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Eligibility & Benefits API

Submit an eligibility inquiry to a payer and receive coverage details for a member.

Authentication

All requests require a bearer token obtained from the OAuth 2.0 client-credentials flow.

POST /v1/token
client_id=YOUR_ID&client_secret=YOUR_SECRET&grant_type=client_credentials

Endpoints

POST /v1/eligibility

Submit an eligibility inquiry.

Required fields:

  • memberId — payer-assigned member identifier
  • payerId — Availity payer identifier
  • serviceTypes — array of service-type codes (e.g. 30 for general health benefits)

GET /v1/eligibility/{id}

Retrieve a previously submitted inquiry's response.

Errors

Errors follow the standard RFC 7807 problem-details shape.