Medicaid coverage for adults can change any month. Patients can switch managed care plans, and coverage sometimes ends mid-month. Many teams that use Stedi serve large Medicaid populations. For them, last month's eligibility check may not match this month's coverage. If you bill the old plan, it denies the claim. When the old plan comes back inactive, staff often look up the new plan in the state Medicaid portal, one patient at a time. Our latest guide shows how to use eligibility checks instead. You'll learn when to run each check and how to find a patient's new plan in the response: hubs.la/Q04C7c0M0

Stedi's eligibility PDFs are now available within milliseconds after an eligibility check. Previously, PDFs took 4-20 seconds, so you had to wait before retrieving them. Now, you can retrieve the PDF as soon as you get the eligibility check response. No integration changes needed. To learn more, check out our changelog: hubs.la/Q04C00P50

Wellmind is a clinician-founded mental health platform. They connect thousands of patients to in-network therapists and psychiatrists, primarily in California but across the U.S. Most of Wellmind's payers pay by Electronic Funds Transfer (EFT). The problem is there's no standard EFT enrollment process. Some payers ask for a voided check or a bank verification letter. Others require micro-deposit verification. Many route payments through third-party payment processors, each with its own portal, account, and paperwork. Each new payer adds another standard operating procedure (SOP) for Wellmind's team to maintain. "Wellmind exists to protect the relational power at the heart of mental healthcare. But more and more of our team's time was going to billing and payments instead," says Laura Beann, founder and CEO of Wellmind. Even when EFTs are set up, the payment and the Electronic Remittance Advice (ERA) arrive separately. The ERA goes to the clearinghouse. The payment goes to the bank. Matching them is manual. Wellmind joined the private beta of Stedi Treasury. Stedi now manages EFT enrollment for Wellmind from end to end. Wellmind submits an enrollment request. Stedi handles the work in payer and payment processor portals. Once an EFT enrollment is live, Stedi automatically links each payment to its ERA. Wellmind can trace any payment back to its ERA and claim in the Stedi portal. Wellmind now receives EFT payments from their largest payers through Stedi Treasury. That includes some of the payers with the toughest enrollment steps. "Stedi handled EFT enrollment for our most difficult payers. Once those payments started flowing through Stedi Treasury, I knew we were moving the rest of our payers over," says Laura. Read the full case study: stedi.com/customers/wellmind Check out Wellmind's website: wellmind.com/

Most dental practices still submit claims in a batch at the end of the day. Mike Huffaker, Chief Revenue Officer at @PlanetDDS, explains why that's a problem in our latest episode of Understanding Healthcare. When you batch claims at the end of the day, any claims with problems get pushed to the next day, where a new batch is already waiting. The backlog delays payment. If problem claims sit long enough, they can miss the payer's timely filing deadline and get denied. Mike's answer is automation. Once treatment is done, each claim would be submitted automatically, with everything attached and no human intervention. Watch the full episode on YouTube: youtube.com/watch?v=ny3Wm9Lc…

Blue Cross Blue Shield (BCBS) isn't one company. It's a collection of 30+ independent regional payers, each licensed to use the Blue Cross and Blue Shield names in their area. BCBS payers participate in the national BlueCard program. With BlueCard, a patient can see providers who are contracted with any participating BCBS payer. The patient's care is still covered by their "home" plan, the plan they have insurance through. BlueCard usually makes billing easier, but providers often have questions. Their billers don't always know which BCBS payer to bill or where eligibility data is coming from. Our latest guide explains how BlueCard routes eligibility checks and claims: stedi.com/blog/how-routing-w…

Congrats to Connor Sweeney and the @BabaHQ team on launching BabaBench. BabaBench tests frontier models on real care coordination work. It uses 47 tasks from Baba’s platform, rebuilt as simulations and reviewed by Baba’s expert advocates. That covers coverage checks, medical equipment, medications, transportation, and follow-up. We’re proud to have Baba as a @stedi partner. See the results below.

