established · 2.8

Eligibility

Score 24.2 / 100 53 providers 54 APIs Search apis.io →
Variants seen in the corpus: Eligibilityeligibility

Providers using this tag (53)

Ranked by API Evangelist rating — Exemplar and Strong are expanded by default.

Exemplar 3 Complete, well-documented, and agent-ready
StediEDIElectronic Data InterchangeHealthcareClearinghouse24 APIs85.6Elation HealthHealthcareUnited StatesEHREMR32 APIs84.1AvailityHealthcareClearinghouseHIPAAX12 EDI12 APIs75.4
Strong 10 Solid coverage with minor gaps
Candid HealthMedical BillingRevenue Cycle ManagementHealthcareClaims60 APIs64.7Ribbon HealthHealthcareProvider DirectoryInsuranceClinical Data11 APIs64.2Turquoise HealthHealthcarePrice TransparencyHospital RatesPayer Rates3 APIs63.8OptumCompanyHealthcareHealth InsuranceClaims9 APIs63.4Blockchain.comCryptocurrencyBitcoinBlockchainExchange18 APIs59.7SplititPaymentsInstallmentsBuy Now Pay LaterCredit Card10 APIs57.5pVerifyHealthcareInsuranceClaims13 APIs56.5SilnaCompanyAutomationHealthcarePrior Authorization42 APIs55.7EligibleBillingHealthcareInsurance5 APIs55.4BluecoreCompanyRetailMarketingCustomer Data Platform8 APIs54.9
Developing 17 Usable, with meaningful gaps to close
ColorCompanyHealthHealthcareGenomics1 API54.1H1HealthcareUnited StatesLife SciencesProvider Data21 APIs53.8PlanSourceEmployee BenefitsBenefits AdministrationInsuranceHuman Resources13 APIs52.1Flume HealthHealthcareHealth PlansPayersHealthcare Data2 APIs49.7Luma HealthHealthcareUnited StatesPatient EngagementScheduling13 APIs48.9TamaraBNPLBuy Now Pay LaterFintechPayments11 APIs48.9WellhubCompanyHealthWellbeingCorporate Benefits4 APIs48.8OrumCompanyPaymentsFintechBanking17 APIs47.8RemoteCompanyHRPayrollEmployer of Record101 APIs47.7Element5CompanyHealthcareRevenue Cycle ManagementPost-Acute Care3 APIs47.2MastercardCredit CardsDigital IdentityFinancial-ServicesFraud Detection249 APIs46.2WaystarHealthcareRevenue Cycle ManagementRCMClearinghouse7 APIs46.2CMS — Centers for Medicare & Medicaid ServicesHealthcareMedicareMedicaidFHIR25 APIs43.9Cashplus BankFinancial-ServicesBankingOpen BankingPSD210 APIs42.7Cashfree PaymentsPaymentsPayoutsUPIIndia23 APIs41.6WalgreensPharmacyHealthcareRetailPrescriptions7 APIs41.2SurescriptsHealthcaree-PrescribingHealth Information NetworkNCPDP SCRIPT8 APIs41.1
Thin 11 Limited public surface area
Orange Business5GArtificial IntelligenceB2BCAMARA38 APIs38.9UnumInsuranceBenefits AdministrationHR IntegrationDisability Insurance8 APIs37.3Department of Veterans Affairs (VA)Federal-GovernmentHealthcareVeterans30 APIs35.6Claim.MDHealthcareMedical ClaimsClearinghouseEDI5 APIs34.3CandidCharitiesDonationsNon-ProfitPhilanthropy9 APIs33.0HiscoxInsuranceUnited KingdomProperty and CasualtySpecialty Insurance4 APIs33.0Nirvana HealthHealthcareInsuranceBenefits4 APIs32.4UnitedHealthcareHealth InsuranceHealthcareFHIRClaims7 APIs31.9HighlineEmbedded FinancePayrollPaymentsACH10 APIs29.4aflacFortune 5006 APIs29.0Pie InsuranceInsuranceInsurtechWorkers CompensationSmall Business7 APIs28.3
Emerging 9 Early or largely undocumented
AdonisCompanyHealthcareRevenue Cycle ManagementRCM1 API25.5AetnaHealth InsuranceHealthcareFHIRPatient Access4 APIs24.2OpkitHealthcareInsuranceBenefits5 APIs22.1Symetra FinancialAnnuitiesBenefitsEmployee BenefitsFinancial-Services3 APIs20.3bswiftCompanyBenefits AdministrationHuman ResourcesInsurance1 API20.0Change HealthcareHealthcareTechnologyAnalyticsEDI1 API18.8Guardian LifeInsuranceLife InsuranceDisability InsuranceDental Insurance15 APIs17.4MirzaCompanyPublic BenefitsGovernmentHealthcare16.7Triple-S ManagementHealth InsuranceManaged CareMedicare AdvantagePuerto Rico2 APIs15.1
Minimal 3 Almost no public developer surface
OverjetDentalDental AIHealthcareRadiograph Analysis5 APIs9.7PhreesiaHealthcarePatient IntakePatient RegistrationPatient Engagement5 APIs9.2Olive AIHealthcareHealthcare AutomationRevenue Cycle ManagementPrior Authorization7.0

