Availity
Availity is a healthcare information network and clearinghouse providing REST APIs for real-time HIPAA EDI transactions. The platform processes over 11 billion annual healthcare transactions connecting providers, health plans, and vendors nationwide. Create your application and subscribe to a plan to make use of Availity APIs for eligibility verification, claims management, prior authorization, and patient cost estimation.
Reference-quality API operations across every facet — a rich contract, published governance, transparent operations, and machine-readable commercial terms.
API Evangelist profiles Availity the way a machine reads it — 195 machine-readable artifacts across 4 APIs, pulled from the provider's own public surface and indexed so a developer, an analyst, or an AI agent can evaluate it against every other provider on the network.
Every provider in the network is reduced to the same set of machine-readable artifacts — OpenAPI contracts, event specifications, GraphQL schemas, runnable collections, pricing and rate-limit signals, security posture, OAuth scopes, and the agent surfaces (MCP servers and skills) that let software drive the API on its own. We profile them because the interface is the part of a company you can actually inspect: it is a truer signal of what a provider does than any marketing page. From those artifacts we compute the Kin Score — Availity scores 73.3/100 (exemplar), with a separate agent-readiness read of 32/100 (agent ready). The full breakdown is below, followed by every artifact we hold — each card links through to its machine-readable definition on apis.io.
Kin Score
This is the API Evangelist rating — a single, repeatable read computed from the artifacts on this page. Green fill is points earned; the red track is points possible, so every bar shows earned-versus-possible at a glance. Every facet and dimension name is a link: it opens that measurement's page on APIs.io, where the rating runs across the whole catalog — the exact checks that feed it, how every profiled provider distributes on it, and who is at the top of it.
Kin Score
How this is scored →scored 2026-09-10 · rubric v0.20.0
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How we profile Availity
Each block below is one kind of artifact we hold for Availity. For each we say what it is and why it earns a place in the profile, then list every one we've indexed — capped at two rows, scroll within the panel for the rest.
APIs 12
Each API is captured as its own OpenAPI definition — every operation, parameter, and response. This is the single most useful machine-readable description of what an API does, and it's what lets us score, lint, mock, and generate against it without asking the provider for anything.
Individual APIs this provider publishes, each with its own machine-readable definition.
Availity Healthcare HIPAA Transactions API
The Availity Healthcare HIPAA Transactions API provides a unified interface for standard HIPAA EDI transactions. REST APIs enable healthcare providers and vendors to submit and ...
Availity Patient Cost Estimator API
The Availity Patient Cost Estimator API enables healthcare providers and institutions to estimate service costs before delivery for both institutional and professional services....
Availity Eligibility & Benefits Value-Add APIs
The Availity Eligibility & Benefits Value-Add APIs provide supplementary data during eligibility transactions. The Care Reminders API retrieves real-time care gap information fr...
Availity Payer List API
The Availity Payer List API (v1.0.4) allows healthcare organizations to query available payers and the transactions they support. Returns payer identifiers, names, and supported...
Availity Configurations API
The Availity Configurations API (v1.0.0) provides provider details and payer-specific validation requirements. Returns configuration rules for enhanced claim status, prior autho...
availity Auth Attachments API
Attach documentation to authorization requests
availity Claim Attachments API
Electronic claim attachment submission and retrieval
availity Claim Status API
Claim status inquiries and tracking
availity Eligibility API
Real-time eligibility and benefits verification
availity Enhanced Claim Status API
Enhanced claim status with value-add data
availity Is Auth Required API
Check if authorization is required before submission
availity Service Reviews API
Prior authorization and service review requests
Scroll within the panel for all 12 ·
Open Collections 10
Open, tool-agnostic collections carry the same runnable value as Postman without locking you to one client — the portable, forkable form of the same exercise.
Open, tool-agnostic API collections (OpenAPI-derived and Bruno).
API Collection
OPEN COLLECTIONAvaility Claim Attachments Auth Attachments API
OPEN COLLECTIONAvaility Auth Attachments Claim Attachments API
OPEN COLLECTIONAvaility Claim Attachments API
OPEN COLLECTIONAvaility Claim Attachments Auth Attachments Claim Status API
OPEN COLLECTIONAvaility Claim Status API
OPEN COLLECTIONAvaility Claim Attachments Auth Attachments Eligibility API
OPEN COLLECTIONAvaility Eligibility & Benefits API
OPEN COLLECTIONScroll within the panel for all 10 ·
Arazzo Workflows 4
Real integrations are rarely a single call. Arazzo describes the multi-step sequences — auth, then create, then confirm — so both a human and an agent can follow the choreography, not just the endpoints.
