ELAYGENT does not claim direct insurance eligibility today. For supported pilots, ELAYGENT can send a signed eligibility-check request to a configured HTTPS bridge and show the response to staff.
Bridge support is useful for pilots where a customer, clearinghouse partner, or integration vendor already owns payer connectivity. It is not the same thing as ELAYGENT querying Stedi, Change Healthcare, or payers directly.
Generic eligibility bridge
Shipped bridge
ELAYGENT can send a signed `eligibility.check` payload to a customer- or partner-hosted HTTPS endpoint, then store the returned eligible/ineligible/unknown result on the appointment.
What it requires
`eligibilityChecksEnabled=true` on the location.
`eligibilityBridgeUrl` set to the bridge endpoint.
`ELIGIBILITY_BRIDGE_SHARED_SECRET` configured on both sides.
Patient intake must include both insurance provider and member ID.
What it does NOT do
This is not a direct payer API.
ELAYGENT does not normalize payer IDs itself in this path; the bridge owns payer mapping.
The result is an operational eligibility signal, not a guarantee of payment.
Stedi via signed bridge
Shipped bridge
Supported only as a bridge provider key today. A customer or partner bridge can receive ELAYGENT's signed payload and call Stedi from its own environment.
What it requires
A bridge service with Stedi credentials and BAA coverage outside ELAYGENT.
Configured `eligibilityBridgeUrl` and shared HMAC secret.
What it does NOT do
ELAYGENT does not store Stedi API credentials today.
No direct Stedi API client exists in this codebase.
No Stedi sandbox fixtures or direct retry/error mapping ship inside ELAYGENT yet.
Change Healthcare via signed bridge
Shipped bridge
Supported only as a bridge provider key today. A customer or partner bridge can receive ELAYGENT's signed payload and call Change Healthcare from its own environment.
What it requires
A bridge service with Change Healthcare credentials and BAA coverage outside ELAYGENT.
Configured `eligibilityBridgeUrl` and shared HMAC secret.
What it does NOT do
ELAYGENT does not store Change Healthcare API credentials today.
No direct Change Healthcare API client exists in this codebase.
No direct payer routing, payer normalization, or clearinghouse enrollment workflow is shipped.
Direct payer / clearinghouse eligibility
Not implemented
ELAYGENT does not currently call payers, Stedi, Change Healthcare, or any clearinghouse directly. Direct eligibility remains a gated GA claim until credentials, BAA/compliance review, normalization, fixtures, and retry/error mapping exist in product.
What it requires
Provider credential storage and rotation.
BAA/compliance review for the direct clearinghouse relationship.
Payer/member normalization and sandbox fixtures.
Per-provider job retry and error mapping.
What it does NOT do
Do not sell direct insurance eligibility.
Do not claim coverage verification or payment guarantee.
Do not claim payer network breadth beyond whatever a configured bridge actually supports.