--- title: "POST /eligibility-manager/batch-eligibility" method: POST path: "/eligibility-manager/batch-eligibility" tags: ["Batch eligibility check"] --- # POST /eligibility-manager/batch-eligibility `POST /eligibility-manager/batch-eligibility` Submit multiple eligibility checks for Stedi to process asynchronously ## Headers - `X-Forwarded-For` string — **(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. ## Request body - BatchEligibilityChecksRequestContent - `items` BatchEligibilityChecksItem[], required — Each entry in this array represents a single eligibility check. You can submit up to 10,000 eligibility checks in a single request. **Warning:** If _any_ of the individual checks contain invalid JSON data, such as missing required properties or invalid values, Stedi rejects the entire batch with a `400` status code and returns errors to help you correct the issues. - `controlNumber` string — Stedi generates a control number for each eligibility check, so you don’t need to include this property in your request. - `dependents` RequestDependent[] — A dependent for which you want to retrieve benefits information. - You can only submit one dependent per eligibility check. - Only include the patient's information here when they are listed as a dependent on the subscriber's insurance plan AND the payer cannot uniquely identify them through information outside the subscriber's policy. For example, if the dependent has their own member ID number, you should identify them in the `subscriber` object instead. This includes member IDs that differ only by a suffix, such as `01`, because the patient can still be uniquely identified. - Most Medicaid plans don't support dependents, with a [few exceptions](https://www.stedi.com/docs/healthcare/send-eligibility-checks#medicaid-dependents). Sending this array to payers that don't support dependents will either cause an error, or the payer may ignore the information and return results for the subscriber instead. - Each payer has different requirements, so you should supply the fields necessary for each payer to identify the dependent in their system. However, we **strongly recommend** including the dependent's date of birth in the request when available because many payers return errors without it. - Enter the patient's name exactly as written on their insurance card, if available, including any special or punctuation characters such as apostrophes, hyphens (dashes), or spaces. Visit [patient names](https://www.stedi.com/docs/healthcare/send-eligibility-checks#patient-names) for all best practices to avoid unnecessary failures. - `additionalIdentification` AdditionalIdentificationDependent — Use this object when you need to provide an additional identification number for the dependent. This is rarely required for standard eligibility checks. - `agencyClaimNumber` string — The Property and Casualty Claim Number associated with the patient. You should only submit this value when when you are submitting an eligibility request to a property and casualty payer. - `contractNumber` string — The contract number for an existing contract between the payer and the provider requesting the eligibility check. - `healthInsuranceClaimNumber` string — This property is never used in practice. - `identificationCardSerialNumber` string — The identification card serial number. You can include this when the ID card has a number in addition to the member ID number. The Identification Card Serial Number uniquely identifies the card when multiple cards have been or will be issued to a member, such as a replacement card. - `insurancePolicyNumber` string — The insurance policy number. - `medicalRecordIdentificationNumber` string — The medical record identification number. - `memberIdentificationNumber` string — Not intended for most use cases. Only set this when the property and casualty patient identifier is a member ID that would be used in an 837 claim submission. If the patient has their own member ID for the health plan, you should identify them in the `subscriber` object. If the patient doesn't have their own member ID, don't set this property. - `patientAccountNumber` string — The patient account number. - `planNetworkIdentificationNumber` string — The plan network identification number. - `planNumber` string — The insurance plan number. - `policyNumber` string — The insurance group or policy number. - `address` RequestDependentAddress — Address information for the dependent. When providing address information, we recommend including `state` for member identification in addition to the required `address1` and `city` properties. - `address1` string, required — The first line of the address. - `address2` string — The second line of the address. - `city` string, required — The city. - `countryCode` string — The two-letter country code from [Part 1 of ISO 3166](https://en.wikipedia.org/wiki/ISO_3166-1_alpha-2). - `countrySubDivisionCode` string — The country subdivision code from [Part 2 of ISO 3166](https://en.wikipedia.org/wiki/ISO_3166-2). - `postalCode` string — The United States or Canadian postal code, excluding punctuation and blanks. - `state` 'NL' | 