Pre Encounter Eligibility Checks V 1 Coordination Of Benefits
Sends a coordination of benefits check through Stedi to determine whether a patient has coverage overlap across multiple payers and, if so, which payer is primary. Medicare and Medicare Advantage plans are not supported.
Authentication
AuthorizationBearer
Send your Taiga API key as a Bearer token. Create and manage keys in the Taiga developer portal.
Request
This endpoint expects an object.
trading_partner_service_id
The Payer ID. Each check must be for a participating health plan for which the patient has coverage. Medicare and Medicare Advantage plans are not supported.
provider
Information about the entity requesting the COB check. Provide either organization_name (for organizations) or first_name and last_name (for individuals), plus npi.
subscriber
The primary policyholder for the insurance plan or a dependent with a unique member ID. You must provide at least one of member_id or ssn.
encounter
Information about the encounter for the COB check. Service dates must be within the past 2 years and must not be in the future.
dependent
A dependent for which you want to check coordination of benefits. If the dependent has their own member ID, include their information in the subscriber object instead.
Response
provider
Information about the provider who submitted the COB request.
subscriber
Information about the primary policyholder.
dependent
Information about the dependent listed in the COB request.
payer
Information about the payer listed in the COB request.
plan_date_information
Date information for the plan.
benefits_information
Raw passthrough of Stedi’s benefits information (coverage, service types, related entities, etc.).
errors
coordination_of_benefits
Overview of the COB response including whether coverage overlap exists and payer primacy.