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_…

StoriiCare is an Electronic Health Record (EHR) and system of record for adult day centers and community-based healthcare providers. EHRs are the software systems care providers use to manage patient records and clinical workflows. Care organizations across 40 US states and 13 countries use StoriiCare. Most providers that use StoriiCare deliver ongoing care. The same participants attend week after week, and most visits are reimbursable services. StoriiCare lets those providers keep the care record and the billing in one integrated system. But claim submission was still manual, and the legacy clearinghouse made it worse. Each customer exported their claims from StoriiCare and keyed them into the clearinghouse portal by hand. The portal was hard enough to use that StoriiCare trained every customer on it, then followed up when they got stuck. Every new customer meant the same clearinghouse setup and the same training again. As StoriiCare grew, claim submission became a bottleneck. StoriiCare switched to Stedi and built Stedi's APIs directly into its product, including the Professional Claims API for claim submission. Stedi also runs every claim through validation checks called claim edits before it reaches the payer, so centers catch errors up front instead of waiting days for a payer rejection. Stedi's Payer Network also lets StoriiCare reach payers the legacy clearinghouse couldn't, including the Veterans Affairs Community Care Network. StoriiCare now submits thousands of claims each month through Stedi, and payer acceptance rates have increased. Customers no longer need to access payer systems directly. They do everything from one place: StoriiCare. "Many of our centers serve veterans, and those claims used to be a dead end. With Stedi, we know we can reach the payers we need," says Mirko Jons, Head of Product at StoriiCare. "Our team spends less time getting customers set up and more time helping them get paid." Read the full case study: stedi.com/customers/storiica…

In case you missed it: Stedi now supports dental claims, attachments, and delivery tracking for paper claims. With paper claims, Stedi prints and mails a claim to any payer for you. You submit paper claims using the same APIs, SFTP, and portal forms you use for electronic claims. Previously, paper claims covered professional (CMS-1500) and institutional (UB-04) claims only. Dental claims weren't supported. Attachments weren't supported. And you only got one 277CA claim acknowledgment when Stedi forwarded the claim for printing. Nothing told you whether the claim reached the mail. Now, you can submit dental claims as paper claims using the ADA dental claim form. You can also send 275 claim attachments – X-rays or treatment plans, for example – with any paper claim. Stedi pairs the claim with the attachment, prints both, and mails them to the payer together. The Stedi portal's claims view now follows each claim through print and mail: staged, queued, printed, mailed, or failed. You get a 277CA when the claim is mailed, and another if the payer address fails validation. Every printed claim gets a PDF proof of the package that went out, so you can show a payer exactly what was sent. For more info, watch our 2026 Stedi Keynote or read the announcement blog. - Keynote: stedi.com/keynote - Announcement blog: stedi.com/blog/paper-claims-…

Stedi now has API endpoints that mirror the CMS-1500 paper claim form. The CMS-1500 – also called the HCFA form – is the standard paper form for professional claims. Every box on it has a number. Billers know those box numbers. Payers cite them in their own guides. And AI coding agents are trained on them. Previously, only the Stedi portal's claim form mirrored the CMS-1500. Our JSON 837P endpoint uses its own schema, so you had to map every box to one of our fields. The new endpoints group fields the way the form does. Our API reference even gives you the box number. There are three endpoints. One submits a claim, one validates a claim without sending it, and one retrieves a submitted claim in the CMS-1500 structure so you can correct it and resubmit. They're the same endpoints that power the Stedi portal's own CMS-1500 Claim Form. For more info, watch our 2026 Stedi Keynote or read the announcement blog. - Keynote: stedi.com/keynote - Announcement blog: stedi.com/blog/introducing-t…