'PE' | 'NS' | 'NB' | 'QC' | 'ON' | 'MB' | 'SK' | 'AB' | 'BC' | 'YT' | 'NT' | 'NU' | 'DC' | 'AS' | 'GU' | 'MP' | 'PR' | 'UM' | 'VI' | 'AA' | 'AE' | 'AP' | 'AK' | 'AL' | 'AR' | 'AZ' | 'CA' | 'CO' | 'CT' | 'DE' | 'FL' | 'GA' | 'HI' | 'IA' | 'ID' | 'IL' | 'IN' | 'KS' | 'KY' | 'LA' | 'MA' | 'MD' | 'ME' | 'MI' | 'MN' | 'MO' | 'MS' | 'MT' | 'NC' | 'ND' | 'NE' | 'NH' | 'NJ' | 'NM' | 'NV' | 'NY' | 'OH' | 'OK' | 'OR' | 'PA' | 'RI' | 'SC' | 'SD' | 'TN' | 'TX' | 'UT' | 'VA' | 'VT' | 'WA' | 'WI' | 'WV' | 'WY' — The US state or Canadian province code. For example, `TN` for Tennessee or `NB` for New Brunswick. - `beginningCardIssueDate` string — The date the insurance card was issued. Use when you need to specify a date range. Provide the end of the range in the `endCardIssueDate` property. - `beginningPlanIssueDate` string — The date the insurance plan begins. Use when you need to specify a date range. Provide the end of the range in the `endPlanIssueDate` property. - `birthSequenceNumber` string — The number assigned to each family member born with the same birth date, such as twins or triplets. Use to indicate the birth order when there are multiple births associated with the provided birth date. - `dateOfBirth` string — The dependent's date of birth (DOB). We **strongly recommend** including the DOB in your request. Many payers need this information to identify the patient in their system and will immediately return an error when it's not provided. - `eligibilityCategory` string — The eligibility category for the dependent. - `endCardIssueDate` string — The date the insurance card expires. Use when you need to specify a date range. Provide the start of the range in the `beginningCardIssueDate` property. - `endPlanIssueDate` string — The date the insurance plan ends. Use when you need to specify a date range. Provide the start of the range in the `beginningPlanIssueDate` property. - `firstName` string — The dependent's first name. - `gender` 'M' | 'F' - `groupNumber` string — The group number for the dependent's insurance plan. - `healthCareCodeInformation` HealthCareInformation[] — Information about the dependent's health care diagnosis. You can include up to eight entries in this array. The first array entry must have `diagnosisTypeCode` set to `ABK`. All subsequent entries must have `diagnosisTypeCode` set to `ABF`. - `diagnosisCode` string, required — The diagnosis code. Omit the decimal points in diagnosis codes - the decimal point is assumed. - `diagnosisTypeCode` 'BK' | 'ABK' | 'BF' | 'ABF', required — The type of diagnosis code you are providing. You can set to `BK` - International Classification of Diseases Clinical Modification (ICD-9-CM) Principal Diagnosis, `ABK` - International Classification of Diseases Clinical Modification (ICD-10-CM) Principal Diagnosis, `BF`- International Classification of Diseases Clinical Modification (ICD-9-CM) Diagnosis, or `ABF`- International Classification of Diseases Clinical Modification (ICD-10-CM) Diagnosis. Note that ICD-9 codes are **deprecated** and should no longer be used in eligibility checks. - `idCard` string — The dependent's insurance card number. - `idCardIssueDate` string — The date the insurance card was issued. Use to specify a single date. - `individualRelationshipCode` '01' | '19' | '34' — The dependent's relationship to the subscriber. You can set this to `01` - Spouse, `19` - Child, `34` - Other Adult. - `issueNumber` string — The issue number for the dependent's insurance policy. - `lastName` string — The dependent's last name. **Don't** include the dependent's name suffix, such as Jr. or III. Use the designated `suffix` property instead. - `memberId` string — This shape is deprecated: This property is no longer used. - `middleName` string — The dependent's middle name or middle initial. - `planIssueDate` string — The date the insurance plan begins. Use to specify a single date. - `providerCode` 'AD' | 'AT' | 'BI' | 'CO' | 'CV' | 'H' | 'HH' | 'LA' | 'OT' | 'P1' | 'P2' | 'PC' | 'PE' | 'R' | 'RF' | 'SK' | 'SU' — Use this for providers that are not requesting the eligibility check - the requestor is specified in the `provider` object. For example, if you are a hospital making an eligibility request, this is where you would specify information about a referring provider's role. You can use one of the following: `AD` - Admitting, `AT` - Attending, `BI` - Billing, `CO` - Consulting, `CV` - Covering, `H` - Hospital, `HH` - Home Health Care, `LA` - Laboratory, `OT` - Other Physician, `P1` - Pharmacist, `P2` - Pharmacy, `PC` - Primary Care Physician, `PE`- Performing, `R`- Rural Health Clinic, `RF` - Referring, `SB` - Submitting, `SK` - Skilled Nursing Facility, `SU` - Supervising - `providerIdentifier` string — The provider identifier you specified in the `referenceIdentificationQualifier` property. For example, the provider's National Provider ID or Federal Taxpayer Identification number. If you set the `referenceIdentificationQualifier` to `PXC`, then this property should contain the provider's taxonomy code. - `referenceIdentificationQualifier` '9K' | 'D3' | 'EI' | 'HPI' | 'PXC' | 'SY' | 'TJ' — The type of `providerIdentifier` you