capabilities.work

What you can do with Availity

Every task in plain language. Pick one, and we can help you get access.

23 things you can do

Availity

Availity is a healthcare information network and clearinghouse providing REST APIs for real-time HIPAA EDI transactions. The platform processes over 11 billion annual healthcare transactions connecting providers, health plans, and vendors nationwide. Create your application and subscribe to a plan to make use of Availity APIs for eligibility verification, claims management, prior authorization, an

4 multi-step recipes

Recipes: multi-step jobs

Claim Attachment (X12 275)
Submit the X12 275 claim attachment and poll until the payer accepts it.Claim Status Inquiry (X12 276/277)
Submit the X12 276 inquiry and poll until the X12 277 status response is finalized.Eligibility and Benefits (X12 270/271)
Find a 270-capable payer, submit the eligibility inquiry, and read the 271 benefit response.Prior Authorization (X12 278)
Check if auth is required, create the X12 278 review, attach clinicals, and read the decision.

Claim Production & Submission

Submit supporting documentation for a claimCheck processing status of a claim attachmentPoll results of an X12 276 claim searchSearch claim status by patient using X12 276Run a summary search across claimsLook up full detail for one claimList past claim status inquiriesCheck the status of a submitted claim

Eligibility & Benefits Verification

Submit an authorization with supporting documentsCheck whether a payer requires prior authorizationGet the result of an auth-required checkList past eligibility inquiriesCheck a patient's insurance eligibility and benefitsGet one eligibility inquiry resultList health plan payers supported for eligibilityCheck processing status of an auth attachment

Other things you can do

Submit a prior authorization requestList past service review submissionsGet a service review's status and details