most providers are actually trying to solve 3 or 4 separate problems when registering a patient and checking their eligibility [2]. The current EDI centered model is insufficient to cover a provider’s needs, the current toolset only partially addresses them, and to date they’ve been ruinously expensive to solve relative to the benefit providers would get. The problems are: Is this patient a member of this plan on this date of service, is the service the provider is about to provide a covered service for the plan, and has the patient exhausted any specific plan limitations for that service (e.g., the plan only covers X number of PT visits in a year). EDI transactions only cover membership [3] Assuming #1 is true, am I (as a provider) contracted with that payer directly, or am I otherwise “in network” (i.e. does the payor consider me to be a provider that they have a list of services and prices they are committed to pay for those services with) Assuming #2 is true, are the services & procedures I’m going to pr…