are using. Use for providers that are not requesting the eligibility check, such as the referring provider. - Set to `HPI` when the National Provider ID is mandated for use. - Set to `PXC` if you're identifying a type of specialty associated with services provided to the dependent. Otherwise, you can set to the following: `9K` - Servicer, `D3` - National Council for Prescription Drug Programs Pharmacy Number, `EI` - Employer's Identification Number, `HPI` - Centers for Medicare and Medicaid Services National Provider Identifier, `PXC` - Health Care Provider Taxonomy Code, `SY` - Social Security Number, `TJ` - Federal Taxpayer's Identification Number - `ssn` string — The dependent's social security number. Don't use this for Federally-administered programs, such as Medicare. - `suffix` string — The dependent's name suffix, such as Sr. or III. Only include the dependent's personal name suffix - **don't** include professional or academic titles, such as M.D. or MBA. - `eligibilitySearchId` string — An identifier that allows Stedi to group eligibility checks for the same patient into a unified record in the Stedi portal called an [eligibility search](https://www.stedi.com/docs/healthcare/eligibility-views). This property is for use by Stedi tools only, such as Stedi's MCP server. - `encounter` Encounter — Details about the eligibility or benefit information you are requesting for the patient. - If you don't specify either `serviceTypeCodes` or a `procedureCode` and `productOrServiceIDQualifier`, Stedi defaults to using `30` (Plan coverage and general benefits) as the only `serviceTypeCodes` value. - You can specify either a single `dateOfService` or a `beginningDateOfService` and `endDateOfService`. The payer defaults to using the current date in their timezone if you don't include one. - When checking eligibility for today, omit the `dateOfService` property to ensure consistent behavior across payers. - We recommend submitting dates up to 12 months in the past or up to the end of the current month. Payers aren't required to support dates outside these ranges. However, some payers such as the Centers for Medicare and Medicaid Services (CMS) do support requests for dates further in the future - especially the next calendar month. Check the payer's documentation to determine their specific behavior. - `beginningDateOfService` string — The beginning date of service. If you include this value, you must also include the `endDateOfService`. - `dateOfService` string — The date of service. You can use this value to specify a single occasion, such as a doctor's visit. If you don't specify a service date (either a single day or a range of dates), the payer defaults to using the current date in their timezone. - `diagnosisCodePointer` string[] — Diagnosis code pointers in order of importance to the service. These pointers are an index to the ICD-10 codes you included in the `subscriber.healthCareCodeInformation` or `dependents.healthCareCodeInformation` object arrays. The pointer values can be from 1 - 8 (integer numbers). If you are including diagnosis codes, you **must** set at least one pointer here for the primary diagnosis. Then, you can add up to three additional pointers (up to four in total). Don't put ICD-10 codes here. - `endDateOfService` string — The end date of service. If you include this value, you must also include the `beginningDateOfService`. - `industryCode` '01' | '02' | '03' | '04' | '05' | '06' | '07' | '08' | '09' | '10' | '11' | '12' | '13' | '14' | '15' | '16' | '17' | '18' | '19' | '20' | '21' | '22' | '23' | '24' | '25' | '26' | '31' | '32' | '33' | '34' | '41' | '42' | '49' | '50' | '51' | '52' | '53' | '54' | '55' | '56' | '57' | '58' | '60' | '61' | '62' | '65' | '71' | '72' | '81' | '99' — The type of facility where the service was provided. You can set this to one of the [place of service codes](https://www.cms.gov/medicare/coding-billing/place-of-service-codes/code-sets). - `medicalProcedures` MedicalProcedure[] — Use only when you need to send multiple procedure codes in a single request. Otherwise, use the `encounter.procedureCode` and `encounter.productOrServiceIDQualifier` properties. - `diagnosisCodePointer` string[] — The diagnosis code pointer. - `procedureCode` string, required — The procedure code. - `procedureModifiers` string[] — Procedure modifiers that provide additional information related to the service. - `productOrServiceIDQualifier` 'AD' | 'CJ' | 'HC' | 'ID' | 'IV' | 'N4' | 'ZZ', required — Code identifying the type/source of the `procedureCode`. You can set this to `AD` - American Dental Association Codes, `CJ` - Current Procedural Terminology (CPT) Codes, `HC` - Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes, `ID` - International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) - Procedure, `IV` - Home Infusion EDI Coalition (HIEC) Product/Service Code, `N4` - National Drug Code in 5-4-2 Format, or `ZZ` - Mutually Defined. - `priorAuthorizationOrReferralNumber` string — The prior authorization or referral number for a particular benefit or procedure. - `procedureCode` string — The procedure code. - `procedureModifiers` string[] — The