContent:
description: Common output structure for list operations with pagination support.
properties:
items:
description: Matching payers sorted by relevance, with the most relevant matches listed first.
items:
$ref: '#/components/schemas/SearchResult'
type: array
nextPageToken:
description: Token that you can supply in subsequent requests to retrieve the next page of results. If
not returned, there are no more results.
maxLength: 1024
minLength: 1
type: string
stats:
$ref: '#/components/schemas/SearchResultsStats'
description: Statistics about the search results, including the total number of payers matching the search
query and the number of payers supported per transaction type.
required:
- items
- stats
type: object
SearchResult:
properties:
matches:
$ref: '#/components/schemas/Matches'
description: 'Shows which properties in the payer record match the search query. This information helps
you understand why Stedi returned this payer and which parts of the payer record matched the search
terms. It''s also especially useful for debugging search queries and building user interfaces that display
matching text.
- Matching text is wrapped in `<b>` HTML tags for highlighting.
- This object only contains properties with matching text. For example, if none of the payer''s aliases
matched the search query, this object will not include the `aliases` property.'
payer:
$ref: '#/components/schemas/SearchPayerRecord'
description: A payer record matching the search query.
score:
deprecated: true
description: A relevance score indicating how well this payer matched the search query. Higher scores
are better matches. The minimum score is 0.
format: double
type: number
required:
- payer
- score
type: object
SearchResultsStats:
properties:
total:
description: Total number of payers matching the search query.
minimum: 0
type: integer
transactionSupport:
$ref: '#/components/schemas/TransactionSupportStats'
deprecated: true
description: 'Number of matching payers supported per transaction type.
The categories for each transaction type are mutually exclusive. For example, to calculate the total
number of payers that support eligibility checks, regardless of whether enrollment is required, you
must add the `supported` and `enrollmentRequired` counts together.
**DEPRECATED**
This shape is deprecated since 2025-06-24: Use the `transactionSupportCounts` property instead.'
transactionSupportCounts:
$ref: '#/components/schemas/TransactionSupportCounts'
description: 'Number of matching payers for each supported transaction type.
To get the total number of payers that support each transaction type, with additional detail on whether
enrollment is required, use `supported.total` instead.'
required:
- total
- transactionSupport
- transactionSupportCounts
type: object
ServiceUnavailableExceptionResponseContent:
description: The server is temporarily unavailable.
properties:
code:
description: Classification of the exception type.
type: string
message:
description: Human readable exception message.
type: string
required:
- message
type: object
SupportedAggregationType:
description: 'Aggregation types a payer supports for 835 Electronic Remittance Advice (ERA) transactions.
Payers can aggregate by the provider''s NPI, tax ID (TIN), or both.
You can use this information to specify an `aggregationPreference` when submitting ERA enrollment requests.'
enum:
- NPI
- TIN
type: string
SupportedBreakdown:
properties:
enrollmentNotRequired:
description: Number of matching payers that support this transaction type and don't require transaction
enrollment.
minimum: 0
type: integer
enrollmentRequired:
description: Number of matching payers that support this transaction type and require [transaction enrollment](https://www.stedi.com/docs/healthcare/transaction-enrollment).
minimum: 0
type: integer
total:
description: Total number of matching payers that support this transaction type (`enrollmentRequired`
+ `enrollmentNotRequired`).
minimum: 0
type: integer
required:
- enrollmentNotRequired
- enrollmentRequired
- total
type: object
ThrottlingExceptionResponseContent:
description: The server response when usage plan or account-level throttling limits exceeded.
properties:
code:
description: Error classification code
type: string
message:
description: Human-readable error message
type: string
required:
- message
type: object
T
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