# Eligible

**Canonical:** https://apis.io/providers/eligible/  
**Website:** https://eligible.com/  
**APIs profiled:** 5

Eligible provides insurance billing APIs for healthcare businesses, enabling the integration of insurance billing experiences into healthcare applications. The platform supports eligibility verification, coverage discovery, claims submission and tracking, payment estimation, enrollment, and remittance processing across a large network of US payers.

## Kin Score — 56.8 / 100 (strong)

Scored 2026-08-20 under rubric 0.12.0. Trend: flat (+0.0 from 56.8).

| Facet | Score |
|---|---|
| Discoverability | 92.6 |
| Contract Quality | 45.1 |
| Governance | 18.2 |
| Contract Governance | 18.2 |
| Operational Transparency | 26.3 |
| Developer Ergonomics | 50.0 |
| Commercial Clarity | 89.5 |
| Access Clarity | 89.5 |

Regulatory layer — **Insurance**: 45.5 (matched via tags).

## Agent readiness — 35.5 (agent-ready)

| Dimension | Value |
|---|---|
| Spec Presence | yes |
| Agentic Access | no |
| Reversibility Documented | no |
| MCP Server | no |
| Auth Clarity | yes |
| Idempotency | no |
| Error Semantics | documented |
| OpenAPI Examples | no |
| Rate Limit Signal | documented |
| Event Surface Described | yes |
| Agent Skills | no |
| Well Known Catalog | no |
| Consent Identity | no |
| Agent Card | no |
| Dry Run Mode | no |

## Access

Paid — onboarding: unknown, pricing: paid, trial: no (confidence: high).

## APIs (5)

- **Eligible Coverage API** — The Coverage API performs real-time insurance eligibility and benefits verification for a patient against a payer. Clients submit provider NPI, payer ID, and member identity inf...
- **Eligible Claims API** — The Claims API supports submission, tracking, and status checking of professional and institutional healthcare claims to payers across the Eligible network. The API also provide...
- **Eligible Payment Estimation API** — The Payment Estimation API calculates expected patient out-of-pocket amounts for a service before it is rendered, combining benefit details from a coverage check with provider c...
- **Eligible Enrollment API** — The Enrollment API manages the trading partner enrollment workflow that providers must complete with payers in order to exchange eligibility, claims, and remittance transactions...
- **Eligible Payers API** — The Payers API exposes the directory of insurance payers supported by Eligible, including payer identifiers, names, supported transaction types, enrollment requirements, and web...

## Security (3)

- **Eligible Authentication** — apiKey · 5 schemes
- **Eligible Domain Security** — TLSv1.3 · DMARC
- **Eligible Trust Center** — HITRUST r2, HITRUST CSF, NIST Cybersecurity Framework v1.1, SOC 2, CAQH CORE Phase I, CAQH CORE Phase II, CAQH CORE Phase III, CAQH CORE Phase IV, EHNAC HNAP, EHNAC CEAP, HIPAA

## Plans (1)

- **Eligible Plans Pricing**

## Tags

Billing, Eligibility, Healthcare, Insurance, Claims

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Profiled by [API Evangelist](https://apievangelist.com) and published on [APIs.io](https://apis.io/providers/eligible/). Scores are computed from the provider's own public artifacts under a published rubric.