The One Big Beautiful Bill Act (OBBBA) changes who can qualify for state Medicaid programs and how often states review coverage. Most of the changes start on January 1, 2027. For many Medicaid patients, that means coverage can change more often. Our guide answers common questions about how the OBBBA affects eligibility checks, like: - How often should you run eligibility checks for Medicaid patients? - Do eligibility responses include Medicaid renewal dates? - Does the OBBBA change Medicare eligibility checks? Read the full guide: stedi.com/blog/how-the-one-b…

More and more dental practices need to be able to submit medical claims. Mike Huffaker, Chief Revenue Officer at @PlanetDDS, explains why in our latest Understanding Healthcare podcast. Mike notes that many forms of oral surgery, like wisdom tooth removal, and other advanced work in the mouth are billable under medical insurance. Sleep apnea devices are another service line that dental practices can bill to medical insurance. Larger dental groups are acquiring more oral surgery practices. Oral surgery groups have rolled up quickly over the past four or five years. Mike estimates there are 8,000 to 10,000 oral surgery practices in the US. Planet DDS and Stedi recently announced a medical claims integration that allows dental practices to submit those medical claims. You can watch the full episode on YouTube: youtube.com/watch?v=ny3Wm9Lc…

Stedi just launched a redesigned eligibility check view in our portal. Previously, each check had separate Overview and Benefits tabs. You had to look at one tab for plan details and another for the benefits they applied to. Now, it’s all on one page – with plan details, coverage statuses, and related entities right in the benefits table. We also added eight new filters. You can use the table’s filters to check coverage for a service, estimate patient responsibility, or confirm prior authorization requirements. More details on our blog: hubs.la/Q04zKqDc0

You can now test how your system handles denials and partial payments using Stedi's test claims workflow. The workflow lets you submit a test claim to the Stedi Test Payer and receive a test ERA. Previously, every test ERA showed each service line as paid in full. Now, you can pick the outcome – paid, partially paid, or denied – by adding a prefix to the subscriber's member ID. It works for professional, dental, and institutional claims. If you don't add a prefix, the test ERA comes back fully paid. That means you can validate how your system posts denials, contractual adjustments, and patient responsibility before production claims go out. To learn more, check out our changelog: hubs.la/Q04zB1Ng0

Pointcare is a leading coverage management platform. Pointcare manages coverage for more than 3 million patients across 130+ community health centers. Pointcare shows patients and health centers each patient's coverage status in real time. It also automates renewals, so patients stay enrolled and visits don't go uncovered. At the beginning of each month, Pointcare runs an automated eligibility check for every patient under management. If coverage lapsed or changed, Pointcare notifies the patient so they can investigate or get new coverage. How fast Pointcare can identify coverage lapses depends on how many eligibility checks their clearinghouse can process at once. "We need to know if someone is covered at the start of the month. If we identify that someone's coverage lapsed on the 28th, that's too late. They've already had the visit," says Balu Sudhakaran, Vice President of Product at Pointcare. As Pointcare's patient population grew into the millions, their legacy clearinghouse took longer and longer to process their eligibility checks. It started to look less like a partner and more like a bottleneck. Pointcare switched to Stedi's JSON Real-Time Eligibility Check API. It lets Pointcare send 50 or more eligibility checks at the same time. Each check returns results in 1-3 seconds on average. Stedi also offered better support and transaction enrollment processes than their previous clearinghouse. Both mattered as Pointcare continued to expand into new states. Pointcare now runs 100% of their eligibility checks through Stedi, around 2.5 million checks a month. "Stedi's speed, uptime, and support have been unbelievably solid. It just doesn't compare to our other clearinghouse," says Balu. Full case study linked below.

We just released a new episode of our Understanding Healthcare podcast. This time, our founder and CEO talked with Mike Huffaker, Chief Revenue Officer at @PlanetDDS, about dental billing. Planet DDS serves roughly 15,000 dental practices, focusing on DSOs and multi-location dental groups. That scale gives Mike a view of the same billing problems across thousands of offices. Many dental practices still call payers to find out what a patient's plan covers. When Mike first got into dental, he assumed payers built that friction on purpose. The more friction, the slower payers pay out. In this clip, he explains why he now thinks that perception is inaccurate. The situation is more about friction that built up over time, with no reason for payers to fix it, than misaligned incentives. Now AI bots call payers on behalf of providers, and that friction costs payers money, too. Watch the full episode on YouTube: youtube.com/watch?v=ny3Wm9Lc…

Many patients change health plans on January 1. For providers, that means any eligibility data from last year might now be wrong. Using that old data to verify patient insurance can lead to denied claims and delayed payments. To get fresh data, providers run eligibility checks on all or a chunk of their patients in early January. But when everyone runs checks at once, payers struggle to keep up. Our guide – updated for 2027 – gives you tips for running successful annual eligibility refreshes: stedi.com/blog/tips-for-annu…

