n8n-nodes-availity-healthcare

[Velocity BPA Licensing Notice]

This n8n node is licensed under the Business Source License 1.1 (BSL 1.1).

Use of this node by for-profit organizations in production environments requires a commercial license from Velocity BPA.

For licensing information, visit https://velobpa.com/licensing or contact [email protected].

An n8n community node for integrating with Availity's healthcare platform, providing access to 8 core healthcare administration resources. Enables healthcare organizations to streamline eligibility verification, claims processing, remittance handling, and provider directory management through automated workflows.

Features

• Eligibility Verification - Real-time patient insurance eligibility and benefits verification
• Claims Processing - Submit, track, and manage healthcare claims submissions
• Remittance Advice - Retrieve and process electronic remittance advice (ERA) documents
• Provider Directory - Access and search comprehensive healthcare provider directories
• Payer Directory - Lookup insurance payer information and network details
• FHIR Resources - Full HL7 FHIR R4 resource support for interoperability
• Authorization Management - Submit and track prior authorization requests
• Transaction Monitoring - Real-time status tracking for all healthcare transactions

Installation

Community Nodes (Recommended)

1. Open n8n
2. Go to Settings → Community Nodes
3. Click Install a community node
4. Enter n8n-nodes-availity-healthcare
5. Click Install

Manual Installation

cd ~/.n8n
npm install n8n-nodes-availity-healthcare

Development Installation

git clone https://github.com/Velocity-BPA/n8n-nodes-availity-healthcare.git
cd n8n-nodes-availity-healthcare
npm install
npm run build
mkdir -p ~/.n8n/custom
ln -s $(pwd) ~/.n8n/custom/n8n-nodes-availity-healthcare
n8n start

Credentials Setup

| Field | Description | Required | |-------|-------------|----------| | API Key | Your Availity API authentication key | Yes | | Environment | API environment (sandbox/production) | Yes | | Client ID | Your registered Availity application client ID | Yes | | Timeout | Request timeout in milliseconds (default: 30000) | No |

Resources & Operations

1. Eligibility Verification

| Operation | Description | |-----------|-------------| | Check Eligibility | Verify patient insurance eligibility and coverage | | Get Benefits | Retrieve detailed benefit information for a patient | | Batch Verification | Process multiple eligibility checks simultaneously | | History | Get eligibility check history and results |

2. Claims Submission

| Operation | Description | |-----------|-------------| | Submit Claim | Submit new healthcare claims for processing | | Get Claim Status | Check the processing status of submitted claims | | Update Claim | Modify existing claim information | | Cancel Claim | Cancel a previously submitted claim | | Batch Submit | Submit multiple claims in a single request | | Get Claim Details | Retrieve comprehensive claim information |

3. Remittance Advice

| Operation | Description | |-----------|-------------| | Get ERA | Retrieve Electronic Remittance Advice documents | | List ERAs | Get list of available remittance advice documents | | Download ERA | Download ERA document in specified format | | Search ERAs | Search remittance advice by various criteria | | Get ERA Status | Check processing status of remittance advice |

4. Provider Directory

| Operation | Description | |-----------|-------------| | Search Providers | Search for healthcare providers by various criteria | | Get Provider | Retrieve detailed provider information | | Verify Provider | Verify provider credentials and network status | | List Specialties | Get list of available provider specialties | | Get Network Status | Check provider network participation status |

5. Payer Directory

| Operation | Description | |-----------|-------------| | Search Payers | Search for insurance payers and plans | | Get Payer | Retrieve detailed payer information | | List Plans | Get available insurance plans for a payer | | Get Coverage | Retrieve coverage details for specific plans | | Verify Payer | Validate payer information and status |

6. FHIR Resources

| Operation | Description | |-----------|-------------| | Create Resource | Create new FHIR resources (Patient, Encounter, etc.) | | Read Resource | Retrieve FHIR resources by ID | | Update Resource | Modify existing FHIR resources | | Delete Resource | Remove FHIR resources | | Search Resources | Search FHIR resources with complex queries | | Get Capability | Retrieve FHIR server capability statement |

7. Transaction Status

| Operation | Description | |-----------|-------------| | Get Status | Check status of any healthcare transaction | | List Transactions | Get list of recent transactions | | Get Transaction Details | Retrieve comprehensive transaction information | | Update Status | Modify transaction status or notes | | Get History | Retrieve transaction processing history |

8. Authorization Requests

| Operation | Description | |-----------|-------------| | Submit Authorization | Submit new prior authorization requests | | Get Authorization Status | Check status of authorization requests | | Update Authorization | Modify existing authorization information | | Cancel Authorization | Cancel pending authorization requests | | List Authorizations | Get list of authorization requests | | Get Authorization Details | Retrieve detailed authorization information |

Usage Examples

// Check patient eligibility
{
  "memberId": "123456789",
  "payerId": "AETNA",
  "serviceDate": "2024-01-15",
  "serviceTypeCode": "30",
  "providerId": "1234567890"
}

// Submit a healthcare claim
{
  "claimType": "professional",
  "patientId": "P123456",
  "providerId": "1234567890",
  "serviceDate": "2024-01-15",
  "diagnosisCodes": ["Z00.00"],
  "procedureCodes": ["99213"],
  "chargeAmount": 150.00
}

// Search for providers
{
  "specialty": "cardiology",
  "location": {
    "city": "Atlanta",
    "state": "GA",
    "zipCode": "30309"
  },
  "networkId": "BCBS_GA",
  "radius": 25
}

// Create FHIR Patient resource
{
  "resourceType": "Patient",
  "identifier": [
    {
      "system": "http://hospital.smarthealthit.org",
      "value": "12345"
    }
  ],
  "name": [
    {
      "family": "Smith",
      "given": ["John", "David"]
    }
  ],
  "birthDate": "1990-05-15"
}

Error Handling

| Error | Description | Solution | |-------|-------------|----------| | Authentication Failed | Invalid API key or credentials | Verify API key and client ID in node credentials | | Rate Limit Exceeded | Too many requests in time window | Implement delays between requests or use batch operations | | Invalid Member ID | Member not found in payer system | Verify member ID format and payer combination | | Service Unavailable | Availity API temporarily unavailable | Implement retry logic with exponential backoff | | Invalid Request Format | Malformed request data | Check request schema against Availity API documentation | | Network Timeout | Request exceeded timeout limit | Increase timeout setting or check network connectivity |

Development

npm install
npm run build
npm test
npm run lint
npm run dev

Author

Velocity BPA

• Website: velobpa.com
• GitHub: Velocity-BPA

Licensing

This n8n community node is licensed under the Business Source License 1.1.

Free Use

Permitted for personal, educational, research, and internal business use.

Commercial Use

Use of this node within any SaaS, PaaS, hosted platform, managed service, or paid automation offering requires a commercial license.

For licensing inquiries: [email protected]

See LICENSE, COMMERCIAL_LICENSE.md, and LICENSING_FAQ.md for details.

Contributing

Contributions are welcome! Please ensure:

1. Code follows existing style conventions
2. All tests pass (npm test)
3. Linting passes (npm run lint)
4. Documentation is updated for new features
5. Commit messages are descriptive

Support

• Issues: GitHub Issues
• Availity Developer Portal: developer.availity.com
• HL7 FHIR Documentation: hl7.org/fhir