naftiko: 1.0.0-alpha1
info:
  label: Availity Healthcare Revenue Cycle Management
  description: 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.
  tags:
  - Availity
  - Revenue Cycle
  - Healthcare
  - Claims
  - Eligibility
  created: '2026-04-19'
  modified: '2026-04-19'
binds:
- namespace: env
  keys:
    AVAILITY_CLIENT_ID: AVAILITY_CLIENT_ID
    AVAILITY_CLIENT_SECRET: AVAILITY_CLIENT_SECRET
capability:
  consumes:
  - import: availity-eligibility
    location: ./shared/eligibility.yaml
  - import: availity-claims
    location: ./shared/claim-status.yaml
  - import: availity-auth
    location: ./shared/service-reviews.yaml
  exposes:
  - type: rest
    port: 8080
    namespace: availity-rcm-api
    description: Unified REST API for healthcare revenue cycle management.
    resources:
    - path: /v1/eligibilities
      name: eligibilities
      description: Member eligibility verification
      operations:
      - method: POST
        name: verify-eligibility
        description: Verify member insurance coverage and benefits
        call: availity-eligibility.check-eligibility
        outputParameters:
        - type: object
          mapping: $.
      - method: GET
        name: list-eligibilities
        description: List eligibility inquiries
        call: availity-eligibility.list-eligibilities
        outputParameters:
        - type: object
          mapping: $.
    - path: /v1/payers
      name: payers
      description: Supported health plan payers
      operations:
      - method: GET
        name: list-payers
        description: List supported payers
        call: availity-eligibility.list-payers
        outputParameters:
        - type: object
          mapping: $.
    - path: /v1/claim-statuses
      name: claim-statuses
      description: Claim status inquiries
      operations:
      - method: POST
        name: check-claim-status
        description: Submit claim status inquiry
        call: availity-claims.create-claim-status-inquiry
        outputParameters:
        - type: object
          mapping: $.
      - method: GET
        name: list-claim-statuses
        description: List claim status inquiries
        call: availity-claims.list-claim-status-inquiries
        outputParameters:
        - type: object
          mapping: $.
    - path: /v1/prior-authorizations
      name: prior-authorizations
      description: Prior authorization requests
      operations:
      - method: POST
        name: check-auth-required
        description: Check if authorization is required
        call: availity-auth.check-is-auth-required
        outputParameters:
        - type: object
          mapping: $.
      - method: POST
        name: submit-authorization
        description: Submit prior authorization request
        call: availity-auth.create-service-review
        outputParameters:
        - type: object
          mapping: $.
  - type: mcp
    port: 9090
    namespace: availity-rcm-mcp
    transport: http
    description: MCP server for AI-assisted healthcare revenue cycle management.
    tools:
    - name: verify-member-eligibility
      description: Verify patient insurance eligibility and benefits before service delivery
      hints:
        readOnly: false
        openWorld: true
      call: availity-eligibility.check-eligibility
      outputParameters:
      - type: object
        mapping: $.
    - name: list-eligibility-history
      description: List previous eligibility inquiries for audit and follow-up
      hints:
        readOnly: true
        openWorld: true
      call: availity-eligibility.list-eligibilities
      outputParameters:
      - type: object
        mapping: $.
    - name: lookup-supported-payers
      description: Find health plan payers available for transactions
      hints:
        readOnly: true
        openWorld: true
      call: availity-eligibility.list-payers
      outputParameters:
      - type: object
        mapping: $.
    - name: submit-claim-status-inquiry
      description: Submit a claim status inquiry to check adjudication status
      hints:
        readOnly: false
        openWorld: true
      call: availity-claims.create-claim-status-inquiry
      outputParameters:
      - type: object
        mapping: $.
    - name: search-claims-summary
      description: Search claims by service date or member ID for revenue tracking
      hints:
        readOnly: true
        openWorld: true
      call: availity-claims.summary-search-claims
      outputParameters:
      - type: object
        mapping: $.
    - name: get-claim-detail
      description: Get detailed claim information including adjudication and payment amounts
      hints:
        readOnly: true
        openWorld: true
      call: availity-claims.detail-search-claim
      outputParameters:
      - type: object
        mapping: $.
    - name: check-prior-auth-required
      description: Determine if a payer requires prior authorization before service delivery
      hints:
        readOnly: true
        openWorld: true
      call: availity-auth.check-is-auth-required
      outputParameters:
      - type: object
        mapping: $.
    - name: submit-prior-authorization
      description: Submit a prior authorization request for a scheduled procedure
      hints:
        readOnly: false
        openWorld: true
      call: availity-auth.create-service-review
      outputParameters:
      - type: object
        mapping: $.
    - name: track-authorization-status
      description: Track the status of a submitted prior authorization request
      hints:
        readOnly: true
        openWorld: true
      call: availity-auth.get-service-review
      outputParameters:
      - type: object
        mapping: $.