Solutions
For insurers
Payer connectivity is data, not a special case named after the insurance company. Each payer records which transactions it accepts and what must be true before a claim goes out.
Eligibility
A 270/271 check returns coverage, copay, deductible, and network status through the same shape whether the connector is the local sandbox or Optum.
Claim status
A clearinghouse rejection is not a denial. The claim never reached adjudication, so it stays out of the appeal worklist.