Multi-step API workflows described with the Arazzo specification.
Availity Claim Attachment (X12 275)
Submit an X12 275 claim attachment, then poll for its processing status until the payer accepts it.
ARAZZOAvaility Claim Status Inquiry (X12 276/277)
Submit an X12 276 claim status request, then poll for the X12 277 claim status response until the payer finalizes it.
ARAZZOAvaility Eligibility and Benefits (X12 270/271)
Locate a payer that supports the 270 transaction, submit an X12 270 eligibility request, then retrieve the resulting 271 benefit response.
ARAZZOAvaility Prior Authorization (X12 278)
Determine whether authorization is required, create the X12 278 service review, attach supporting clinical documentation, then read back the authorization decision.
ARAZZOPricing Plans 1
Pricing is part of the interface. Machine-readable plans tell you what a tier costs and includes before you commit — one of the things the Kin Score reads for access clarity — renamed from commercial clarity in rubric 0.12, because a free statutory interface has access terms and no commercial ones.
Published pricing tiers and plan structures.
Rate Limits 1
Rate limits are the difference between a demo that works and a production integration that doesn't fall over. Publishing them is an operational-transparency signal — and a hard requirement for any agent that plans its own throughput.
Documented rate limits and quota policies.
Availity Rate Limits
RATE LIMITSFinOps 1
Cost, billing, and metering signals let a buyer model the financial operations of an API before it's live. We profile them for the same reason we profile pricing: the money is part of the contract.
Cost, billing, and metering signals for API financial operations.
Availity Finops
FINOPSFeatures 8
The notable capabilities this provider advertises, captured as structured features so they can be searched and compared instead of read one landing page at a time.
Notable capabilities this provider offers.
OAuth 2.0 Authentication
Client credentials grant flow with 5-minute token expiration and HTTPS/TLS encryption for secure API access.
Real-Time EDI Transactions
Processing over 8.8 million daily transactions and 11 billion annual healthcare transactions across all major health plans.
Nationwide Payer Network
Access to every major health plan nationwide and over 1 million providers through the Availity clearinghouse.
Multi-Format Responses
Returns JSON and XML representations including errors using HTTP response codes. Supports CSV, PDF, PNG, and XLS for specific endpoints.
Cursor-Based Pagination
Collection resources support offset/limit pagination with limit range of 1-50 items per request with link relations.
Mock/Sandbox Testing
Demo subscriptions support custom response selection via X-Api-Mock-Scenario-ID and X-Api-Mock-Response headers.
Rate Limiting
Standard tier provides 100,000 calls per day and 100 calls per second for HIPAA transaction APIs.
ASC X12 EDI Standards
Full support for HIPAA EDI version 005010 transactions including 270/271, 276/277, 278, and 835 transaction sets.
Scroll within the panel for all 8 ·
Semantic Vocabularies 5
JSON-LD contexts give the data shared meaning across APIs. We profile them because semantics are what let a machine reconcile 'customer' here with 'customer' somewhere else.
JSON-LD contexts and semantic vocabularies used across these APIs.
Availity Availity Context
JSON-LDAvaility Claim Context
JSON-LDAvaility Context
JSON-LDAvaility Eligibility Context
JSON-LDAvaility Service Context
JSON-LDSpectral Rules 2
Governance rulesets we run against this provider's specs — the automated checks behind parts of the score. Profiling them makes the quality bar explicit and re-runnable, not a matter of opinion.
Availity API Rules
SPECTRALAvaility API Rules
SPECTRALJSON Schema 63
Standalone JSON Schema definitions describe the data models behind the API. We profile them so the shapes are validatable on their own — useful long after a single request is forgotten.
Standalone JSON Schema definitions for this provider's data models.