procedure modifier that provides additional information related to the performance of the service. - `productOrServiceIDQualifier` 'AD' | 'CJ' | 'HC' | 'ID' | 'IV' | 'N4' | 'ZZ' — Code identifying the type/source of the `procedureCode`. You can set this to `AD` - American Dental Association Codes, `CJ` - Current Procedural Terminology (CPT) Codes, `HC` - Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes, `ID` - International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) - Procedure, `IV` - Home Infusion EDI Coalition (HIEC) Product/Service Code, `N4` - National Drug Code in 5-4-2 Format, or `ZZ` - Mutually Defined. - `referenceIdentificationQualifier` '9F' | 'G1' — The type of information you provided in the `priorAuthorizationOrReferralNumber` property. You can set this to `9F` - Referral Number or `G1` - Prior Authorization Number. - `serviceTypeCodes` RequestEligibilityServiceTypeCode[] — One or more codes classifying the type of services for which you want to receive benefits information. If you don't specify a service type code or a `procedureCode` and `productOrServiceIDQualifier`, Stedi defaults to using `30` - Health Benefit Plan Coverage. Visit [Service Type Codes](https://www.stedi.com/docs/healthcare/eligibility-stc-procedure-codes#full-stc-list) for a complete list. Not all payers support all service type codes, and not all payers support multiple service type codes in the same request. We recommend including one service type code per request unless you're sure the payer supports multiple. Payers aren't required to respond with exactly the same STC(s) in the response, so you may receive benefits information for STCs you didn't request. However, receiving different STCs can mean that the payer is ignoring the STC you sent, which is why we recommend [testing payers](https://www.stedi.com/docs/healthcare/eligibility-stc-procedure-codes#test-payer-stc-support) to determine their support for specific STCs. - `externalPatientId` string — A unique identifier for the patient that Stedi uses to identify and correlate historical eligibility checks for the same individual. We recommend including this value in all requests. - `informationReceiverName` InformationReceiverName - `address` RequestProviderAddress — Address information for the provider. - Only include when specifically instructed by a payer, such as when the provider has multiple locations and you need to identify the specific location making the request. - You must include at least the `address1` and `city` properties. - `address1` string, required — The first line of the address. - `address2` string — The second line of the address. - `city` string, required — The city. - `countryCode` string — The two-letter country code from [Part 1 of ISO 3166](https://en.wikipedia.org/wiki/ISO_3166-1_alpha-2). - `countrySubDivisionCode` string — The country subdivision code from [Part 2 of ISO 3166](https://en.wikipedia.org/wiki/ISO_3166-2). - `postalCode` string — The United States or Canadian postal code, excluding punctuation and blanks. - `state` 'NL' | 'PE' | 'NS' | 'NB' | 'QC' | 'ON' | 'MB' | 'SK' | 'AB' | 'BC' | 'YT' | 'NT' | 'NU' | 'DC' | 'AS' | 'GU' | 'MP' | 'PR' | 'UM' | 'VI' | 'AA' | 'AE' | 'AP' | 'AK' | 'AL' | 'AR' | 'AZ' | 'CA' | 'CO' | 'CT' | 'DE' | 'FL' | 'GA' | 'HI' | 'IA' | 'ID' | 'IL' | 'IN' | 'KS' | 'KY' | 'LA' | 'MA' | 'MD' | 'ME' | 'MI' | 'MN' | 'MO' | 'MS' | 'MT' | 'NC' | 'ND' | 'NE' | 'NH' | 'NJ' | 'NM' | 'NV' | 'NY' | 'OH' | 'OK' | 'OR' | 'PA' | 'RI' | 'SC' | 'SD' | 'TN' | 'TX' | 'UT' | 'VA' | 'VT' | 'WA' | 'WI' | 'WV' | 'WY' — The US state or Canadian province code. For example, `TN` for Tennessee or `NB` for New Brunswick. - `contactNumber` string - `contractNumber` string - `devicePinNumber` string - `facilityIdNumber` string - `facilityNetworkIdNumber` string - `federalTaxpayerIdentificationNumber` string - `informationReceiverAdditionalIdentifierState` string - `medicaidProviderNumber` string — The provider's Medicaid provider number. - `medicareProviderNumber` string - `nationalProviderIdentifier` string - `priorIdentifierNumber` string - `providerPlanNetworkIdNumber` string - `socialSecurityNumber` string - `stateLicenceNumber` string - `submitterIdNumber` string - `portalPassword` string — The password that the provider uses to log in to the payer's portal. For payers Medicaid California, AltaMed, and Kern Family Health Care, this property is **required** and should be the [provider's PIN](https://www.stedi.com/docs/healthcare/eligibility-troubleshooting#portal-credentials). Otherwise, this is not commonly used. - `portalUsername` string — The username that the provider uses to log in to the payer's portal. This is not commonly used. - `provider` Provider, required — Information about the entity requesting the eligibility check. This may be an individual practitioner, a medical group, a hospital, or another type of healthcare provider. - You must provide the `organizationName` (if the entity is an organization), or `firstName` and `lastName` (if the provider is an individual). - You must also provide an identifier - this is typically the provider's [National Provider