Eligibility
Workflows using this tag
Element5 — Verify eligibility and await result · Element5
Element5 — Upload document and submit authorization · Element5
Onboard a Bluecore customer and send a transactional message · Bluecore
Availity Claim Attachment (X12 275) · Availity
Availity Prior Authorization (X12 278) · Availity
Availity Eligibility and Benefits (X12 270/271) · Availity
Availity Claim Status Inquiry (X12 276/277) · Availity
Providers using this tag (25)
Ranked by API Evangelist rating — Exemplar and Strong are expanded by default.
Exemplar 2 Complete, well-documented, and agent-ready
Strong 5 Solid coverage with minor gaps
Developing 11 Usable, with meaningful gaps to close
Thin 3 Limited public surface area
Emerging 2 Early or largely undocumented
APIs with this tag (48)
Ranked by the provider's API Evangelist rating — the Kin Score is scored per provider, not per API, so every API of a provider shares its band. How the rating works →
Exemplar 2 Complete, well-documented, and agent-ready
Strong 9 Solid coverage with minor gaps
Candid Health Eligibility APIThe Eligibility API from Candid Health — 1 operation(s) for eligibility.Orange Business Operator Eligibility (France) APICheck broadband and fibre eligibility at a French address for operator partners — feeds B2B onboarding flows.Orange Business RIP Operator Eligibility (France) APIPublic-initiative network (RIP) fibre eligibility check for French regional fibre rollouts, used by alterna...Availity Eligibility & Benefits Value-Add APIsThe Availity Eligibility & Benefits Value-Add APIs provide supplementary data during eligibility transactio...availity Eligibility APIReal-time eligibility and benefits verificationBluecore Eligibility APIThe Eligibility API from Bluecore — 2 operation(s) for eligibility.Mastercard Benefit Eligibility Service APIThis API is for third-parties who want to enable eligibility checks based on input criteria including card ...Optum Eligibility APIMedical EligibilityOptum Real (Medical) APIOptum Real point-of-care APIs on the oihub gateway: pre-service eligibility, claim pre-check, claim actions...
Developing 15 Usable, with meaningful gaps to close
pVerify CGX Widget APIProvision and drive the embeddable eligibility-and-estimates widget. Setup runs against the premium portal ...pVerify Dental Eligibility APIDental insurance eligibility and benefit verification, including the only version-prefixed path in the pVer...pVerify Eligibility APIReal-time X12 270/271 insurance eligibility verification. Submit an EligibilitySummary inquiry, poll the pe...Eligible Coverage APIThe Coverage API performs real-time insurance eligibility and benefits verification for a patient against a...Blockchain.com Eligibility APIAvailable currencies, regions, and payment methods for the partner account.Color Eligibility APIEligibility entries and eligibility-file uploads for a population.KORE Wireless Eligibility APIRetrieve details about the eligibility of a given accountCMS — Centers for Medicare & Medicaid Services Eligibility APIThe Eligibility API from CMS — Centers for Medicare & Medicaid Services — 1 operation(s) for eligibility.Vyne Dental Eligibility and Benefits API (Onederful)Real-time and asynchronous dental eligibility and benefits checks (JSON, HTML and EDI 271 responses), enhan...Aetna Provider EDI ConnectivityHIPAA X12 electronic data interchange for health care professionals - EDI 837 claims, 270/271 eligibility a...Splitit Eligibility APICheck shopper eligibility for installment plansWaystar Eligibility Verification APIReal-time and batch insurance eligibility and benefits verification, exchanging X12 270 inquiries and 271 r...Element5 Eligibility APIEligibility related APIsOrum Eligibility APIThe Eligibility API from Orum — 1 operation(s) for eligibility.VA Community Care Eligibility APIDetermine whether a Veteran is eligible for community-care services under VA referral programs.
