X12 Eligibility Check
Category: Healthcare Standards: X12 270/271 · HIPAA 5010
Check insurance eligibility and benefits via X12 270/271
What this node does
- Real-time eligibility
- Benefit inquiry
- Coverage verification
- Multi-payer support
How to use
- In the Hydra Builder, open or create a workflow
- In the node palette on the left, find X12 Eligibility Check under the Healthcare category (or use the search bar)
- Drag the node onto the canvas
- Double-click the node to open its configuration dialog
- Fill in the required parameters (see Configuration below)
- Connect the Patient ID and Payer ID input port from an upstream node
- Optionally connect the Service Type port if needed
- Connect the Is Eligible and Copay and Deductible and Coverage Details output to the next node downstream
Inputs
| Port | Type | Required | Description |
|---|---|---|---|
| Patient ID | text | ✓ | Plain text string |
| Payer ID | text | ✓ | Plain text string |
| Service Type | text | Optional | Plain text string |
Outputs
| Port | Type | Description |
|---|---|---|
| Is Eligible | text | Plain text string |
| Copay | text | Plain text string |
| Deductible | text | Plain text string |
| Coverage Details | json | JSON data object |
Configuration
Open the configuration dialog by double-clicking the X12 Eligibility Check node on the canvas.
| Parameter | What to enter |
|---|---|
serviceTypeCode | Configure serviceTypeCode in the node settings |
dateOfService | Configure dateOfService in the node settings |
providerNPI | Configure providerNPI in the node settings |
When to use this node
- Verify patient eligibility
- Check benefits before service
- Coverage discovery
Need help configuring this node?
Go to Settings → Connectors to set up the connection this node depends on, then reference the connector ID in the node configuration dialog.