UnitedHealthcare Provider API — Eligibility

naftiko: 1.0.0-alpha2
info:
  label: UnitedHealthcare Provider API — Eligibility
  description: 'UnitedHealthcare Provider API — Eligibility. 2 operations. Lead operation: UnitedHealthcare Real Patient Benefit
    Check. Self-contained Naftiko capability covering one Unitedhealthcare business surface.'
  tags:
  - Unitedhealthcare
  - Eligibility
  created: '2026-05-19'
  modified: '2026-05-19'
binds:
- namespace: env
  keys:
    UNITEDHEALTHCARE_API_KEY: UNITEDHEALTHCARE_API_KEY
capability:
  consumes:
  - type: http
    namespace: provider-eligibility
    baseUri: https://api.uhcprovider.com
    description: UnitedHealthcare Provider API — Eligibility business capability. Self-contained, no shared references.
    resources:
    - name: eligibility-v1-patient-benefit-check
      path: /eligibility/v1/patient-benefit-check
      operations:
      - name: checkpatientbenefit
        method: POST
        description: UnitedHealthcare Real Patient Benefit Check
        outputRawFormat: json
        outputParameters:
        - name: result
          type: object
          value: $.
        inputParameters:
        - name: body
          in: body
          type: object
          description: Request body (JSON).
          required: true
    - name: eligibility-v1-real-time
      path: /eligibility/v1/real-time
      operations:
      - name: checkeligibility
        method: POST
        description: UnitedHealthcare Real-Time Eligibility Check
        outputRawFormat: json
        outputParameters:
        - name: result
          type: object
          value: $.
        inputParameters:
        - name: body
          in: body
          type: object
          description: Request body (JSON).
          required: true
    authentication:
      type: bearer
      token: '{{env.UNITEDHEALTHCARE_API_KEY}}'
  exposes:
  - type: rest
    namespace: provider-eligibility-rest
    port: 8080
    description: REST adapter for UnitedHealthcare Provider API — Eligibility. One Spectral-compliant resource per consumed
      operation, prefixed with /v1.
    resources:
    - path: /v1/eligibility/v1/patient-benefit-check
      name: eligibility-v1-patient-benefit-check
      description: REST surface for eligibility-v1-patient-benefit-check.
      operations:
      - method: POST
        name: checkpatientbenefit
        description: UnitedHealthcare Real Patient Benefit Check
        call: provider-eligibility.checkpatientbenefit
        with:
          body: rest.body
        outputParameters:
        - type: object
          mapping: $.
    - path: /v1/eligibility/v1/real-time
      name: eligibility-v1-real-time
      description: REST surface for eligibility-v1-real-time.
      operations:
      - method: POST
        name: checkeligibility
        description: UnitedHealthcare Real-Time Eligibility Check
        call: provider-eligibility.checkeligibility
        with:
          body: rest.body
        outputParameters:
        - type: object
          mapping: $.
  - type: mcp
    namespace: provider-eligibility-mcp
    port: 9090
    transport: http
    description: MCP adapter for UnitedHealthcare Provider API — Eligibility. One tool per consumed operation, routed inline
      through this capability's consumes block.
    tools:
    - name: unitedhealthcare-real-patient-benefit-check
      description: UnitedHealthcare Real Patient Benefit Check
      hints:
        readOnly: false
        destructive: false
        idempotent: false
      call: provider-eligibility.checkpatientbenefit
      with:
        body: tools.body
      outputParameters:
      - type: object
        mapping: $.
    - name: unitedhealthcare-real-time-eligibility-check
      description: UnitedHealthcare Real-Time Eligibility Check
      hints:
        readOnly: false
        destructive: false
        idempotent: false
      call: provider-eligibility.checkeligibility
      with:
        body: tools.body
      outputParameters:
      - type: object
        mapping: $.