openapi: 3.1.0
info:
  title: Availity Service Reviews (Prior Authorization) API
  description: The Availity Service Reviews API enables the ASC X12N 278 transaction for prior authorization and healthcare service reviews. Includes IsAuthRequired and Attachments add-on APIs.
  version: 2.0.0
  contact:
    name: Availity Developer Portal
    url: https://developer.availity.com/
servers:
- url: https://api.availity.com
  description: Availity Production API
security:
- oauth2: []
tags:
- name: Service Reviews
  description: Prior authorization and service review requests
- name: Is Auth Required
  description: Check if authorization is required before submission
- name: Auth Attachments
  description: Attach documentation to authorization requests
paths:
  /availity/intelligent-payer-network/v1/service-reviews:
    post:
      operationId: createServiceReview
      summary: Availity Create Service Review
      description: Submit a prior authorization or service review request (X12 278 transaction) to a health plan payer.
      tags:
      - Service Reviews
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/ServiceReviewRequest'
      responses:
        '200':
          description: Service review created
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ServiceReviewResponse'
              examples:
                CreateServiceReview200Example:
                  summary: Default createServiceReview 200 response
                  x-microcks-default: true
                  value:
                    id: '500123'
                    status: PENDING
                    certificationNumber: AUTH-2025-001234
        '400':
          $ref: '#/components/responses/BadRequest'
        '401':
          $ref: '#/components/responses/Unauthorized'
    get:
      operationId: listServiceReviews
      summary: Availity List Service Reviews
      description: Retrieve a list of previous service review submissions for the authenticated provider.
      tags:
      - Service Reviews
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      parameters:
      - name: payerId
        in: query
        schema:
          type: string
        description: Filter by payer ID
        example: BCBS001
      - name: limit
        in: query
        schema:
          type: integer
          default: 25
          minimum: 1
          maximum: 50
        description: Number of results per page
      - name: offset
        in: query
        schema:
          type: integer
          default: 0
        description: Pagination offset
      responses:
        '200':
          description: List of service reviews
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ServiceReviewList'
  /availity/intelligent-payer-network/v1/service-reviews/{id}:
    get:
      operationId: getServiceReview
      summary: Availity Get Service Review
      description: Retrieve the status and details of a specific service review by ID.
      tags:
      - Service Reviews
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      parameters:
      - name: id
        in: path
        required: true
        schema:
          type: string
        description: Service review transaction ID
        example: '500123'
      responses:
        '200':
          description: Service review details
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ServiceReviewResponse'
        '404':
          $ref: '#/components/responses/NotFound'
  /value-adds/v1/isauthrequired:
    post:
      operationId: checkIsAuthRequired
      summary: Availity Check if Authorization is Required
      description: Query whether a payer requires prior authorization before submitting a service review request.
      tags:
      - Is Auth Required
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/IsAuthRequiredRequest'
      responses:
        '200':
          description: Auth requirement check initiated
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/AsyncJobResponse'
        '400':
          $ref: '#/components/responses/BadRequest'
  /value-adds/v1/isauthrequired/{id}:
    get:
      operationId: getIsAuthRequiredResult
      summary: Availity Get Authorization Requirement Result
      description: Poll for the result of an IsAuthRequired check.
      tags:
      - Is Auth Required
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      parameters:
      - name: id
        in: path
        required: true
        schema:
          type: string
        description: Job ID from POST response
        example: '500123'
      responses:
        '200':
          description: Auth requirement result
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/IsAuthRequiredResponse'
        '404':
          $ref: '#/components/responses/NotFound'
  /value-adds/v2/attachments:
    post:
      operationId: submitAuthAttachment
      summary: Availity Submit Authorization with Attachment
      description: Submit an authorization request with supporting document attachments.
      tags:
      - Auth Attachments
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/AttachmentRequest'
      responses:
        '200':
          description: Attachment submitted
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/AsyncJobResponse'
        '400':
          $ref: '#/components/responses/BadRequest'
  /value-adds/v2/attachments/{id}:
    get:
      operationId: getAttachmentStatus
      summary: Availity Get Attachment Processing Status
      description: Retrieve the processing status of a submitted authorization attachment.