Identifier](https://www.stedi.com/docs/healthcare/national-provider-identifier) (`npi`). If the provider doesn't have an NPI, you can supply an alternative, such as their `taxId` or `ssn`. - Don't include additional properties, such as `taxId` or `address`, unless they are specifically required or suggested by the payer. - `address` RequestProviderAddress — Address information for the provider. - Only include when specifically instructed by a payer, such as when the provider has multiple locations and you need to identify the specific location making the request. - You must include at least the `address1` and `city` properties. - `address1` string, required — The first line of the address. - `address2` string — The second line of the address. - `city` string, required — The city. - `countryCode` string — The two-letter country code from [Part 1 of ISO 3166](https://en.wikipedia.org/wiki/ISO_3166-1_alpha-2). - `countrySubDivisionCode` string — The country subdivision code from [Part 2 of ISO 3166](https://en.wikipedia.org/wiki/ISO_3166-2). - `postalCode` string — The United States or Canadian postal code, excluding punctuation and blanks. - `state` 'NL' | 'PE' | 'NS' | 'NB' | 'QC' | 'ON' | 'MB' | 'SK' | 'AB' | 'BC' | 'YT' | 'NT' | 'NU' | 'DC' | 'AS' | 'GU' | 'MP' | 'PR' | 'UM' | 'VI' | 'AA' | 'AE' | 'AP' | 'AK' | 'AL' | 'AR' | 'AZ' | 'CA' | 'CO' | 'CT' | 'DE' | 'FL' | 'GA' | 'HI' | 'IA' | 'ID' | 'IL' | 'IN' | 'KS' | 'KY' | 'LA' | 'MA' | 'MD' | 'ME' | 'MI' | 'MN' | 'MO' | 'MS' | 'MT' | 'NC' | 'ND' | 'NE' | 'NH' | 'NJ' | 'NM' | 'NV' | 'NY' | 'OH' | 'OK' | 'OR' | 'PA' | 'RI' | 'SC' | 'SD' | 'TN' | 'TX' | 'UT' | 'VA' | 'VT' | 'WA' | 'WI' | 'WV' | 'WY' — The US state or Canadian province code. For example, `TN` for Tennessee or `NB` for New Brunswick. - `contactNumber` string — The provider's contract number. Only include when required by a payer. This shape is deprecated: Use `contractNumber` instead. - `contractNumber` string — The provider's contract number. Only include when required by a payer. - `devicePinNumber` string — The provider's electronic device pin number. Only include when required by a payer. - `employersId` string — Deprecated; The submitter's Employer's Identification Number (EIN). Only use when an employer is checking the eligibility and benefits of their employees. This shape is deprecated: This property is no longer used. - `facilityIdNumber` string — The ID number for the provider's facility. Only include when required by a payer. - `facilityNetworkIdNumber` string — The provider's facility network identification number. Only include when required by a payer. - `firstName` string — The provider's first name. This property is required if the provider is an individual. - `informationReceiverAdditionalIdentifierState` string — The two-character state ID of the state that assigned the `stateLicenseNumber`. Only include when required by a payer. - `lastName` string — The provider's last name. This property is required if the provider is an individual. - `medicaidProviderNumber` string — The provider's Medicaid provider number. Only include when required by a payer. - `medicareProviderNumber` string — The provider's Medicare provider number. Only include when required by a payer. - `npi` string — The provider's [National Provider Identifier (NPI)](https://www.stedi.com/docs/healthcare/national-provider-identifier). This identifier is required for all healthcare providers who are eligible to receive an NPI. Some non-traditional providers such as transportation services, durable medical equipment (DME) suppliers, or alternative medicine practitioners are not eligible to receive an NPI. If the provider doesn't have an NPI, requests with alternate IDs are virtually never supported. In the rare circumstance that a payer has instructed you to use an alternate ID, the payer will typically require you to supply either their `taxId` or `ssn` instead. - `organizationName` string — The provider's business name. This property is required if the provider is not an individual. - `payorId` string — Only used for payer-to-payer transactions, which are not currently supported. Do not use. - `pharmacyProcessorNumber` string — The provider's pharmacy processor number. Only include when specifically instructed by a payer - for example, when the provider doesn't have an [NPI](https://www.stedi.com/docs/healthcare/national-provider-identifier). This use case is very rarely supported, and is typically when the provider is a non-medical provider, such as a social worker, home health aide, or transportation service. - `priorIdentifierNumber` string — The provider's prior identifier number. Only include when required by a payer. - `providerCode` 'AD' | 'AT' | 'BI' | 'CO' | 'CV' | 'H' | 'HH' | 'LA' | 'OT' | 'P1' | 'P2' | 'PC' | 'PE' | 'R' | 'RF' | 'SB' | 'SK' | 'SU' - `providerPlanNetworkIdNumber` string — The provider's plan network identification number. Only include when required by a payer. - `providerType` 'payer' | 'third-party administrator' | 'employer' | 'hospital' | 'facility' | 'gateway provider' | 'plan sponsor' | 'provider' — Identify the type of provider. - `referenceIdentification` string — The provider's [Taxonomy Code](https://x12.org/codes/provider-taxonomy-codes). Only used when the provider's taxonomy code is relevant to the eligibility/benefit inquiry. For example, an institutional provider such as a hospital may need to use a taxonomy code to specify a specific unit or department. - `serviceProviderNumber` string — The provider's service provider number. Only include when specifically instructed by a payer - for example, when the provider doesn't have an [NPI](https://www.stedi.com/docs/healthcare/national-provider-identifier). This use case is very rarely supported, and is typically when the provider is a non-medical provider, such as a social worker, home health aide, or transportation service. - `servicesPlanID` string - `ssn` string — The provider's Social Security Number (SSN). - Only include when specifically instructed by a payer - for example, if the provider doesn't have an [NPI](https://www.stedi.com/docs/healthcare/national-provider-identifier). This use case is very rarely supported, and is typically when the provider is a non-medical provider, such as a social worker, home health aide, or transportation service. - If the payer has instructed you to send an EIN but the provider operates using their SSN, use provider.taxId instead of this field. - Don't use this for Federally-administered programs, such as Medicare. - `stateLicenceNumber` string — The provider's state license number. If you include this information, you must also include the `informationReceiverAdditionalIdentifierState`. Only include when required by a payer. - `submitterIdNumber` string — The provider's submitter identification number. Only include when required by a payer. - `taxId` string — The provider's Federal Taxpayer Identification Number. This is typically the provider's EIN (Employer Identification Number), but the provider's SSN may be used if the provider does not have an EIN. Only include if required by the payer. - `submitterTransactionIdentifier` string, required — A unique identifier for the eligibility check within this batch request. Stedi returns this identifier in the response for the [Poll Batch Eligibility Checks](https://www.stedi.com/docs/healthcare/api-reference/get-healthcare-polling-eligibility) endpoint. - `subscriber` RequestSubscriber, required — The primary policyholder for the insurance plan _or_ a dependent with a unique member ID. If a dependent has a unique member ID, include their information here and leave `dependents` empty. - At a minimum, our API requires that you supply at least one of these fields in the request: `memberId`, `dateOfBirth`, or `lastName`. However, each payer has different requirements, so you should supply the fields necessary for each payer to identify the subscriber in their system. - When you provide all four of `memberId`, `dateOfBirth`, `firstName`, and `lastName`, payers are required to return a response if the member is in their database. Some payers may be able to search with less information, but this varies by payer. - We recommend always including the patient's member ID when possible. - Enter the patient's name exactly as written on their insurance card, if available, including any special or punctuation characters such as apostrophes, hyphens (dashes), or spaces. Visit [patient names](https://www.stedi.com/docs/healthcare/send-eligibility-checks#patient-names) for all best practices to avoid unnecessary failures. - `additionalIdentification` AdditionalIdentificationSubscriber — Use this object when you need to provide an identification number other than or in addition to the subscriber's member ID. For example, you may provide the patient account number. Don't include the health insurance claim number or the medicaid recipient ID number here unless they are different from the member ID. - `agencyClaimNumber` string — The Property and Casualty Claim Number associated with the patient. You should only submit this value when when you are submitting an eligibility request to a property and casualty payer. - `contractNumber` string — The contract number for an existing contract between the payer and the provider requesting the eligibility check. - `healthInsuranceClaimNumber` string — The health insurance claim number. - `identificationCardSerialNumber` string — The identification card serial number. You can include this when the ID card has a number in addition to the member ID number. The Identification Card Serial Number uniquely identifies the card when multiple cards have been or will be issued to a member, such as a replacement card. - `insurancePolicyNumber` string — The insurance policy number. - `medicalRecordIdentificationNumber` string — The medical record identification number. - `memberIdentificationNumber` string — This property is never used in practice. Supply the subscriber's member ID in `subscriber.memberId`. - `patientAccountNumber` string — The patient account number. - `planNetworkIdentificationNumber` string — The plan network identification number. - `planNumber` string — The insurance plan number. - `policyNumber` string — The insurance group or policy