specification: API Commons Plans
specificationVersion: '0.1'
schema: https://raw.githubusercontent.com/api-evangelist/interface-research/main/schema/api-commons.yml#/$defs/Plans
provider: Availity
providerId: availity
created: '2026-05-04'
modified: '2026-08-15'
generated: '2026-08-15'
method: searched
source: https://developer.availity.com/portal/catalogue-products/healthcare-hipaa-transactions-1, https://developer.availity.com/portal/catalogue-products/aws-availity-payer-list-1, https://developer.availity.com/blog/2025/3/25/availity-api-guide
docs: https://developer.availity.com/portal/catalogue-products/healthcare-hipaa-transactions-1
reconciled: true
supersedes: >-
  This file previously carried method: generated from the 2026-05-04 bulk sweep and described only
  the corporate product lines (Essentials, Essentials Pro, Clearinghouse, RCM, Extend) with no
  numbers. Upgraded to method: searched on 2026-08-15 by reading the API PRODUCT CATALOGUE plans
  Availity publishes on its developer portal, which do carry published quotas.
plan_count: 7
summary: >-
  Availity publishes plan TIERS with real quota numbers on its developer portal product pages, and
  publishes NO PRICE for any of them. That combination is the whole finding: an integrator can learn
  exactly how many calls a plan allows and cannot learn what a call costs. The Demo plan is free,
  self-serve and auto-approved. Every production plan is sales-gated — a portal request plus a sales
  conversation plus contracting through Trading Partner Management. The corporate product lines
  (Essentials, Essentials Pro, Clearinghouse, RCM, Extend) are separately quote-based.
pricing_published: false
pricing_note: >-
  No price, no rate card, no per-transaction cost and no currency appears on any public Availity
  page for any API plan or product. Availity Essentials (the provider portal, not the API) is free
  to providers because participating health plans pay for it — that is the only price Availity
  states publicly, and it is not an API price.
tags:
  - Healthcare
  - HIPAA
  - X12 EDI
  - Eligibility
  - Claims
  - Clearinghouse
  - Revenue Cycle Management
description: >-
  Availity's API business is sold as subscribable PRODUCTS on the developer portal, each carrying
  plan tiers with published call quotas but no published price, plus a set of quote-based corporate
  product lines. The Demo tier is genuinely self-serve; production is contract-gated.
sources:
  - https://developer.availity.com/portal/catalogue-products/healthcare-hipaa-transactions-1
  - https://developer.availity.com/portal/catalogue-products/aws-availity-payer-list-1
  - https://developer.availity.com/blog/2025/3/25/availity-api-guide
  - https://www.availity.com/
plans:
  - id: healthcare-hipaa-transactions-standard
    name: Healthcare HIPAA Transactions — Standard
    type: subscription
    kind: api-product-plan
    scope: healthcare-hipaa-transactions-standard
    description: >-
      Production tier of the core API product covering Coverages (270/271), Claim Statuses
      (276/277), Service Reviews (278), Dental Claims, professional and institutional claim
      predeterminations, Configurations, Payer List and Dfs.
    quota:
      calls: 100000
      period: day
      published: true
    rate_limit:
      calls: 100
      period: second
      published: true
    price: not published
    currency: null
    self_serve: false
    gate: >-
      Portal subscription request AND a sales conversation; Trading Partner Management completes
      contracting before the subscription is activated. A BAA is required.
    entries:
      - label: Standard plan subscription
        name: healthcare_hipaa_transactions_standard
        type: subscription
        metric: transaction
        limit: 100000
        timeFrame: day
        geo: US
        unit: 1
        price: contact sales
        userMultiplied: false
  - id: healthcare-hipaa-transactions-demo
    name: Healthcare HIPAA Transactions — Demo
    type: free
    kind: api-product-plan
    scope: healthcare-hipaa-transactions-demo
    description: >-
      Free, PHI-free sandbox tier returning canned responses. Selected by requesting the -demo plan
      scope at the token endpoint; same host and token format as production.
    quota:
      calls: null
      period: null
      published: false
      note: >-
        Availity documents the Demo plan and its behaviour but does not publish its quota or rate
        limit on the public product page. Recorded as null rather than guessed.
