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 (24)
Ranked by API Evangelist rating — Exemplar and Strong are expanded by default.
Exemplar 3 Complete, well-documented, and agent-ready
Strong 4 Solid coverage with minor gaps
Developing 10 Usable, with meaningful gaps to close
Thin 4 Limited public surface area
Emerging 1 Early or largely undocumented
APIs with this tag (46)
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 4 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...Stedi Eligibility PDF APIThe Eligibility PDF API from Stedi — 1 operation(s) for retrieving a rendered PDF of an X12 271 eligibility...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 verification
Strong 5 Solid coverage with minor gaps
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...Optum Eligibility APIMedical EligibilityOptum Real (Medical) APIOptum Real point-of-care APIs on the oihub gateway: pre-service eligibility, claim pre-check, claim actions...Mastercard Benefit Eligibility Service APIThis API is for third-parties who want to enable eligibility checks based on input criteria including card ...
Developing 16 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...Splitit Eligibility APICheck shopper eligibility for installment plansEligible 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.Bluecore Eligibility APIThe Eligibility API from Bluecore — 2 operation(s) for eligibility.KORE Wireless Eligibility APIRetrieve details about the eligibility of a given accountAetna Provider EDI ConnectivityHIPAA X12 electronic data interchange for health care professionals - EDI 837 claims, 270/271 eligibility a...CMS — Centers for Medicare & Medicaid Services Eligibility APIThe Eligibility API from CMS — Centers for Medicare & Medicaid Services — 1 operation(s) for eligibility.Waystar Eligibility Verification APIReal-time and batch insurance eligibility and benefits verification, exchanging X12 270 inquiries and 271 r...Orum Eligibility APIThe Eligibility API from Orum — 1 operation(s) for eligibility.Element5 Eligibility APIEligibility related APIsVA Community Care Eligibility APIDetermine whether a Veteran is eligible for community-care services under VA referral programs.Cashfree Payments Eligibility APICollection of APIs to check eligible entities - payment methods, offers, affordability
Thin 14 Limited public surface area
Surescripts Eligibility and FormularyVerifies patient pharmacy benefit eligibility and returns formulary and benefit coverage details so prescri...aflac Eligibility APIEmployee eligibility verification operations.Walgreens Eligibility APIVaccine eligibility checkingCashplus Eligibility APIFirst-party partner API for running credit card eligibility checks against Cashplus/Zempler credit products...Unum Eligibility APIMember eligibility management and verificationALEX Partner Integration APIThe ALEX Partner Integration API lets a Jellyvision partner — typically a benefits administration or enroll...Claim.MD Eligibility APIReal-time eligibility and benefit verification (270/271).Nirvana Health Eligibility APIActive-coverage discovery and eligibility verification.Candid Nonprofit Eligibility APIEvaluates whether a given nonprofit is eligible to receive a grant or donation based on configurable rules ...Hiscox Eligibility APIPartner-facing eligibility lookup that returns the list of US states and the Hiscox products offered by pro...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, ...Highline Pay by Paycheck APIThe Highline API lets billers, lenders, and platforms verify consumer eligibility for paycheck-deduction pa...Pie Insurance Eligibility APIThe Eligibility API from Pie Insurance — 1 operation(s) for eligibility.
Emerging 5 Early or largely undocumented
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...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
Overjet Insurance Verification APIModeled surface for Overjet's automated dental insurance verification - checking patient eligibility and be...Phreesia Insurance Eligibility Verification APIReal-time insurance eligibility and benefits verification at or before check-in, returning coverage, copay,...
Companies reaching this through an API (29)
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
Candid
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
52.7
log-scaled weighted occurrences
Breadth
0.6
spread across providers
Quality lift
55.7
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 9 co-occurrences
Claims 21 co-occurrences
Price Transparency 6 co-occurrences
Health Insurance 15 co-occurrences
X12 5 co-occurrences
Where this tag comes from
Api tag46
Provider tag24
Openapi tag16
Openapi op tag38
Work with this as data
Every tag here is available over the APIs.io API and to AI agents over MCP.