number. - `address` RequestSubscriberAddress — Address information for the subscriber. When providing address information: - The `address1` and `city` properties are **required** for standard eligibility checks and MBI lookups with SSN. We also recommend including `state` for member identification. - When performing an [MBI lookup without SSN](https://www.stedi.com/docs/healthcare/mbi-lookup) (Payer ID: `MBILUNOSSN`), only `state` is required. You can omit `address1` and `city`. - `address1` string — The first line of the address. Required for all payers except payer ID `MBILUNOSSN`. - `address2` string — The second line of the address. - `city` string — The city. Required for all payers except payer ID `MBILUNOSSN`. - `countryCode` string — The two-letter country code from [Part 1 of ISO 3166](https://en.wikipedia.org/wiki/ISO_3166-1_alpha-2). - `countrySubDivisionCode` string — The country subdivision code from [Part 2 of ISO 3166](https://en.wikipedia.org/wiki/ISO_3166-2). - `postalCode` string — The United States or Canadian postal code, excluding punctuation and blanks. - `state` 'NL' | 'PE' | 'NS' | 'NB' | 'QC' | 'ON' | 'MB' | 'SK' | 'AB' | 'BC' | 'YT' | 'NT' | 'NU' | 'DC' | 'AS' | 'GU' | 'MP' | 'PR' | 'UM' | 'VI' | 'AA' | 'AE' | 'AP' | 'AK' | 'AL' | 'AR' | 'AZ' | 'CA' | 'CO' | 'CT' | 'DE' | 'FL' | 'GA' | 'HI' | 'IA' | 'ID' | 'IL' | 'IN' | 'KS' | 'KY' | 'LA' | 'MA' | 'MD' | 'ME' | 'MI' | 'MN' | 'MO' | 'MS' | 'MT' | 'NC' | 'ND' | 'NE' | 'NH' | 'NJ' | 'NM' | 'NV' | 'NY' | 'OH' | 'OK' | 'OR' | 'PA' | 'RI' | 'SC' | 'SD' | 'TN' | 'TX' | 'UT' | 'VA' | 'VT' | 'WA' | 'WI' | 'WV' | 'WY' — The US state or Canadian province code. For example, `TN` for Tennessee or `NB` for New Brunswick. - `beginningCardIssueDate` string — The date the subscriber's insurance card was issued. Use when you need to specify a date range. Provide the end of the range in the `endCardIssueDate` property. - `beginningPlanIssueDate` string — The date the subscriber's insurance plan begins. Use when you need to specify a date range. Provide the end of the range in the `endPlanIssueDate` property. - `birthSequenceNumber` string — The number assigned to each family member born with the same birth date, such as twins or triplets. Use to indicate the birth order when there are multiple births associated with the provided birth date. - `caseNumber` string — The case number associated with the subscriber. - `coverageLevelCode` string — This property is no longer used. - `dateOfBirth` string — The subscriber's date of birth. - `endCardIssueDate` string — The date the subscriber's insurance card expires. Use when you need to specify a date range. Provide the start of the range in the `beginningCardIssueDate` property. - `endPlanIssueDate` string — The date the subscriber's insurance plan ends. Use when you need to specify a date range. Provide the start of the range in the `beginningPlanIssueDate` property. - `firstName` string — The patient's first name. - `gender` 'M' | 'F' - `groupNumber` string — The group number associated with the subscriber's insurance policy. - `healthCareCodeInformation` HealthCareInformation[] — Information about the subscriber's health care diagnosis. You can include up to eight entries in this array. The first array entry must have `diagnosisTypeCode` set to `ABK`. All subsequent entries must have `diagnosisTypeCode` set to `ABF`. - `diagnosisCode` string, required — The diagnosis code. Omit the decimal points in diagnosis codes - the decimal point is assumed. - `diagnosisTypeCode` 'BK' | 'ABK' | 'BF' | 'ABF', required — The type of diagnosis code you are providing. You can set to `BK` - International Classification of Diseases Clinical Modification (ICD-9-CM) Principal Diagnosis, `ABK` - International Classification of Diseases Clinical Modification (ICD-10-CM) Principal Diagnosis, `BF`- International Classification of Diseases Clinical Modification (ICD-9-CM) Diagnosis, or `ABF`- International Classification of Diseases Clinical Modification (ICD-10-CM) Diagnosis. Note that ICD-9 codes are **deprecated** and should no longer be used in eligibility checks. - `idCard` string — The subscriber's identification card number. Include this property when this number is different than the subscriber's member ID. This is common in Medicaid. - `idCardIssueDate` string — The date the subscriber's insurance card was issued. Use to specify a single date. - `lastName` string — The subscriber's last name. **Don't** include the subscriber's name suffix, such as Jr. or III. Use the designated `suffix` property instead. - `medicaidRecipientIdentificationNumber` string — The Medicaid Recipient Identification Number. You can provide this number to identify the subscriber when it is the primary number the payer knows a member by (such as for Medicare or Medicaid). Do not supply this value unless it is different from the `memberId`. - `memberId` string — The member ID for the subscriber's insurance policy. - `middleName` string — The patient's middle name or middle initial. - `planIssueDate` string — The date the subscriber's insurance plan begins. Use to specify a single date. - `providerCode` 'AD' | 'AT' | 'BI' | 'CO' | 'CV' | 