APIs with this tag (54)

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 5 Complete, well-documented, and agent-ready
Stedi Batch Eligibility Check APIThe Batch Eligibility Check API from Stedi — 4 operation(s) for submitting and polling asynchronous batches...85.6Stedi Eligibility PDF APIThe Eligibility PDF API from Stedi — 1 operation(s) for retrieving a rendered PDF of an X12 271 eligibility...85.6Elation Patient Insurance API (Premium) & EligibilityPremium patient insurance API for managing patient policies, insurance card images, and running insurance e...84.1Availity Eligibility & Benefits Value-Add APIsThe Availity Eligibility & Benefits Value-Add APIs provide supplementary data during eligibility transactio...75.4availity Eligibility APIReal-time eligibility and benefits verification75.4
Strong 12 Solid coverage with minor gaps
Candid Health Eligibility APIReal-time and batch insurance eligibility checks.64.7Turquoise Consumer Pricing APIREST API providing consumer-friendly healthcare price estimates — cash and insurer-negotiated rates — for s...63.8Optum Medical Network Eligibility and Claims APIRESTful JSON and native X12 EDI (270/271, 837P/837I, 276/277, 835) healthcare transaction APIs for real-tim...63.4Optum Real (Medical) APIOptum Real point-of-care APIs on the oihub gateway: pre-service eligibility, claim pre-check, claim actions...63.4Optum Real for Dental APIReal-time dental data exchange APIs for pre-care eligibility and eligibility intelligence, pre-care cost es...63.4Blockchain.com Eligibility APIAvailable currencies, regions, and payment methods for the partner account.59.7Splitit Eligibility APICheck shopper eligibility for installment plans57.5pVerify CGX Widget APIProvision and drive the embeddable eligibility-and-estimates widget. Setup runs against the premium portal ...56.5pVerify Dental Eligibility APIDental insurance eligibility and benefit verification, including the only version-prefixed path in the pVer...56.5pVerify Eligibility APIReal-time X12 270/271 insurance eligibility verification. Submit an EligibilitySummary inquiry, poll the pe...56.5Eligible Coverage APIThe Coverage API performs real-time insurance eligibility and benefits verification for a patient against a...55.4Bluecore Eligibility APIThe Eligibility API from Bluecore — 2 operation(s) for eligibility.54.9
Developing 15 Usable, with meaningful gaps to close
Color External API V1Color's partner-facing REST API — 13 operations over three surfaces: eligibility entries (list/create/read/...54.1H1 Ribbon Cost Estimates & Eligibility APIProcedure cost estimates and insurance eligibility - submit eligibility checks and retrieve supported eligi...53.8Flume Console APIThe REST API for Relay by Flume Health. Manages Accounts, Account Contracts, Connections, Endpoints and the...49.7Luma Health Eligibility & Insurance APIInsurance records with real-time eligibility verification and the insurance payors directory.48.9Tamara Pre-Checkout Eligibility APICheck whether Tamara considers a customer eligible for a BNPL purchase before exposing Tamara as a payment ...48.9Orum Eligibility APIThe Eligibility API from Orum — 1 operation(s) for eligibility.47.8Remote Eligibility APIThe Eligibility API from Remote — 2 operation(s) for eligibility.47.7Element5 Eligibility APIEligibility related APIs47.2Mastercard Benefit Eligibility Service APIThis API is for third-parties who want to enable eligibility checks based on input criteria including card ...46.2Waystar Eligibility Verification APIReal-time and batch insurance eligibility and benefits