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

1. In the Agentic Studio, open or create a workflow
2. In the node palette on the left, find X12 Eligibility Check under the Healthcare category (or use the search bar)
3. Drag the node onto the canvas
4. Double-click the node to open its configuration dialog
5. Fill in the required parameters (see Configuration below)
6. Connect the Patient ID and Payer ID input port from an upstream node
7. Optionally connect the Service Type port if needed
8. 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

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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.