'H' | 'HH' | 'LA' | 'OT' | 'P1' | 'P2' | 'PC' | 'PE' | 'R' | 'RF' | 'SK' | 'SU' — Use this for providers that are not requesting the eligibility check - the requestor is specified in the `provider` object. For example, if you are a hospital making an eligibility request, this is where you would specify information about a referring provider's role. This property is **required** when the `providerIdentifier` and `referenceIdentificationQualifier` properties are populated. You can use one of the following: `AD` - Admitting, `AT` - Attending, `BI` - Billing, `CO` - Consulting, `CV` - Covering, `H` - Hospital, `HH` - Home Health Care, `LA` - Laboratory, `OT` - Other Physician, `P1` - Pharmacist, `P2` - Pharmacy, `PC` - Primary Care Physician, `PE` - Performing, `R` - Rural Health Clinic, `RF` - Referring, `SB` - Submitting, `SK` - Skilled Nursing Facility, `SU` - Supervising - `providerIdentifier` string — The provider identifier you specified in the `referenceIdentificationQualifier` property. It is **required** if you set the `referenceIdentificationQualifier`. For example, this property could contain the provider's National Provider ID or Federal Taxpayer Identification number. If you set the `referenceIdentificationQualifier` to `PXC`, then this property should contain the provider's taxonomy code. - `referenceIdentificationQualifier` '9K' | 'D3' | 'EI' | 'HPI' | 'PXC' | 'SY' | 'TJ' — Use this for providers that are not requesting the eligibility check. This is the type of `providerIdentifier` you are providing. - Set to `HPI` when the National Provider ID is mandated for use. - Set to `PXC` if you're identifying a type of specialty associated with services provided to the subscriber. Otherwise, you can set to the following: `9K` - Servicer, `D3` - National Council for Prescription Drug Programs Pharmacy Number, `EI` - Employer's Identification Number, `HPI` - Centers for Medicare and Medicaid Services National Provider Identifier, `PXC` - Health Care Provider Taxonomy Code, `SY - Social Security Number, `TJ` - Federal Taxpayer's Identification Number - `spendDownAmount` string — Identify the dollar amount the subscriber will apply toward their spend down amount, if required. For some Medicaid programs, individuals must pay a certain amount towards their healthcare cost (spend down) before coverage starts. - `spendDownTotalBilledAmount` string — The subscriber's spend down total billed amount. - `ssn` string — The subscriber's Social Security Number (SSN). Many commercial and government payers ignore this property due to concerns about member privacy. However, some Medicaid programs support alternative searches using the patient's Social Security Number, instead of the member ID. - `suffix` string — The name suffix, such as Jr., Sr., or III. Only include the subscriber's personal name suffix - **don't** include professional or academic titles, such as M.D. or MBA. - `tradingPartnerName` string — The payer's name, such as Cigna or Aetna. - `tradingPartnerServiceId` string, required — The payer ID. Visit the [Payer Network](https://www.stedi.com/healthcare/network) for a complete list. - You can send requests using the primary payer ID, the Stedi payer ID, or any alias listed in the payer record. - You must include leading `0` characters - payer IDs are alphanumeric strings and must be treated as complete strings, not integers. For example, use `00540` for SISCO, not `540`. - `maxRetryHours` integer — The maximum number of hours that Stedi will retry eligibility checks in this batch that fail due to [payer connectivity issues](https://www.stedi.com/docs/healthcare/eligibility-troubleshooting#payer-connectivity-issues). Must be an integer between 8 and 24 hours. If not specified, the default is 8 hours. - `name` string — The name that Stedi will use when displaying this batch on the [Eligibility check batches page](https://portal.stedi.com/app/healthcare/checks/batch). It must be unique within your Stedi account. If you don't specify a name, Stedi sets this property to the autogenerated `batchId` returned in the response. ## Response `200` BatchEligibilityChecks 200 response - BatchEligibilityChecksResponseContent - `batchId` string, required — An identifier for this batch of eligibility checks. You can use this identifier to retrieve the results of this batch using the [Poll Batch Eligibility Checks](https://www.stedi.com/docs/healthcare/api-reference/get-healthcare-polling-eligibility) endpoint. - `submittedAt` string, date-time, required — The date and time that the batch of eligibility checks was submitted to Stedi for processing. ## Other responses - `400` — ValidationException 400 response - `401` — UnauthorizedException 401 response - `403` — AccessDeniedException 403 response - `404` — ResourceNotFoundException 404 response - `409` — ResourceConflictException 409 response - `500` — InternalFailureException 500 response --- [API](https://skmtc.net/stedi/apis/stedi-manager.md) · [All operations](https://skmtc.net/stedi/apis/stedi-manager/llms.txt) · [OpenAPI document](https://skmtc-service-staging.skmtc.workers.dev/v1/apis/stedi/stedi-manager/revisions/216291f9e103/schema)