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.
Availity publishes 18 API contracts indexed on the APIs.io network, including Auth Attachments API, Claim Attachments API, Claim Status API, and 15 more. Tagged areas include Healthcare, Clearinghouse, HIPAA, X12 EDI, and Eligibility.
The Availity catalog on APIs.io includes 5 JSON-LD contexts and 3 Spectral governance rulesets.
Availity’s developer surface includes developer portal, documentation, getting-started guide, support, authentication, API reference, engineering blog, and 71 more developer resources.
What this lets a business do 2
Business capabilities this provider's published APIs can perform, derived from its own contracts. Browse all capabilities →
What people ask Availity 7
The questions people put to an LLM, and the jobs they hand an agent, that Availity's APIs answer — each one linked to the operation that does it. Generated by API Evangelist
Kin Score
Kin Score
How this is scored →scored 2026-11-06 · rubric v0.27.0
It updates itself when the score changes. Paste this where you link to your API docs:
<a href="https://apis.io/providers/availity/"><img src="https://apis.io/badge/availity/card.svg" alt="Availity on APIs.io — Kin Score by API Evangelist"></a>Other styles, a README pill and a shields.io endpoint are on the badge page.
- MCP Server +12 pts — deployment.mode + probe verdict on the mcp/ manifest, not the pointer; an unprobed slug falls back to authorship
- Idempotency +9 pts — OpenAPI mutating operations declare an idempotency key — a header, a request-body property, or a named de-duplication token whose own description says so (verified); else common[].type matches /idempoten/i (documented)
- A2A Agent Card +8 pts — a2a/
-a2a.yml manifest, graded on conformance.grade against A2A 1.0.0 - Registration Without a Human +6 pts — a `registration_endpoint` in the served RFC 8414 / OIDC discovery document
- Delegated User Identity +6 pts — a served discovery document listing authorization_code in grant_types_supported (served), else an oauth2 authorizationCode flow or openIdConnect declared in an OpenAPI (documented)
- Typed Event Surface +6 pts — AsyncAPI document, OR webhooks/callbacks objects in the as-published OpenAPI, OR common[].type includes Webhooks
- Contract Quality scores 60.8 — up to +9.8 composite points
- Contract Governance scores 31.8 — up to +8.2 composite points
- Access Clarity scores 65.8 — up to +6.8 composite points
Markets this provider is in provisional
The Kin Score Market layer reads a provider inside its market: its position, and how deep its integrations go. Depth is only comparable within a position. Provisional and unweighted: not part of the Kin Score or agent readiness.
| Market | Position | Depth | Registered MCP server | Declares compatibility |
|---|---|---|---|---|
| Certified Health IT (health IT accreditation and certification registers) | standard | 51.1 | - | - |
| Payer Interoperability (CAQH CORE, X12, Da Vinci, WEDI) | standard | 51.1 | - | - |
Registered MCP server and declares compatibility are report only — not weighted. Undeclared means we found nothing we can read, so there is no number: we never infer integrations.
Standards implemented 2
Standards this provider implements or carries. De facto ones are profiled and measured by the API Commons; formal ones come from the standards directory and are linked by the provider's own tags. The evidence column says how each claim was established — not that it was made.
APIs 18
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 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 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
Availity Availity Payer List API
The Availity Payer List API from Availity — 1 operation(s) for availity payer list.
Availity Claim Statuses API
The Claim Statuses API from Availity — 2 operation(s) for claim statuses.
Availity Configurations API
The Configurations API from Availity — 1 operation(s) for configurations.
Availity Coverages API
The Coverages API from Availity — 2 operation(s) for coverages.
Availity Dental Claims API
The Dental Claims API from Availity — 2 operation(s) for dental claims.
Availity Dfs API
The Dfs API from Availity — 1 operation(s) for dfs.
Availity Institutional Claims API
The Institutional Claims API from Availity — 2 operation(s) for institutional claims.
Availity Patient Cost Estimator 2.0.0 Professional API
The Patient Cost Estimator 2.0.0 Professional API from Availity — 2 operation(s) for patient cost estimator 2.0.0 professional.
Availity Professional Claims API
The Professional Claims API from Availity — 2 operation(s) for professional claims.
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Open Collections 9
Open, tool-agnostic API collections (OpenAPI-derived and Bruno).
Availity 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 for all 9
Arazzo Workflows 4
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.