      tags:
      - Auth Attachments
      x-microcks-operation:
        delay: 0
        dispatcher: FALLBACK
      parameters:
      - name: id
        in: path
        required: true
        schema:
          type: string
        description: Attachment job ID
        example: '500123'
      responses:
        '200':
          description: Attachment status
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/AttachmentStatusResponse'
        '404':
          $ref: '#/components/responses/NotFound'
components:
  securitySchemes:
    oauth2:
      type: oauth2
      flows:
        clientCredentials:
          tokenUrl: https://api.availity.com/availity/v1/token
          scopes:
            hipaa: Access to HIPAA transaction APIs
  responses:
    BadRequest:
      description: Bad request
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/Error'
    Unauthorized:
      description: Unauthorized
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/Error'
    NotFound:
      description: Not found
      content:
        application/json:
          schema:
            $ref: '#/components/schemas/Error'
  schemas:
    ServiceReviewRequest:
      type: object
      required:
      - payerId
      - provider
      - subscriber
      - requestType
      properties:
        payerId:
          type: string
          example: BCBS001
        requestType:
          type: string
          enum:
          - INITIAL
          - UPDATE
          - CANCEL
          - REFERRAL
          example: INITIAL
        provider:
          type: object
          properties:
            npi:
              type: string
              example: '1234567890'
            taxId:
              type: string
              example: '123456789'
        subscriber:
          type: object
          properties:
            memberId:
              type: string
              example: MEM123456
            firstName:
              type: string
              example: Jane
            lastName:
              type: string
              example: Smith
        serviceInformation:
          type: object
          properties:
            procedureCodes:
              type: array
              items:
                type: string
            diagnosisCodes:
              type: array
              items:
                type: string
            serviceFromDate:
              type: string
              format: date
            serviceToDate:
              type: string
              format: date
    ServiceReviewResponse:
      type: object
      properties:
        id:
          type: string
          example: '500123'
        status:
          type: string
          enum:
          - PENDING
          - APPROVED
          - DENIED
          - PARTIALLY_APPROVED
          - PENDING_ADDITIONAL_INFO
          example: APPROVED
        certificationNumber:
          type: string
          example: AUTH-2025-001234
        effectiveDate:
          type: string
          format: date
          example: '2025-04-01'
        expirationDate:
          type: string
          format: date
          example: '2025-10-01'
    ServiceReviewList:
      type: object
      properties:
        data:
          type: array
          items:
            $ref: '#/components/schemas/ServiceReviewResponse'
        total:
          type: integer
          example: 15
        offset:
          type: integer
          example: 0
    IsAuthRequiredRequest:
      type: object
      properties:
        serviceReview:
          type: object
          description: Authorization details to check
          properties:
            payerId:
              type: string
              example: BCBS001
            procedureCode:
              type: string
              example: '99213'
    IsAuthRequiredResponse:
      type: object
      properties:
        id:
          type: string
          example: '500123'
        authRequired:
          type: string
          enum:
          - Auth Required
          - No Auth Required
          example: Auth Required
        payerMessage:
          type: string
          example: Prior authorization required for this procedure
    AttachmentRequest:
      type: object
      required:
      - payerId
      - patient
      - subscriber
      - provider
      - certificationNumber
      - attachments
      properties:
        payerId:
          type: string
          example: BCBS001
        patient:
          type: object
          properties:
            firstName:
              type: string
              example: Jane
            lastName:
              type: string
              example: Smith
        subscriber:
          type: object
          properties:
            memberId:
              type: string
              example: MEM123456
        provider:
          type: object
          properties:
            npi:
              type: string
              example: '1234567890'
        certificationNumber:
          type: string
          example: AUTH-2025-001234
        attachments:
          type: array
          items:
            type: object
            properties:
              contentType:
                type: string
                example: application/pdf
              title:
                type: string
                example: Clinical Notes
              data:
                type: string
                format: byte
    AttachmentStatusResponse:
      type: object
      properties:
        id:
          type: string
          example: '500123'
        status:
          type: string
          enum:
          - SUBMITTED
          - AV_ACCEPTED
          - AV_REJECTED
          - PY_ACCEPTED
          - PY_REJECTED
          example: AV_ACCEPTED
    AsyncJobResponse:
      type: object
      properties:
        id:
          type: string
          description: Job ID for polling
          example: '500123'
        status:
          type: string
          example: PROCESSING
    Error:
      type: object
      properties:
        code:
          type: string
          example: INVALID_REQUEST
        message:
          type: string
          example: Required field missing
        details:
          type: array
          items:
            type: string