Availity · JSON Structure

Eligibility Eligibility Request Structure

EligibilityRequest schema from Availity API

Type: object Properties: 6 Required: 4
HealthcareClearinghouseHIPAAX12 EDIEligibilityClaimsPrior AuthorizationRevenue Cycle ManagementPayersPrice Transparency

EligibilityRequest is a JSON Structure definition published by Availity, describing 6 properties, of which 4 are required. It conforms to the https://json-structure.org/meta/core/v0/# meta-schema.

Properties

controlNumber provider subscriber dependent payer encounter

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

JSON Structure

Raw ↑ 
{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/availity/refs/heads/main/json-structure/eligibility-eligibility-request-structure.json",
  "description": "EligibilityRequest schema from Availity API",
  "type": "object",
  "required": [
    "controlNumber",
    "provider",
    "subscriber",
    "payer"
  ],
  "properties": {
    "controlNumber": {
      "type": "string",
      "description": "Unique transaction control number (up to 9 characters)",
      "maxLength": 9
    },
    "provider": {
      "$ref": "#/components/schemas/Provider"
    },
    "subscriber": {
      "$ref": "#/components/schemas/Subscriber"
    },
    "dependent": {
      "$ref": "#/components/schemas/Dependent"
    },
    "payer": {
      "$ref": "#/components/schemas/Payer"
    },
    "encounter": {
      "type": "object",
      "properties": {
        "serviceTypeCodes": {
          "type": "array",
          "description": "X12 service type codes (e.g., 30 for Health Benefit Plan Coverage)",
          "items": {
            "type": "string"
          }
        },
        "beginningDate": {
          "type": "date"
        },
        "endDate": {
          "type": "date"
        }
      }
    }
  },
  "name": "EligibilityRequest"
}