Availity

availity Is Auth Required API

Check if authorization is required before submission

Documentation GitHub OpenAPI

Business capability

Eligibility & Benefits Verification BC-2800.30

Operations 2

Each operation below carries the questions people ask an LLM about it and the instructions they give an agent to run it. Generated by API Evangelist overlay

POST /value-adds/v1/isauthrequired Check whether a payer requires prior authorization · Availity Check if Authorization is Required #

Ask an LLM

“Does this procedure need prior authorization from the patient's health plan?”

“Can I find out if an auth is required before I submit a service review?”

Tell an agent

Check whether prior authorization is required for {serviceReview}.

Find out if the payer needs an authorization for service {serviceReview} before I submit.

GET /value-adds/v1/isauthrequired/{id} Get the result of an auth-required check · Availity Get Authorization Requirement Result #

Ask an LLM

“Is the answer back on whether my service needs prior authorization?”

“How do I retrieve the outcome of an IsAuthRequired job?”

Tell an agent

Get the auth-required result for job {id}.

Poll IsAuthRequired check {id} and tell me if authorization is needed.

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OpenAPI Specification

openapi: 3.2.0
info:
  title: Availity Service Reviews (Prior Authorization) Is Auth…
  description: The Availity Service Reviews API enables the ASC X12N 278 transaction for prior authorization and healthcare service reviews. Includes IsAuthRequired and Attachments add-on APIs.
  version: 2.0.0
  contact:
    name: Availity Developer Portal
    url: https://developer.availity.com/
servers:
- url: https://api.availity.com
  description: Availity Production API
security:
- oauth2: []
tags:
- name: Is Auth Required
  description: Check if authorization is required before submission
paths:
  /value-adds/v1/isauthrequired:
    post:
      operationId: checkIsAuthRequired
      summary: Availity Check if Authorization is Required
      description: Query whether a payer requires prior authorization before submitting a service review request.
      tags:
      - Is Auth Required
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/IsAuthRequiredRequest'
      responses:
        '200':
          description: Auth requirement check initiated
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/AsyncJobResponse'
        '400':
          $ref: '#/components/responses/BadRequest'
  /value-adds/v1/isauthrequired/{id}:
    get:
      operationId: getIsAuthRequiredResult
      summary: Availity Get Authorization Requirement Result
      description: Poll for the result of an IsAuthRequired check.
      tags:
      - Is Auth Required
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      parameters:
      - name: id
        in: path
        required: true
        schema:
          type: string
        description: Job ID from POST response
        example: '500123'
      responses:
        '200':
          description: Auth requirement result
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/IsAuthRequiredResponse'
        '404':
          $ref: '#/components/responses/NotFound'
components:
  schemas:
    Error:
      type: object
      properties:
        code:
          type: string
          example: INVALID_REQUEST
        message:
          type: string
          example: Required field missing
        details:
          type: array
          items:
            type: string
    AsyncJobResponse:
      type: object
      properties:
        id:
          type: string
          description: Job ID for polling
          example: '500123'
        status:
          type: string
          example: PROCESSING
    IsAuthRequiredRequest:
      type: object
      properties:
        serviceReview:
          type: object
          description: Authorization details to check
          properties:
            payerId:
              type: string
              example: BCBS001
            procedureCode:
              type: string
              example: '99213'
    IsAuthRequiredResponse:
      type: object
      properties:
        id:
          type: string
          example: '500123'
        authRequired:
          type: string
          enum:
          - Auth Required
          - No Auth Required
          example: Auth Required
        payerMessage:
          type: string
          example: Prior authorization required for this procedure
  responses:
    BadRequest:
      description: Bad request
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/Error'
    NotFound:
      description: Not found
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/Error'
  securitySchemes:
    oauth2:
      type: oauth2
      flows:
        clientCredentials:
          tokenUrl: https://api.availity.com/availity/v1/token
          scopes:
            hipaa: Access to HIPAA transaction APIs