AsyncJobResponse
JSON SCHEMAAttachmentRequest
JSON SCHEMAAttachmentStatusResponse
JSON SCHEMABenefit
JSON SCHEMAClaimAttachmentRequest
JSON SCHEMAClaimAttachmentResponse
JSON SCHEMAClaimStatusList
JSON SCHEMAClaimStatusRequest
JSON SCHEMAClaimStatusResponse
JSON SCHEMACoverage
JSON SCHEMADependent
JSON SCHEMADetailSearchRequest
JSON SCHEMAAvaility Eligibility Response
JSON SCHEMAEligibilityError
JSON SCHEMAEligibilityList
JSON SCHEMAEligibilityRequest
JSON SCHEMAEligibilityResponse
JSON SCHEMAError
JSON SCHEMAIsAuthRequiredRequest
JSON SCHEMAIsAuthRequiredResponse
JSON SCHEMAPayer
JSON SCHEMAPayerInfo
JSON SCHEMAPayerList
JSON SCHEMAPlanInformation
JSON SCHEMAProvider
JSON SCHEMASearchBy276Request
JSON SCHEMAServiceReviewList
JSON SCHEMAServiceReviewRequest
JSON SCHEMAServiceReviewResponse
JSON SCHEMASubscriber
JSON SCHEMASubscriberInfo
JSON SCHEMASummarySearchRequest
JSON SCHEMAClaimAttachmentRequest
JSON SCHEMAClaimAttachmentResponse
JSON SCHEMAAsyncJobResponse
JSON SCHEMAClaimStatusList
JSON SCHEMAClaimStatusRequest
JSON SCHEMAClaimStatusResponse
JSON SCHEMADetailSearchRequest
JSON SCHEMASearchBy276Request
JSON SCHEMASummarySearchRequest
JSON SCHEMABenefit
JSON SCHEMACoverage
JSON SCHEMADependent
JSON SCHEMAEligibilityError
JSON SCHEMAEligibilityList
JSON SCHEMAEligibilityRequest
JSON SCHEMAEligibilityResponse
JSON SCHEMAPayerInfo
JSON SCHEMAPayerList
JSON SCHEMAPayer
JSON SCHEMAPlanInformation
JSON SCHEMAProvider
JSON SCHEMASubscriberInfo
JSON SCHEMASubscriber
JSON SCHEMAAsyncJobResponse
JSON SCHEMAAttachmentRequest
JSON SCHEMAAttachmentStatusResponse
JSON SCHEMAIsAuthRequiredRequest
JSON SCHEMAIsAuthRequiredResponse
JSON SCHEMAServiceReviewList
JSON SCHEMAServiceReviewRequest
JSON SCHEMAServiceReviewResponse
JSON SCHEMAScroll within the panel for all 63 ·
JSON Structure 33
JSON Structure captures the data shapes in a form built for tooling — a complement to JSON Schema that keeps the model machine-legible.
JSON Structure definitions describing this provider's data shapes.
Availity Eligibility Structure
JSON STRUCTUREAvaility Structure
JSON STRUCTUREClaim Attachments Claim Attachment Request Structure
JSON STRUCTUREClaim Attachments Claim Attachment Response Structure
JSON STRUCTUREClaim Status Async Job Response Structure
JSON STRUCTUREClaim Status Claim Status List Structure
JSON STRUCTUREClaim Status Claim Status Request Structure
JSON STRUCTUREClaim Status Claim Status Response Structure
JSON STRUCTUREClaim Status Detail Search Request Structure
JSON STRUCTUREClaim Status Search By276 Request Structure
JSON STRUCTUREClaim Status Summary Search Request Structure
JSON STRUCTUREEligibility Benefit Structure
JSON STRUCTUREEligibility Coverage Structure
JSON STRUCTUREEligibility Dependent Structure
JSON STRUCTUREEligibility Eligibility Error Structure
JSON STRUCTUREEligibility Eligibility List Structure
JSON STRUCTUREEligibility Eligibility Request Structure
JSON STRUCTUREEligibility Eligibility Response Structure
JSON STRUCTUREEligibility Payer Info Structure
JSON STRUCTUREEligibility Payer List Structure
JSON STRUCTUREEligibility Payer Structure
JSON STRUCTUREEligibility Plan Information Structure
JSON STRUCTUREEligibility Provider Structure
JSON STRUCTUREEligibility Subscriber Info Structure
JSON STRUCTUREEligibility Subscriber Structure
JSON STRUCTUREService Reviews Async Job Response Structure
JSON STRUCTUREService Reviews Attachment Request Structure
JSON STRUCTUREService Reviews Attachment Status Response Structure
JSON STRUCTUREService Reviews Is Auth Required Request Structure
JSON STRUCTUREService Reviews Is Auth Required Response Structure
JSON STRUCTUREService Reviews Service Review List Structure
JSON STRUCTUREService Reviews Service Review Request Structure
JSON STRUCTUREService Reviews Service Review Response Structure
JSON STRUCTUREScroll within the panel for all 33 ·
Examples 35
Real request and response payloads are what turn a spec from abstract into obvious — and they're one of the twelve things an agent needs to call an API correctly on the first try.
Example request and response payloads for these APIs.
Availity Eligibility Example
EXAMPLEEligibility Benefit Example
EXAMPLEEligibility Coverage Example
EXAMPLEEligibility Payer Example
EXAMPLEEligibility Provider Example
EXAMPLEScroll within the panel for all 35 ·
Security Posture 2
Authentication, domain security, vulnerability disclosure, and trust-center signals — the evidence that a provider takes security seriously enough to document it. We profile it because you can't govern what you can't see.