verification, exchanging X12 270 inquiries and 271 r...46.2CMS — Centers for Medicare & Medicaid Services Eligibility APIThe Eligibility API from CMS — Centers for Medicare & Medicaid Services — 1 operation(s) for eligibility.43.9Cashplus Eligibility APIFirst-party partner API for running credit card eligibility checks against Cashplus/Zempler credit products...42.7Cashfree Payments Eligibility APICollection of APIs to check eligible entities - payment methods, offers, affordability41.6Walgreens Eligibility APIVaccine eligibility checking41.2Surescripts Eligibility and FormularyVerifies patient pharmacy benefit eligibility and returns formulary and benefit coverage details so prescri...41.1
Thin 13 Limited public surface area
Orange Business Operator Eligibility (France) APICheck broadband and fibre eligibility at a French address for operator partners — feeds B2B onboarding flows.38.9Orange Business RIP Operator Eligibility (France) APIPublic-initiative network (RIP) fibre eligibility check for French regional fibre rollouts, used by alterna...38.9Unum Eligibility APIMember eligibility management and verification37.3VA Community Care Eligibility APIDetermine whether a Veteran is eligible for community-care services under VA referral programs.35.6VA Veteran Service History and Eligibility APIRetrieve a Veteran's service history and eligibility for VA programs.35.6Claim.MD Eligibility APIReal-time eligibility and benefit verification (270/271).34.3Candid Nonprofit Eligibility APIEvaluates whether a given nonprofit is eligible to receive a grant or donation based on configurable rules ...33.0Hiscox Eligibility APIPartner-facing eligibility lookup that returns the list of US states and the Hiscox products offered by pro...33.0Nirvana Health Eligibility APIActive-coverage discovery and eligibility verification.32.4UnitedHealthcare Eligibility APIReal-time eligibility and benefit verification31.9Highline Pay by Paycheck APIThe Highline API lets billers, lenders, and platforms verify consumer eligibility for paycheck-deduction pa...29.4aflac Eligibility APIEmployee eligibility verification operations.29.0Pie Insurance Eligibility APIThe Eligibility API from Pie Insurance — 1 operation(s) for eligibility.28.3
Emerging 7 Early or largely undocumented
Adonis APIAdonis platform API for revenue cycle management, including real-time patient eligibility and benefits veri...25.5Aetna Provider EDI APIElectronic Data Interchange connectivity for healthcare providers enabling electronic submission of claims,...24.2Symetra Benefits Administration APISymetra's Benefits Administration API enables HR platforms, benefits administrators, and technology partner...20.3bswift Partner APIbswift's partner-facing REST API, served from an AWS API Gateway at api.bswift.com. bswift publicly describ...20.0Change Healthcare Medical Network APIJSON-over-REST front end to the HIPAA X12 EDI transaction set — 270/271 eligibility, 276/277 claim status, ...18.8Benefits APISecure, real-time access to read and update employee and dependent benefit data. Once a Guardian policy is ...17.4Triple-S Salud Provider PortalMi Triple-S is the online provider portal for Triple-S Salud, offering healthcare providers access to insur...15.1
Minimal 2 Almost no public developer surface
Overjet Insurance Verification APIModeled surface for Overjet's automated dental insurance verification - checking patient eligibility and be...9.7Phreesia Insurance Eligibility Verification APIReal-time insurance eligibility and benefits verification at or before check-in, returning coverage, copay,...9.2

