slug: availity
provider: Availity
generated_by: planning/capability-mapping/scripts/classify_capabilities.py
model: claude-opus-5
frame:
- Healthcare Providers
min_confidence: 0.7
capability_model:
  source: https://github.com/vincentmakes/turbo-ea-capabilities
  license: CC-BY-4.0
  attribution: Turbo EA Capabilities by Vincent Verdet — Turbo EA, https://github.com/vincentmakes/turbo-ea-capabilities,
    CC BY 4.0
  notice: NOTICE
edge_count: 6
edges:
- tag: Eligibility
  spec_file: availity-eligibility-api-openapi.yml
  capability_id: BC-2800.30
  capability_id_l1: BC-2800
  capability_name: Eligibility & Benefits Verification
  confidence: 0.94
  evidence: 'POST .../eligibilities  checkEligibility  Availity Check Member Eligibility; schemas: Coverage,
    PlanInformation, Benefit'
  reason: Real-time verification of member insurance coverage and benefits against payers — directly Eligibility
    & Benefits Verification.
- tag: Claim Status
  spec_file: availity-claim-status-api-openapi.yml
  capability_id: BC-2870.30
  capability_id_l1: BC-2870
  capability_name: Claim Production & Submission
  confidence: 0.85
  evidence: createClaimStatusInquiry  Availity Create Claim Status Inquiry
  reason: Payer claim status inquiry (X12 276/277-style) is explicitly the status-tracking element of
    claim production and submission.
- tag: Enhanced Claim Status
  spec_file: availity-enhanced-claim-status-api-openapi.yml
  capability_id: BC-2870.30
  capability_id_l1: BC-2870
  capability_name: Claim Production & Submission
  confidence: 0.85
  evidence: POST .../status/searchBy276  Availity Search Claim by X12 276
  reason: X12 276 claim status search and detail/summary claim searches — claim submission status tracking
    within healthcare revenue cycle.
- tag: Claim Attachments
  spec_file: availity-claim-attachments-api-openapi.yml
  capability_id: BC-2870.30
  capability_id_l1: BC-2870
  capability_name: Claim Production & Submission
  confidence: 0.82
  evidence: POST /availity/intelligent-payer-network/v1/claim-attachments  submitClaimAttachment  Availity
    Submit Claim Attachment
  reason: Electronic submission of supporting documentation alongside healthcare claims to payers, with
    status tracking — part of claim production and submission in provider revenue cycle.
- tag: Is Auth Required
  spec_file: availity-is-auth-required-api-openapi.yml
  capability_id: BC-2800.30
  capability_id_l1: BC-2800
  capability_name: Eligibility & Benefits Verification
  confidence: 0.8
  evidence: POST /value-adds/v1/isauthrequired  checkIsAuthRequired  Availity Check if Authorization is
    Required
  reason: Determines whether payer prior authorization is required for a planned service — an authorisation-requirement
    check before service delivery, i.e. eligibility/benefits verification. Not API auth despite the tag
    string.
- tag: Auth Attachments
  spec_file: availity-auth-attachments-api-openapi.yml
  capability_id: BC-2800.30
  capability_id_l1: BC-2800
  capability_name: Eligibility & Benefits Verification
  confidence: 0.7
  evidence: POST /value-adds/v2/attachments  submitAuthAttachment  Availity Submit Authorization with
    Attachment
  reason: Operations submit a prior-authorization request with supporting documentation and poll its processing
    status. Prior authorization sits under Eligibility & Benefits Verification (authorisation requirements
    before service delivery). Some ambiguity vs. revenue-cycle claim documentation, hence moderate confidence.