Send mock requests to the Eligibility Check endpoint

When you submit the following requests to the Eligibility Check endpoint, Stedi returns mock benefits data from the specified payer you can use for testing. You need a Stedi API key for authentication, and you must set the stedi-test header to true.

Medical

Request notes:

tradingPartnerServiceId: Any partner other than the one listed returns a Payer not configured error.
encounter: Only service type code 30 is supported.
provider: You can use any organization name and any NPI, as long as it passes check digit validation. To generate a dummy NPI, you can use this free tool.
subscriber: You must use the exact values in the test request. Other birthdates, first names, last names, and member IDs return errors.

Aetna

test request for Aetna

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"112233445",
    "tradingPartnerServiceId": "60054", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0001112223"
    },
    "subscriber": {
        "firstName": "Jane",
        "lastName": "Doe",
        "dateOfBirth": "20040404",
        "memberId": "AETNA12345"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

Ambetter

test request for Ambetter

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"112233445",
    "tradingPartnerServiceId": "68069", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0001112223"
    },
    "subscriber": {
        "firstName": "John",
        "lastName": "Doe",
        "dateOfBirth": "19940404",
        "memberId": "AMBETTER123"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

Anthem Blue Cross Blue Shield of CA

test request for Anthem BCBSCA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"112233445",
    "tradingPartnerServiceId": "040", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0001112223"
    },
    "subscriber": {
        "firstName": "John",
        "lastName": "Doe",
        "dateOfBirth": "19750101",
        "memberId": "BCBSCA123456"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

Blue Cross and Blue Shield of Texas

test request for BCBSTX

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"112233445",
    "tradingPartnerServiceId": "G84980", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0001112223"
    },
    "subscriber": {
        "firstName": "Jane",
        "lastName": "Doe",
        "dateOfBirth": "20100101",
        "memberId": "BCBSTX123456"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

Cigna

test request for CIGNA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"123456789",
    "tradingPartnerServiceId": "62308", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0123456789"
    },
    "subscriber": {
        "firstName": "James",
        "lastName": "Jones",
        "dateOfBirth": "19910202",
        "memberId": "23456789100"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

test request for CIGNA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"123456789",
    "tradingPartnerServiceId": "62308", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0123456789"
    },
    "subscriber": {
        "firstName": "Rolando",
        "lastName": "Arrojo",
        "dateOfBirth": "19710102",
        "memberId": "5643296"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

test request for CIGNA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"123456789",
    "tradingPartnerServiceId": "62308", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0123456789"
    },
    "subscriber": {
        "firstName": "Rod",
        "lastName": "Beck",
        "dateOfBirth": "19720203",
        "memberId": "R5TJR4HR4H"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

test request for CIGNA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"123456789",
    "tradingPartnerServiceId": "62308", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0123456789"
    },
    "subscriber": {
        "firstName": "David",
        "lastName": "Cone",
        "dateOfBirth": "19730304",
        "memberId": "5642296"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

test request for CIGNA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"123456789",
    "tradingPartnerServiceId": "62308", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0123456789"
    },
    "subscriber": {
        "firstName": "Frank",
        "lastName": "Castillo",
        "dateOfBirth": "19750405",
        "memberId": "FTRJRG3254"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

test request for CIGNA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"123456789",
    "tradingPartnerServiceId": "62308", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0123456789"
    },
    "subscriber": {
        "firstName": "Casey",
        "lastName": "Fossum",
        "dateOfBirth": "19760506",
        "memberId": "5641296"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

test request for CIGNA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"123456789",
    "tradingPartnerServiceId": "62308", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0123456789"
    },
    "subscriber": {
        "firstName": "Rich",
        "lastName": "Garces",
        "dateOfBirth": "19770607",
        "memberId": "DHW5445"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

Humana

test request for Humana

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"112233445",
    "tradingPartnerServiceId": "61101", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0001112223"
    },
    "subscriber": {
        "firstName": "Jane",
        "lastName": "Doe",
        "dateOfBirth": "19750505",
        "memberId": "HUMANA123"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

