availity · Capability

Availity Healthcare Revenue Cycle Management

Unified workflow for revenue cycle management combining eligibility verification, claim status tracking, and prior authorization. Used by billing departments and revenue cycle teams to streamline patient encounter workflows.

Run with Naftiko AvailityRevenue CycleHealthcareClaimsEligibility

What You Can Do

POST
Verify eligibility — Verify member insurance coverage and benefits
/v1/eligibilities
GET
List eligibilities — List eligibility inquiries
/v1/eligibilities
GET
List payers — List supported payers
/v1/payers
POST
Check claim status — Submit claim status inquiry
/v1/claim-statuses
GET
List claim statuses — List claim status inquiries
/v1/claim-statuses
POST
Check auth required — Check if authorization is required
/v1/prior-authorizations
POST
Submit authorization — Submit prior authorization request
/v1/prior-authorizations

MCP Tools

verify-member-eligibility

Verify patient insurance eligibility and benefits before service delivery

list-eligibility-history

List previous eligibility inquiries for audit and follow-up

read-only
lookup-supported-payers

Find health plan payers available for transactions

read-only
submit-claim-status-inquiry

Submit a claim status inquiry to check adjudication status

search-claims-summary

Search claims by service date or member ID for revenue tracking

read-only
get-claim-detail

Get detailed claim information including adjudication and payment amounts

read-only
check-prior-auth-required

Determine if a payer requires prior authorization before service delivery

read-only
submit-prior-authorization

Submit a prior authorization request for a scheduled procedure

track-authorization-status

Track the status of a submitted prior authorization request

read-only

APIs Used

availity-eligibility availity-claims availity-auth