Availity · JSON Structure

Eligibility Coverage Structure

Coverage schema from Availity API

Type: object Properties: 8

HealthcareClearinghouseHIPAAX12 EDIEligibilityClaimsPrior AuthorizationRevenue Cycle ManagementPayersPrice Transparency

Coverage is a JSON Structure definition published by Availity, describing 8 properties. It conforms to the https://json-structure.org/meta/core/v0/# meta-schema.

Properties

serviceTypeCodes serviceTypeNames insuranceType planCoverage coverageStatus effectiveDate expirationDate benefits

Meta-schema: https://json-structure.org/meta/core/v0/#

JSON Structure

{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/availity/refs/heads/main/json-structure/eligibility-coverage-structure.json",
  "description": "Coverage schema from Availity API",
  "type": "object",
  "properties": {
    "serviceTypeCodes": {
      "type": "array",
      "items": {
        "type": "string"
      }
    },
    "serviceTypeNames": {
      "type": "array",
      "items": {
        "type": "string"
      }
    },
    "insuranceType": {
      "type": "string"
    },
    "planCoverage": {
      "type": "string"
    },
    "coverageStatus": {
      "type": "string",
      "enum": [
        "Active",
        "Inactive",
        "Cancelled"
      ]
    },
    "effectiveDate": {
      "type": "date"
    },
    "expirationDate": {
      "type": "date"
    },
    "benefits": {
      "type": "array",
      "items": {
        "$ref": "#/components/schemas/Benefit"
      }
    }
  },
  "name": "Coverage"
}