Stedi X12 270/271 Eligibility and Benefits Check

arazzo: 1.0.1
info:
  title: Stedi X12 270/271 Eligibility and Benefits Check
  summary: Locate the right payer in the Stedi network, then run an X12 270 eligibility inquiry and read the 271 benefits response.
  description: >-
    The canonical Stedi real-time eligibility flow, encoding the X12 270/271
    transaction set for the healthcare revenue cycle. A payer is resolved from the
    Stedi payer network with its eligibility-check support confirmed, and a 270
    inquiry is submitted for the subscriber so the 271 benefits and coverage detail
    can be read back. Every step inlines its request so the flow is self-contained.
  version: 1.0.0
sourceDescriptions:
- name: stediHealthcare
  url: ../openapi/stedi-healthcare-openapi.yml
  type: openapi
workflows:
- workflowId: eligibility-check
  summary: Find an eligibility-capable payer, then run the X12 270/271 eligibility and benefits inquiry.
  description: >-
    Resolves the payer in the Stedi network with 270 eligibility support, then
    submits the X12 270 inquiry and reads the 271 benefits response.
  inputs:
    type: object
    required:
    - payerQuery
    - eligibilityRequest
    properties:
      payerQuery:
        type: string
        description: Free-text search to resolve the payer (name or payer id) in the Stedi payer network.
      eligibilityRequest:
        type: object
        description: X12 270 eligibility inquiry packet (controlNumber, tradingPartnerServiceId, provider, subscriber, encounter).
  steps:
  - stepId: findPayer
    description: Resolve the payer in the Stedi network and confirm it supports X12 270 real-time eligibility checks.
    operationId: SearchPayers
    parameters:
    - name: query
      in: query
      value: $inputs.payerQuery
    - name: eligibilityCheck
      in: query
      value: true
    successCriteria:
    - condition: $statusCode == 200
    outputs:
      payerStediId: $response.body#/payers/0/stediId
  - stepId: checkEligibility
    description: Submit the X12 270 eligibility inquiry and read the 271 benefits and coverage response.
    operationId: EligibilityCheck
    requestBody:
      contentType: application/json
      payload: $inputs.eligibilityRequest
    successCriteria:
    - condition: $statusCode == 200
    outputs:
      benefits: $response.body#/benefitsInformation
  outputs:
    payerStediId: $steps.findPayer.outputs.payerStediId
    benefits: $steps.checkEligibility.outputs.benefits