ARAZZOAgent Skills 5
Packaged agent skills for driving this provider's APIs from an AI assistant.
availity-authenticate
AGENT SKILLavaility-claim-status-inquiry
AGENT SKILLavaility-eligibility-and-benefits
AGENT SKILLavaility-patient-cost-estimate
AGENT SKILLavaility-prior-authorization
AGENT SKILLAvaility API pricing
Prices published by Availity, read 2026-08-15 from developer.availity.com/portal/catalogue-products/healthca.... A free plan or tier is listed.
| Plan | Price |
|---|---|
| Healthcare HIPAA Transactions — Standard subscription | — |
| Healthcare HIPAA Transactions — Demo free | Free |
| Healthcare HIPAA Transactions High Volume subscription | — |
| AWS Availity Payer List — Standard subscription | — |
| RCM Coverages — Standard subscription | — |
| Availity Essentials freemium | Free |
| Essentials Pro / Clearinghouse / RCM / Extend enterprise | — |
Plan details, limits and sources →
Rate limits
- Healthcare HIPAA Transactions — Standard plan, daily quota: 100000 calls / 1 day(s)
- Healthcare HIPAA Transactions — Standard plan, burst rate: 100 calls / 1 sec(s)
- AWS Availity Payer List — Standard plan, daily quota: 1000000 calls / 1 day(s)
Pricing Plans 1
Published pricing tiers and plan structures.
Rate Limits 1
Documented rate limits and quota policies.
Availity Rate Limits
RATE LIMITSService Levels 1
Uptime the provider promises or reports, as SLA4OAI. Read from its own pages; APIs.io runs no monitors.
Availity
SLAFinOps 1
Cost, billing, and metering signals for API financial operations.
Availity Finops
FINOPSFeatures 8
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.
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Semantic Vocabularies 5
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 3
Spectral governance rulesets for linting and validating these APIs.
OpenAPI Overlays 18
Overlays applied on top of this provider's contracts. Each card says who wrote it: a document the provider publishes, or one API Evangelist derived or generated.
Availity Aws Payer List Overlay
DERIVEDAvaility Claim Statuses Overlay
DERIVEDAvaility Configurations Overlay
DERIVEDAvaility Coverages Overlay
DERIVEDAvaility Dental Claims Overlay
DERIVEDAvaility Dfs Overlay
DERIVEDAvaility Payer List Overlay
DERIVEDAvaility Service Reviews Overlay
DERIVEDScroll for all 18
JSON Schema 63
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 for all 63
JSON Structure 33
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 for all 33
Examples 35
Example request and response payloads for these APIs.
Availity Eligibility Example
EXAMPLEEligibility Benefit Example
EXAMPLEEligibility Coverage Example
EXAMPLEEligibility Payer Example
EXAMPLEEligibility Provider Example
EXAMPLEScroll for all 35
Security Posture 2
Authentication, domain security, vulnerability disclosure, and trust-center signals.
Scopes 1
OAuth scopes governing access to this provider's APIs.
Agentic Access 1
Recommended x-agentic-access execution contracts for AI agents.
Use Cases 8
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.
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Integrations 8
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.
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Resources
Get Started 5
Portal, sign-up, and the first successful call
Documentation 15
Reference material describing how the API behaves
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Agent Surfaces 3
MCP servers, agent skills, and machine-readable catalogs
Design & Contract 21
Pagination, idempotency, versioning, errors, and events
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Build 6
SDKs, sample code, and the tooling you integrate with
Access & Security 4
Authentication, authorization, and security posture
Operate 4
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 14
Properties that don't map to a standard resource type
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Source (apis.yml)
Availity API — frequently asked questions
Does Availity have an API?
Yes. APIs.io lists 18 APIs from Availity, including Availity Healthcare HIPAA Transactions API, Availity Eligibility & Benefits Value-Add APIs and availity Auth Attachments API, and 15 more.
Is there an OpenAPI specification for the Availity API?
Yes. APIs.io indexes 16 OpenAPI specifications for Availity, each linked for download from this page.
How do I authenticate with the Availity API?
Availity documents its authentication (oauth2 · 1 scheme). The details are profiled on APIs.io as Availity Authentication.
How much does the Availity API cost?
APIs.io lists 7 pricing plans for Availity, with each plan's price, limits and inclusions under Pricing on this page.
Is the Availity API ready for AI agents?
Availity has a Kin Score of 65.8 out of 100 (strong) and an Agent Readiness score of 35.5 (agent-ready), scored by API Evangelist on 2026-11-06.
Work with this as data
Every provider here is available over the APIs.io API and to AI agents over MCP.