Thin 12 Limited public surface area
Surescripts Eligibility and FormularyVerifies patient pharmacy benefit eligibility and returns formulary and benefit coverage details so prescri...Cashplus Eligibility APIFirst-party partner API for running credit card eligibility checks against Cashplus/Zempler credit products...Walgreens Eligibility APIVaccine eligibility checkingaflac Eligibility APIEmployee eligibility verification operations.Cashfree Payments Eligibility APICollection of APIs to check eligible entities - payment methods, offers, affordabilityALEX Partner Integration APIThe ALEX Partner Integration API lets a Jellyvision partner — typically a benefits administration or enroll...Hiscox Eligibility APIPartner-facing eligibility lookup that returns the list of US states and the Hiscox products offered by pro...Unum Eligibility APIMember eligibility management and verificationCandid Nonprofit Eligibility APIEvaluates whether a given nonprofit is eligible to receive a grant or donation based on configurable rules ...UnitedHealthcare Eligibility APIReal-time eligibility and benefit verificationChange Healthcare Medical Network APIJSON-over-REST front end to the HIPAA X12 EDI transaction set — 270/271 eligibility, 276/277 claim status, ...Pie Insurance Eligibility APIThe Eligibility API from Pie Insurance — 1 operation(s) for eligibility.
Emerging 8 Early or largely undocumented
Nirvana Health Eligibility APIActive-coverage discovery and eligibility verification.Claim.MD Eligibility APIReal-time eligibility and benefit verification (270/271).bswift Partner APIbswift's partner-facing REST API, served from an AWS API Gateway at api.bswift.com. bswift publicly describ...Adonis APIAdonis platform API for revenue cycle management, including real-time patient eligibility and benefits veri...Highline Pay by Paycheck APIThe Highline API lets billers, lenders, and platforms verify consumer eligibility for paycheck-deduction pa...Symetra Benefits Administration APISymetra's Benefits Administration API enables HR platforms, benefits administrators, and technology partner...Benefits APISecure, real-time access to read and update employee and dependent benefit data. Once a Guardian policy is ...Triple-S Salud Provider PortalMi Triple-S is the online provider portal for Triple-S Salud, offering healthcare providers access to insur...
Minimal 2 Almost no public developer surface
Phreesia Insurance Eligibility Verification APIReal-time insurance eligibility and benefits verification at or before check-in, returning coverage, copay,...Overjet Insurance Verification APIModeled surface for Overjet's automated dental insurance verification - checking patient eligibility and be...
Companies reaching this through an API (28)
These companies publish an API, specification or operation carrying “Eligibility” but do not classify their business under it. Listed unranked and kept out of the count above, because one tagged operation is not a statement about what a company does.
Adonis
Aetna
Aflac
Blockchain.com
Bluecore
bswift
Cashfree Payments
Cashplus Bank
Claim.MD
CMS — Centers for Medicare & Medicaid Services
Department of Veterans Affairs (VA Lighthouse)
Element5
Guardian Life
Highline
Hiscox
Jellyvision
KORE Wireless
Mastercard
Orange Business
Orum
Overjet
Phreesia
Pie Insurance
Splitit
Symetra Financial
Triple-S Management
Unum
Walgreens
Score breakdown
Frequency
52.4
log-scaled weighted occurrences
Breadth
0.6
spread across providers
Quality lift
46.9
mean composite of providers using it
Cohesion
0.0
strength of nearest seed neighbor
Where this tag sits
Related tags
Clearinghouse 8 co-occurrences
Prior Authorization 11 co-occurrences
Payers 10 co-occurrences
Claims 22 co-occurrences
Price Transparency 6 co-occurrences
Benefits 10 co-occurrences
Health Insurance 15 co-occurrences
Where this tag comes from
Api tag48
Provider tag25
Openapi tag18
Openapi op tag41
Markets provisional
Kin Score markets whose measured providers carry this tag. Share is the fraction of the market's measured providers that carry it — it describes the market, not this tag.
| Market | Share of the market's providers |
|---|---|
| Payer Interoperability (CAQH CORE, X12, Da Vinci, WEDI) | 24% |
Cohort brief
Auto-generatedThe 25 providers in the APIs.io catalog tagged Eligibility, scored on the Kin Score. Every figure below is computed from the catalog — nothing here is written.
