Due Health · AI Eligibility Verification
Due Health verifies every appointment in real time — parsing the 271, scoring the financial risk, detecting missing referral and prior auth requirements, and routing only the exceptions your team needs to touch.
- X12 270/271 · Stedi
- Athena Health
- BAA Before PHI
- HIPAA Compliant
Chapter 01 · The Problem
Monday. 47 appointments. Zero of them verified.
A biller pulls the schedule. Reads raw EDI. Decides by hand. That worked when schedules were 12 patients deep. It does not work for a 25-provider group running 800 visits a week across four locations and every payer plan in the tri-state area.
ISA*00* *00* *ZZ*EMEDNYBAT *ZZ*ETIN * GS*HB*EMEDNYBAT*ETIN*20260817*0801*1*X*005010X279A1~ ST*271*0001*005010X279A1~ BHT*0022*11*10001234*20260817*0801~ HL*1**20*1~ NM1*PR*2*AETNA*****PI*60054~ HL*2*1*21*1~ NM1*1P*2*MERCER STREET FAMILY MED*****XX*1234567890~ HL*3*2*22*0~ TRN*2*93175-012547*9877281234~ NM1*IL*1*ALVAREZ*MARIANA****MI*W123456789~ DMG*D8*19860412*F~ EB*1**30*HM*AETNA PPO 80/20~ EB*C*FAM*30**23*1500*****Y~
"When a claim denies for a preventable eligibility reason, the loss has already happened."
Chapter 02 · The Pipeline
The pipeline your team already sees.
Six agents. One sequential handoff. Every appointment ingested from Athena, verified through Stedi, parsed, risk-scored, and routed — with a plain-language trail your front desk (and your auditors) can read at a glance.
Marcus Adeyemi
ActiveUnknownMedium · 40Sample data · not a real patientec_557343ec2903 · Jun 30, 2:53 PM · synthetic record
running… 0.0s · Jun 30, 2:53 PM
Awaiting ingestion…
6 agents · sequential handoff · fully auditable
Sample · synthetic · fictional
All names, patient IDs, appointments, and payer responses shown are entirely synthetic. Nothing on this page is real protected health information (PHI), and none of this content is subject to HIPAA. Due Health never displays real patient data in marketing or demos.
This is the exact case view inside Due Health — not a marketing mock.
Chapter 03 · The Platform
One worklist. Every appointment scored and routed overnight.
Your team works the list — not the spreadsheet, not the inbox, not the payer portal.
| Patient | Payer | Appt | Patient resp. | Risk | Next action |
|---|---|---|---|---|---|
| Alvarez, Mariana | Aetna PPO | Mon 09:15 | $48.00 | LOW | ✓ Auto-cleared |
| Park, Joon | BCBS NJ HMO | Mon 09:30 | $215.40 | MED | ⚠ Referral missing |
| Chen, Robert | UHC Choice | Mon 09:45 | $0.00 | LOW | ✓ Deductible met |
| Okafor, Adaeze | Cigna OAP | Mon 10:00 | $1,240.00 | HIGH | ⚠ Prior auth required |
| Singh, Priya | Humana Gold | Mon 10:15 | $72.00 | LOW | ⏳ Awaiting 271 |
| Russo, Daniela | Oxford EPO | Mon 10:30 | $95.00 | LOW | ✓ Estimate sent |
| Nguyen, Thanh | Empire BCBS | Mon 10:45 | $182.50 | MED | ⚠ Inactive plan |
Sample · synthetic · fictional
All names, patient IDs, appointments, and payer responses shown are entirely synthetic. Nothing on this page is real protected health information (PHI), and none of this content is subject to HIPAA. Due Health never displays real patient data in marketing or demos.
Verify
Every 271 parsed and scored. Raw EDI becomes structured fields the second the response lands.
See in product →Route
Exceptions only, sorted by risk. Missing referrals, inactive plans, prior-auth flags — each with the next action.
See in product →Collect
Estimates out before check-in. When responsibility crosses your threshold, an SMS estimate fires automatically.
See in product →Chapter 04 · The Data Advantage
Every claim processed makes the system more accurate. That's not a feature. That's a moat.
Stedi Payer Network
Access to 1,000+ payers via Stedi's 270/271 infrastructure. Coverage that grows as Stedi's network grows.
Claim Outcome Intelligence
ERA payment data, denial codes, and adjudication timelines feed back into payer behavior profiles. The system learns which plans deny which codes.
Practice-Specific Memory
Authorization requirements, referral patterns, and payer behavior tuned to your specific provider, specialty, and payer mix — not industry averages.
Chapter 05 · Infrastructure
Built on the infrastructure the industry already trusts.
Stedi
270/271 · X12 standard
1,000+ payers · stedi.com/payers
due.health
AI Intelligence Layer
Parsing · Scoring · Routing
Athena Health
PM/EHR · API integration
Appointments · Insurance · Claim sync
Roadmap: ModMed · eClinicalWorks · NextGen · AdvancedMD
Chapter 06 · Security
HIPAA-compliant from the first call. A BAA before any PHI changes hands.
- ✓BAARequired and executed before any PHI is exchanged
- ✓TransitTLS 1.3
- ✓At restAES-256
- ✓Data residencyUS-only · us-east-1
- ✓Audit logEvery agent action · timestamped · immutable
- ✓Stedi BAAExecuted
- ✓Athena Health BAAExecuted
- ✓PHI accessRole-based · minimum necessary
Early Access · Building Now
Due Health is in early access. We're building with practices, not just for them.
Built with a 13-provider multispecialty group (podiatry and optometry) and a 30+ provider dermatology and surgical group in NY/NJ. Early access practices get direct product access, locked early access pricing, and influence over what ships next.
This is not a waitlist.
25 minutes. We'll show you the exception worklist, the agent workflow, and what your Monday looks like when eligibility is done before your front desk arrives.
FAQ
Questions practices ask us first.
What is AI insurance eligibility verification?+
AI insurance eligibility verification automates the process of confirming a patient's insurance coverage before their appointment. Due Health parses the 271 response into structured benefit fields — deductible, copay, coinsurance, prior auth requirements, referral requirements, network status — scores the financial risk, and routes exceptions to a human worklist.
How is Due Health different from a clearinghouse?+
Clearinghouses like Availity, Waystar, and Change Healthcare transport the 270/271 transaction. Due Health sits above the transaction layer — uses Stedi as 270/271 infrastructure and adds AI parsing, benefit extraction, risk scoring, referral detection, prior auth flagging, patient estimation, and exception routing on top.
Does Due Health replace my practice management system?+
No. Due Health integrates with your PM system. The primary integration is Athena Health — appointments, patients, and insurance pull directly via API. Due Health adds an intelligence layer on top.
What payers does Due Health support?+
Due Health accesses the Stedi payer network, covering 1,000+ payers nationwide — Medicare, Medicaid, UnitedHealthcare, Aetna, BCBS, Cigna, Humana, and regional plans. Coverage grows as Stedi's network grows.
Is Due Health HIPAA compliant?+
Yes. Due Health executes a Business Associate Agreement (BAA) before any PHI is exchanged. All data encrypted in transit (TLS 1.3) and at rest (AES-256), stored in a US-only data plane, with every agent action logged in an immutable audit trail.
See it on your actual schedule.
25 minutes. Your real numbers. Live in your browser.
Book a walkthrough →