Authentication, domain security, vulnerability disclosure, and trust-center signals.
Scopes 1
OAuth scopes are the vocabulary of least-privilege access. Profiling them shows exactly what an integration — or an agent acting on a user's behalf — is allowed to do.
OAuth scopes governing access to this provider's APIs.
Agentic Access 1
An x-agentic-access contract marks which operations are safe for an agent to run on its own and which need a human in the loop. It is the difference between an API an agent can use and one it can use safely.
Recommended x-agentic-access execution contracts for AI agents.
Use Cases 8
What developers actually build with this provider — captured so the catalogue answers 'what is this for', not just 'what does this expose'.
What developers build with this provider.
Real-Time Eligibility Verification
Verify patient insurance coverage, co-pays, deductibles, and benefits in real time before scheduling or rendering services.
Claim Status Tracking
Track submitted claims through adjudication, checking ACKNOWLEDGED, PENDING, PAID, DENIED, and ADJUSTED statuses.
Prior Authorization Management
Submit and track prior authorization requests using X12 278 transactions to check if authorization is required before service delivery.
Patient Cost Estimation
Estimate patient out-of-pocket costs before services are rendered to meet price transparency requirements and inform patients.
Electronic Claim Attachments
Electronically attach clinical documentation to claims and authorizations, reducing manual faxing and accelerating adjudication.
Care Gap Identification
Retrieve real-time care reminders during eligibility checks to identify preventive care gaps and coordinate outreach.
Digital Member ID Cards
Retrieve member ID cards digitally during eligibility verification, reducing administrative burden and improving patient experience.
Multi-Payer Data Consolidation
Connect to all major payers through a single clearinghouse API rather than managing individual payer connections.
Scroll within the panel for all 8 ·
Integrations 8
Pre-built integrations with other platforms tell you where this provider already fits in a stack.
Pre-built integrations with other platforms and tools.
EHR Systems
Integrates with electronic health record systems to embed eligibility and claims workflows into clinical workflows.
Practice Management Systems
Connects practice management software to payer networks for revenue cycle management and claims processing.
Revenue Cycle Management Platforms
Integrates with RCM platforms to automate eligibility verification, claim submission, and payment reconciliation.
Blue Cross Blue Shield Plans
Direct integration with BCBS plans nationwide for eligibility, claims, and prior authorization transactions.
Humana
Integration with Humana for care reminders, eligibility verification, and claims processing.
Molina Healthcare
Integration with Molina Healthcare for eligibility and benefits verification and care reminders.
Florida Blue
Integration with Florida Blue for care reminders and real-time eligibility verification.
Healthfirst New York
Integration with Healthfirst New York for eligibility and care gap identification.
Scroll within the panel for all 8 ·
Resources
Every other property we hold for Availity — documentation, portals, status pages, policies, and corporate surface — grouped by the job it does, following the integrator's arc from getting started to running in production.
Get Started 5
Portal, sign-up, and the first successful call
Documentation 15
Reference material describing how the API behaves
Scroll within the panel for all 15 ·
Agent Surfaces 3
MCP servers, agent skills, and machine-readable catalogs
Design & Contract 12
Pagination, idempotency, versioning, errors, and events
Scroll within the panel for all 12 ·
Build 5
SDKs, sample code, and the tooling you integrate with
Access & Security 4
Authentication, authorization, and security posture
Operate 3
Status, limits, changes, and where to get help
Commercial 4
Pricing, plans, and the legal terms of use
Company 3
The organization behind the API
Other 12
Properties that don't map to a standard resource type
Scroll within the panel for all 12 ·
← All providers · Data indexed from github.com/api-evangelist/availity · machine-readable index on apis.io
This is an independent, third-party profile of Availity, published by API Evangelist. We do not operate, host, resell, or support these APIs, and we are not affiliated with or endorsed by the company unless stated above. Everything here is built from publicly available information — the company's own site, developer portal, documentation, public repositories, and the specifications it publishes for public use. Nothing is obtained by breaching a system, defeating an access control, or using credentials.
The Kin Score and Agent Readiness rating are independently calculated assessments of a company's public API artifacts, scored against a published rubric. They are not certifications, endorsements, security assessments, or audits.
Corrections, re-scores, and removal are free — no partnership or purchase required, and you do not need to justify the request. A removed company is recorded as unrated, never scored zero for having asked. Acknowledgement within one business day; removal within two.
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