Availity · Schema

EligibilityRequest

EligibilityRequest schema from Availity API

HealthcareClearinghouseHIPAAX12 EDIEligibilityClaimsPrior AuthorizationRevenue Cycle ManagementPayersPrice Transparency

Properties

Name Type Description
controlNumber string Unique transaction control number (up to 9 characters)
provider object
subscriber object
dependent object
payer object
encounter object
View JSON Schema on GitHub

JSON Schema

eligibility-eligibility-request-schema.json Raw ↑
{
  "$schema": "https://json-schema.org/draft/2020-12/schema",
  "$id": "https://raw.githubusercontent.com/api-evangelist/availity/refs/heads/main/json-schema/eligibility-eligibility-request-schema.json",
  "title": "EligibilityRequest",
  "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": "string",
          "format": "date"
        },
        "endDate": {
          "type": "string",
          "format": "date"
        }
      }
    }
  }
}

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