Score breakdown

Frequency
54.6
log-scaled weighted occurrences
Breadth
1.5
spread across providers
Quality lift
50.7
mean composite of providers using it
Cohesion
0.0
strength of nearest seed neighbor

Related tags

Clearinghouse 7 co-occurrences Prior Authorization 10 co-occurrences Payers 8 co-occurrences Claims 21 co-occurrences Price Transparency 6 co-occurrences Enrollment 9 co-occurrences Claim Status 5 co-occurrences Benefits 9 co-occurrences

Where this tag comes from

Api tag54
Provider tag24
Openapi tag20
Openapi op tag48

Cohort brief

Auto-generated

The 53 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
53
all scored
Mean Kin Score
41.7
+21.0 vs catalog 20.7
Mean Agent Readiness
24.9
+15.2 vs catalog 9.7
Spread
7–85.6
median 42.7 · σ 18.2
How the 53 split by band
Exemplar 3Strong 10Developing 17Thin 11Emerging 9Minimal 3
Facet averages, against the whole catalog
FacetThis cohortCatalogDifferenceScored
Contract Quality 43.8 17.5 +26.3 53
Developer Ergonomics 39.4 17.9 +21.5 53
Access Clarity 38.8 22.3 +16.5 53
Discoverability 74.5 60.4 +14.1 53
Contract Governance 18.2 6.4 +11.8 53
Operational Transparency 22.8 11.3 +11.5 53

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
ArtifactThis cohortCatalogDifference
MCP server (any) 32% 16% +16
MCP server (first-party) 15% 7% +8
Agent Skills 0% 0% 0
OAuth scopes 32% 9% +23
Security 100% 88% +12
Arazzo workflows 11% 2% +9
Governance rules 30% 13% +17

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. 1 Stedi 85.6
  2. 2 Elation Health 84.1
  3. 3 Availity 75.4
  4. 4 Candid Health 64.7
  5. 5 Ribbon Health 64.2
  6. 6 Turquoise Health 63.8
  7. 7 Optum 63.4
  8. 8 Blockchain.com 59.7
  9. 9 Splitit 57.5
  10. 10 pVerify 56.5
Top by Agent Readiness
  1. 1 Bluecore 54.1
  2. 2 Stedi 52.9
  3. 3 Turquoise Health 48.6
  4. 4 Elation Health 48.1
  5. 5 PlanSource 45.1
  6. 6 Color 43.7
  7. 7 Optum 42.6
  8. 8 Remote 41.3
  9. 9 Candid Health 39.6
  10. 10 Orum 38.8
All 53 members of this roster resolve to a scored provider in the catalog.Generated from the catalog build of 25 August 2026, across 26891 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.

MCP server

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https://apis.io/mcp

Tools for tags

7 MCP tools reach this
  • find_tagsBrowse and filter every tag in the catalog.
  • get_cohortThis tag as a scored cohort — every provider carrying it, with scores.
  • cohort_statsPRO — the distribution across this tag: mean, median, band split, adoption rates.
  • cohort_rankingsPRO — the leaderboard, on composite AND agent-readiness axes.
  • apis_io_searchSTART HERE — APIs, providers and tags for one query, each with its total.
  • resolveTurn a domain, URL or GitHub org into the provider it belongs to.
  • find_cohortsEvery scored population of providers in the catalog.
All 92 tools

Call it yourself

curl for this page
This tag 
curl "https://apis.io/api/v1/tags/eligibility"
All tags 
curl "https://apis.io/api/v1/tags?limit=25"
As a scored cohort 
curl "https://apis.io/api/v1/cohorts/tag/eligibility"
The distribution (Pro) 
curl "https://apis.io/api/v1/cohorts/tag/eligibility/stats" \
  -H "X-API-Key: $APIS_IO_KEY"

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