Providers
25
all scored
Mean Kin Score
44.7
+22.5 vs catalog 22.2
Mean Agent Readiness
28.9
+16.9 vs catalog 12
Spread
0–79.4
median 48.3 · σ 19.4
How the 25 split by band
Exemplar 2Strong 5Developing 11Thin 3Emerging 2Minimal 2
Facet averages, against the whole catalog
| Facet | This cohort | Catalog | Difference | Scored |
|---|---|---|---|---|
| Contract Quality | 42.3 | 17.2 | +25.1 | 25 |
| Access Clarity | 47.4 | 23.9 | +23.5 | 25 |
| Developer Ergonomics | 46.4 | 23.2 | +23.2 | 25 |
| Operational Transparency | 33.3 | 13 | +20.3 | 25 |
| Contract Governance | 16.5 | 6.5 | +10 | 25 |
| Discoverability | 66.7 | 57.9 | +8.8 | 25 |
A facet is averaged over the members that carry it, not over the whole cohort — the “Scored” column is that count. Averaging an absent facet as zero would score our own coverage gaps as the providers’ posture.
What this cohort publishes
| Artifact | This cohort | Catalog | Difference |
|---|---|---|---|
| MCP server (any) | 24% | 13% | +11 |
| MCP server (first-party) | 24% | 12% | +12 |
| Agent Skills | 0% | 0% | 0 |
| OAuth scopes | 28% | 11% | +17 |
| Security | 100% | 98% | +2 |
| Arazzo workflows | 12% | 2% | +10 |
| Governance rules | 28% | 16% | +12 |
mcp_pct counts any mcp/ artifact including ones API Evangelist derived from the provider OpenAPI; mcp_first_party_pct counts only servers the provider publishes. Prefer the latter.
Top by Kin Score
- 1 Elation Health 79.4
- 2 Stedi 77.3
- 3 Candid Health 66.2
- 4 Availity 64.9
- 5 Optum 57
- 6 Ribbon Health 56.6
- 7 Turquoise Health 55
- 8 Silna 52.2
- 9 pVerify 51.2
- 10 Eligible 50.3
Top by Agent Readiness
- 1 Stedi 61.7
- 2 Turquoise Health 54.6
- 3 Flume Health 50.4
- 4 PlanSource 46.4
- 5 Color 44.7
- 6 Elation Health 43.4
- 7 Silna 39.6
- 8 Optum 37.8
- 9 Candid Health 36.9
- 10 pVerify 36
All 25 members of this roster resolve to a scored provider in
the catalog.
Coverage caveat. 16 of 25 scored members had under half their catalog-attributable points satisfied at all (catalog_earned / catalog_max < 0.5). They are INCLUDED in the mean above. A large share here means the cohort mean is partly a measurement of how far our enrichment reached, not only of how these providers publish.Generated from the catalog build of 24 October 2026, across 31984 providers, using the same computation served by the APIs.io cohort API. Briefs are published for rosters of 5 or more scored providers; below that a distribution is not meaningful.
Coverage caveat. 16 of 25 scored members had under half their catalog-attributable points satisfied at all (catalog_earned / catalog_max < 0.5). They are INCLUDED in the mean above. A large share here means the cohort mean is partly a measurement of how far our enrichment reached, not only of how these providers publish.Generated from the catalog build of 24 October 2026, across 31984 providers, using the same computation served by the APIs.io cohort API. Briefs are published for rosters of 5 or more scored providers; below that a distribution is not meaningful.
Work with this as data
Every tag here is available over the APIs.io API and to AI agents over MCP.