Availity API
★ Only Publicly Available OpenAPI DocumentHealthcareEhr Emroauth24 EndpointsREST
For Agents
Look up healthcare payers, submit prior-authorization service reviews, and track their status against US insurance carriers via Availity's clearinghouse.
Use for: I want to check if a procedure requires prior authorization for a patient, Submit a service review to UnitedHealthcare through Availity, Look up the Availity payer ID for Aetna, Retrieve the status of a prior-authorization request I submitted yesterday
Not supported: Does not handle clinical EHR data, claim adjudication payments, or patient scheduling — use for payer discovery and prior-authorization service reviews only.
Jentic publishes the only available OpenAPI specification for Availity API, keeping it validated and agent-ready. The Availity API exposes US healthcare payer connectivity for revenue-cycle workflows, including payer list lookups, eligibility and benefits checks, and prior-authorization service reviews. Authentication uses OAuth 2.0 client-credentials, and responses follow X12 270/271 and 278 transaction semantics through a JSON facade. The current spec covers four operations across token issuance, payer discovery, and service-review lifecycle.
Install Jentic One Beta
Connect the Availity API to your agent
Jentic One is a self-hosted execution layer for AI agents. It lets your agent call the Availity API, or any other public or private API you need. You set the rules, the agent never sees your credentials, and every call is logged.
Two steps, two machines. Install the instance in a safe environment, then register your agent from wherever it runs.
1
Step 1: Jentic One Host machine
# On the machine that will host your Jentic One instance:
curl -fsSL https://raw.githubusercontent.com/jentic/jentic-one/main/tools/install.sh | sh2
Step 2: Agent machine
# On the machine where your agent runs (keep this separate from the instance):
curl -fsSL https://raw.githubusercontent.com/jentic/jentic-one/main/tools/install.sh | sh
jentic register # connects your agent to your Jentic One instanceJentic One is in public beta. The setup above keeps your agent separate from the instance, which is what you want before using real credentials: an agent running as the same OS user as Jentic One can read its stored keys directly. Just evaluating? A single local install is fine to start. See the secure deployment guide for the tiers.
Capabilities
What an agent can do with Availity API.
Issue an OAuth 2.0 access token for the Availity clearinghouse via the /v1/token endpoint
Query the Availity payer list to resolve a payer ID before submitting eligibility or claim transactions
Submit a prior-authorization service review (X12 278) to a specific payer through /v2/service-reviews
Retrieve the adjudication status of a previously submitted service review by its identifier
Map provider, subscriber, and service-line fields into Availity's JSON envelope without writing X12 by hand
Use Cases
Patterns agents use Availity API for, with concrete tasks.
★ Automated Prior-Authorization Submission
Hospitals and revenue-cycle teams use the Availity service-review endpoint to submit X12 278 prior-authorization requests electronically instead of faxing forms. The Availity API normalises payer-specific fields into a JSON body and returns a tracking ID plus payer response, replacing manual portal entry that typically takes 10-15 minutes per request.
Submit a service review for CPT 70553 to payer ID 60054 with subscriber member ID and service date, then poll /v2/service-reviews/{id} until status is final
Payer Discovery and Routing
Before sending any 270 or 278 transaction, integrations must resolve the correct Availity payer ID. The /v1/availity-payer-list endpoint returns supported payers with their transaction capabilities, enabling routing logic that picks the right payer code without hard-coding tables that drift over time.
Fetch the Availity payer list, filter for payers supporting service reviews, and return the payer ID matching 'Blue Cross Blue Shield of Texas'
Service-Review Status Polling
Prior-authorization decisions are rarely instant. Agents poll /v2/service-reviews/{id} to surface approved, denied, or pended outcomes back to schedulers and clinicians, eliminating the need to log into Availity Essentials to chase status. The endpoint returns structured certification numbers and decision reasons.
Retrieve service review {id} every 30 minutes for 24 hours and notify the scheduler when status transitions to approved or denied
Agent-Driven Eligibility Workflows via Jentic
AI agents handling patient intake call the Availity API through Jentic to verify coverage, identify required prior authorizations, and submit service reviews in a single conversation. Jentic resolves OAuth, payer IDs, and request schemas so agents can focus on the clinical context rather than X12 plumbing.
Given a patient member ID and procedure code, search Jentic for 'submit a service review', load the schema, and execute against Availity, then summarise the response in plain English
Key Endpoints
4 endpoints — jentic publishes the only available openapi specification for availity api, keeping it validated and agent-ready.
METHOD
PATH
DESCRIPTION
POST
/v1/token
Issue an OAuth 2.0 access token
GET
/v1/availity-payer-list
List supported payers and capabilities
POST
/v2/service-reviews
Submit a prior-authorization service review
GET
/v2/service-reviews/{id}
Retrieve the status of a service review
POST
/v1/token
Issue an OAuth 2.0 access token
GET
/v1/availity-payer-list
List supported payers and capabilities
POST
/v2/service-reviews
Submit a prior-authorization service review
GET
/v2/service-reviews/{id}
Retrieve the status of a service review
Why Jentic?
Three things that make agents converge on Jentic-routed access.
Credential isolation
Availity client_id and client_secret are stored encrypted in the Jentic vault. Jentic exchanges them for short-lived OAuth access tokens at /v1/token on the agent's behalf — raw secrets never enter the agent's context.
Intent-based discovery
Agents search by intent (e.g., 'submit a prior authorization') and Jentic returns the matching Availity service-review operation with its full request schema, so the agent can populate payer, subscriber, and service-line fields without reading X12 documentation.
Time to first call
Direct Availity integration: 1-2 weeks for OAuth, payer-list caching, and X12 278 field mapping. Through Jentic: under 1 hour — search, load schema, execute.
Related APIs
Alternatives and complements available in the Jentic catalogue.
Complementary
Stripe
Pair Availity prior-auth checks with Stripe for patient-responsibility billing once coverage is confirmed.
Choose Stripe when the workflow moves past coverage verification into collecting patient payments or co-pays.
FAQs
Specific to using Availity API through Jentic.
Why is there no official OpenAPI spec for Availity API?
Availity does not publish an OpenAPI specification. Jentic generates and maintains this spec so that AI agents and developers can call Availity API via structured tooling. It is validated against the live API and kept up to date. Get started at https://app.jentic.com/sign-up.
What authentication does the Availity API use?
The Availity API uses OAuth 2.0 client-credentials. Your agent posts client_id and client_secret to /v1/token and receives a bearer access token. Through Jentic, your client credentials live in the Jentic vault and are exchanged for short-lived tokens automatically — the agent never sees the raw secret.
Can I submit prior authorizations with the Availity API?
Yes. POST /v2/service-reviews submits an X12 278 prior-authorization request to a payer, and GET /v2/service-reviews/{id} retrieves the decision. The current spec covers submission and retrieval — coverage of attachment uploads and inquiry transactions varies by payer.
What are the rate limits for the Availity API?
Availity does not publish a single global rate limit; throttling is governed per-application and per-payer in their developer portal. Plan for at least one-second spacing between service-review submissions to the same payer and back off on HTTP 429.
How do I look up a payer ID through Jentic?
Search Jentic for 'list Availity payers', load the schema for GET /v1/availity-payer-list, and execute. The response contains payer names, IDs, and the transaction types each payer supports so the agent can pick the right code before submitting.
Is the Availity API free to use?
Availity offers free developer accounts for testing, but production access typically requires a sponsoring provider or trading-partner agreement and may carry transaction fees through your contract with Availity.
GET STARTED