Stedi Insurance Discovery

arazzo: 1.0.1
info:
  title: Stedi Insurance Discovery
  summary: Start an insurance discovery check for a patient, then poll until the X12 270/271 coverage search completes and read the discovered coverage.
  description: >-
    The canonical Stedi insurance discovery flow, which fans an X12 270 eligibility
    inquiry across the payer network to surface a patient's active coverage in the
    healthcare revenue cycle. A discovery check is started for the patient
    demographic and the check is polled until it reports COMPLETE so the discovered
    payers and 271 benefits can be read back. Every step inlines its request so the
    flow is self-contained.
  version: 1.0.0
  x-realizes-capability-ids:
  - BC-2800.30
  x-capability-derivation:
    method: 'deterministic join: sourceDescriptions -> per-tag OpenAPI -> tag/capability edge. No classification at this step.'
    min_confidence: 0.7
    sources:
    - capability_id: BC-2800.30
      capability_name: Eligibility & Benefits Verification
      spec: stedi-insurance-discovery-api-openapi.yml
      confidence: 0.88
    model: Turbo EA Capabilities by Vincent Verdet — Turbo EA, https://github.com/vincentmakes/turbo-ea-capabilities, CC BY 4.0
sourceDescriptions:
- name: insuranceDiscoveryApi
  url: ../openapi/stedi-insurance-discovery-api-openapi.yml
  type: openapi
workflows:
- workflowId: insurance-discovery
  summary: Start an insurance discovery check and poll until the X12 270/271 coverage search completes.
  description: >-
    Starts an asynchronous insurance discovery check for a patient demographic and
    polls until it reports COMPLETE, returning the discovered coverage.
  inputs:
    type: object
    required:
    - discoveryRequest
    properties:
      discoveryRequest:
        type: object
        description: Insurance discovery request packet (provider, subscriber demographic, encounter) used to search the payer network for active coverage.
  steps:
  - stepId: startDiscovery
    description: Start the insurance discovery check, fanning an X12 270 inquiry across the payer network for the patient demographic.
    operationId: InsuranceDiscoveryCheck
    requestBody:
      contentType: application/json
      payload: $inputs.discoveryRequest
    successCriteria:
    - condition: $statusCode == 200
    outputs:
      discoveryId: $response.body#/discoveryId
  - stepId: pollDiscovery
    description: Poll the discovery check until the coverage search across the payer network finishes (status COMPLETE).
    operationId: GetInsuranceDiscoveryCheck
    parameters:
    - name: discoveryId
      in: path
      value: $steps.startDiscovery.outputs.discoveryId
    successCriteria:
    - context: $response.body
      condition: $.status == "COMPLETE"
      type: jsonpath
    outputs:
      results: $response.body
  outputs:
    discoveryId: $steps.startDiscovery.outputs.discoveryId
    results: $steps.pollDiscovery.outputs.results