    price: '0.00'
    currency: USD
    self_serve: true
    gate: auto-approved, no contract
    entries:
      - label: Demo plan subscription
        name: healthcare_hipaa_transactions_demo
        type: subscription
        metric: transaction
        limit: -1
        timeFrame: day
        geo: US
        unit: 1
        price: '0.00'
        userMultiplied: false
  - id: healthcare-hipaa-transactions-highvolume
    name: Healthcare HIPAA Transactions High Volume
    type: subscription
    kind: api-product-plan
    scope: healthcare-hipaa-transactions-highvolume
    description: >-
      Elevated-throughput variant of the core product. Its plan scopes (-standard and -unlimited)
      appear in Availity's own published Swagger securityDefinitions, but the product is not listed
      on the public catalogue page.
    quota:
      calls: null
      period: null
      published: false
    price: not published
    currency: null
    self_serve: false
    gate: contract-only; not offered on the public catalogue
    entries:
      - label: High Volume subscription
        name: healthcare_hipaa_transactions_highvolume
        type: subscription
        metric: transaction
        limit: -1
        timeFrame: day
        geo: US
        unit: 1
        price: contact sales
        userMultiplied: false
  - id: aws-availity-payer-list-standard
    name: AWS Availity Payer List — Standard
    type: subscription
    kind: api-product-plan
    scope: aws-availity-payer-list-standard
    description: >-
      Separately subscribable product exposing the payer list through an AWS-hosted route at
      basePath /epdm-payer-list-aws/v1.
    quota:
      calls: 1000000
      period: day
      published: true
    rate_limit:
      calls: 100
      period: second
      published: true
    price: not published
    currency: null
    self_serve: false
    entries:
      - label: AWS Payer List Standard subscription
        name: aws_availity_payer_list_standard
        type: subscription
        metric: transaction
        limit: 1000000
        timeFrame: day
        geo: US
        unit: 1
        price: contact sales
        userMultiplied: false
  - id: rcm-coverages-standard
    name: RCM Coverages — Standard
    type: subscription
    kind: api-product-plan
    scope: rcm-coverages-standard
    description: >-
      Revenue-cycle-management-specific entitlement over the Coverages (270/271) API. Declared in
      Availity's Coverages Swagger securityDefinitions but not offered as a public catalogue product.
    quota:
      calls: null
      period: null
      published: false
    price: not published
    currency: null
    self_serve: false
    gate: contract-only; visible only inside the machine-readable document
    entries:
      - label: RCM Coverages subscription
        name: rcm_coverages_standard
        type: subscription
        metric: transaction
        limit: -1
        timeFrame: day
        geo: US
        unit: 1
        price: contact sales
        userMultiplied: false
  - id: availity-essentials
    name: Availity Essentials
    type: freemium
    kind: corporate-product
    description: >-
      Free multi-payer provider portal (not an API plan). Providers access eligibility, claim
      status, ERA and authorizations across participating payers; the cost is borne by the payers.
    price: '0.00'
    currency: USD
    entries:
      - label: Provider portal access
        name: provider_portal
        type: subscription
        metric: seat
        limit: -1
        timeFrame: month
        geo: US
        unit: 1
        price: '0.00'
        userMultiplied: false
    elements:
      - name: Eligibility & Benefits (270/271)
      - name: Claim Status (276/277)
      - name: Electronic Remittance Advice (835)
      - name: Authorizations
      - name: Multi-Payer Reporting
  - id: availity-commercial-lines
    name: Essentials Pro / Clearinghouse / RCM / Extend
    type: enterprise
    kind: corporate-product
    description: >-
      Availity's paid product lines — Essentials Pro (expanded portal workflows), Clearinghouse /
      Trading Partner Network (per-transaction X12 processing), Revenue Cycle Management, and
      Availity Extend (workflow orchestration). All quote-based; no price, tier structure or
      transaction rate is published.
    price: not published
    currency: null
    entries:
      - label: Quote-based commercial engagement
        name: commercial_engagement
        type: subscription
        metric: month
        limit: -1
        timeFrame: month
        geo: US
        unit: 1
        price: contact sales
        userMultiplied: false
    elements:
      - name: Essentials Pro — advanced claim status, coverage discovery, worklists, reporting
      - name: Clearinghouse / Trading Partner Network — 270/271, 276/277, 278, 835, 837
      - name: Revenue Cycle Management — pre-service estimation, claim editing, denial management
      - name: Availity Extend — workflow orchestration and real-time API integration
maintainers:
  - FN: Kin Lane
    email: kin@apievangelist.com