We've released a redesigned version of our JSON Real-Time Eligibility Check API endpoint. It returns the same benefits information as our legacy JSON real-time eligibility endpoint with an improved response shape. The new shape is easier for developers and AI coding agents, like Claude Code and Codex, to parse. Each benefit type has its own schema, and benefits are grouped by health plan. If you're still on the legacy endpoint, our latest guide can help you migrate to the new endpoint. It covers what's changed and explains the new response shape. The guide also includes migration tips and a prompt for your coding agent. Read the migration guide: stedi.com/blog/migrate-to-th…

Kona Counseling – a Stedi customer – has published a new Stedi Billing Expert skill for developers using coding agents to build on Stedi's JSON APIs. Kona wrote the skill for their own app. It covers eligibility checks, claims, claim status, and ERAs. The skill is possible in part because Stedis docs are public and built for agents to read. Every page has a raw Markdown version, and the docs publish an llms.txt index. You can read the full skill on GitHub: github.com/garthcodes/claude… It's also listed on MCP Market: mcpmarket.com/tools/skills/s… To learn more about how you can use Stedi with coding agents, check out our docs: stedi.com/docs/healthcare/bu…

Many EHRs, RCM tools, and other platforms use Stedi to process payer transactions – like eligibility checks and claims – from their own products. We call them our Platform Partners. If you're one of them, you likely need to charge providers – your customers – for those transactions. Our latest guide covers billing models we've seen work and tips for putting them into practice. You'll learn what Stedi bills for, how to track each provider's usage, and how to charge for it. Read the blog: stedi.com/blog/how-to-bill-p…

We just launched a redesigned JSON Real-Time Eligibility Check API endpoint as part of our 2026 Stedi Keynote earlier this month. Our legacy JSON Eligibility API endpoint mirrored the X12 eligibility response. Benefits for every plan and every benefit type land in one flat array of objects. Those objects share the same schema, but the fields used in each vary based on benefit type. Co-insurance uses a percentage. Deductibles and co-pays have a monetary amount. Our new endpoint groups benefits by health plan. Within each plan, it uses a different schema for each benefit type. Co-insurance requires a percentage. Deductibles require an amount. We also got rid of other X12 baggage. Instead of deciphering benefit type based on a code value (1 for active coverage, A for co-insurance), each benefit type has an easy-to-read array key. These changes make it easier for developers and AI coding agents, like Claude Code or Codex, to pick up the API quickly. You can read the announcement on our blog: stedi.com/blog/introducing-o… You can watch the keynote here: stedi.com/keynote

Cair Health is an agentic operating system for revenue cycle management (RCM) – the administrative work that turns a patient visit into a payment. Cair's agents check coverage, code visits from clinical notes, scrub claims, work denials, and post payments. Cair's platform carries more than 80 integrations. Those integrations let Cair's agents read encounters, notes, and claim data out of each customer's system, and write results back. The problem is that none of them could submit a claim to a payer. Cair's agents could retrieve, correct, scrub, and validate a claim, but they couldn't deliver the finished claim to a payer. Customers had to complete that step themselves. The handoff also meant Cair had less visibility into the claims lifecycle after submission. Cair couldn't retrieve the claim acknowledgments or Electronic Remittance Advice (ERAs) directly. If a customer wanted Cair's agents to work a denial, they had to feed that information back in. "Customers had to forward us their remittances," says Ishan Balakrishnan, co-founder of Cair Health. "If a claim was denied, it just showed up again a few weeks later. There wasn't a neat claims lifecycle we could follow." Cair integrated their agents with Stedi's JSON Claim Submission API. The Stedi Payer Network lets Cair submit electronic claims to the payers their customers already bill, using their existing payer IDs with no mapping required. Cair also uses Stedi's webhooks to get notified of new claim acknowledgments and ERAs. Cair's claims volume grew by 4.3x in their second month on Stedi. Two months later, their monthly claims volume had increased by 141x. Cair now submits tens of thousands of claims a month to 199 payers through Stedi, and payers accept 98% of them. "Now our agents follow the claim all the way to the payer's response," says Ishan. "There are no more customer handoffs or manual forwarding. Stedi lets us automate and track the entire claims workflow from submission to payment." Read the full case study: stedi.com/customers/cair-hea… To watch Cair Health in action, check out this clip from our June 2026 Platform Partner Demo Day: youtube.com/watch?v=juTeGA9_…