UnitedHealthcare

test request for UHC

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"112233445",
    "tradingPartnerServiceId": "87726", 
    "provider": {
        "organizationName": "Provider Name",
        "npi": "0001112223"
    },
    "subscriber": {
        "firstName": "Jane",
        "lastName": "Doe",
        "dateOfBirth": "19710101",
        "memberId": "UHC123456"
    },
    "encounter": {
        "serviceTypeCodes": ["30"]
    }
}'

Dental

Request notes:

tradingPartnerServiceId: Any partner other than the one listed returns a Payer not configured error.
encounter: Only service type code 35 is supported.
provider: You can use any organization name and any NPI, as long as it passes check digit validation. To generate a dummy NPI, you can use this free tool.
subscriber: You must use the exact values in the test request. Other birthdates, first names, last names, and member IDs return errors.

Ameritas

test request for Ameritas

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"164867197",
    "tradingPartnerServiceId": "100925", 
    "provider": {
        "firstName": "Plaque",
        "lastName": "Penguin",
        "npi": "1282565121"
    },
    "subscriber": {
        "firstName": "Falcon",
        "lastName": "Dent",
        "dateOfBirth": "19850607",
        "memberId": "007007007"
    },
    "encounter": {
        "serviceTypeCodes": ["35"]
    }
}'

Anthem Blue Cross Blue Shield of CA

test request for BCBSCA

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"592233731",
    "tradingPartnerServiceId": "84103", 
    "provider": {
        "organizationName": "One",
        "npi": "1481480079"
    },
    "subscriber": {
        "firstName": "Aardvark",
        "lastName": "Dent",
        "dateOfBirth": "19701212",
        "memberId": "987654321"
    },
    "encounter": {
        "serviceTypeCodes": ["35"]
    }
}'

Cigna

test request for Cigna

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"590491431",
    "tradingPartnerServiceId": "59-1031071", 
    "provider": {
        "organizationName": "One",
        "npi": "0001112223"
    },
    "subscriber": {
        "firstName": "Jaguar",
        "lastName": "Dent",
        "dateOfBirth": "19960505",
        "memberId": "U3141592653"
    },
    "encounter": {
        "serviceTypeCodes": ["35"]
    }
}'

Metlife

test request for Metlife

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"590555808",
    "tradingPartnerServiceId": "101256", 
    "provider": {
        "organizationName": "One",
        "npi": "1231231239"
    },
    "subscriber": {
        "firstName": "Elephant",
        "lastName": "Dent",
        "dateOfBirth": "19840229",
        "memberId": "88877788"
    },
    "encounter": {
        "serviceTypeCodes": ["35"]
    }
}'

UnitedHealthcare

test request for UnitedHealthcare

curl --request POST \
  --url 'https://healthcare.us.stedi.com/2024-04-01/change/medicalnetwork/eligibility/v3' \
  --header 'Authorization: Key {api_key}' \
  --header 'stedi-test: true' \
  --header 'Content-Type: application/json' \
  --data '{
    "controlNumber":"143153149",
    "tradingPartnerServiceId": "52133", 
    "provider": {
        "organizationName": "One",
        "npi": "1487885067"
    },
    "subscriber": {
        "firstName": "Beaver",
        "lastName": "Dent",
        "dateOfBirth": "19690628",
        "memberId": "404404404"
    },
    "encounter": {
        "serviceTypeCodes": ["35"]
    }
}'

Healthcare

EDI platform

​Medical

​Aetna

​Ambetter

​Anthem Blue Cross Blue Shield of CA

​Blue Cross and Blue Shield of Texas

​Cigna

​Humana

​UnitedHealthcare

​Dental

​Ameritas

​Anthem Blue Cross Blue Shield of CA

​Cigna

​Metlife

​UnitedHealthcare

Medical

Aetna

Ambetter

Anthem Blue Cross Blue Shield of CA

Blue Cross and Blue Shield of Texas

Cigna

Humana

UnitedHealthcare

Dental

Ameritas

Anthem Blue Cross Blue Shield of CA

Cigna

Metlife

UnitedHealthcare