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How to check eligibility on Availity

A faithful recreation of the Availity Essentials Eligibility & Benefits inquiry — every name, ID, and dollar figure is invented sample data.

essentials.availity.com/eligibility-and-benefits
REC
Sample data — not a real patient
SAMPLE, MARIA
Health Benefit Plan Coverage
Trans. Date: Today
Member: W000123456
Aetna · DOB 03/15/1968
Edit · Delete
No Patient History

Eligibility & Benefits

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Fields marked with an asterisk * are required.

RIVERSIDE HAND & ORTHOPEDICS
Select a payer…
Clear Section
Provider Information

Select a provider or enter one of the following: Provider NPI or Provider Tax ID

Search for a provider by name, NPI, tax ID…
Optional
Patient Information
MARIA
Female
Self
Service Information
Today
Select…
Submit another patient
Checking eligibility with Aetna…
Date of Service: TodayTransaction ID 75200000000 · Customer ID 000000
ACTIVE COVERAGEMARIA SAMPLE✎ Edit⎙ Print
Member Status
Active Coverage
Date of Birth
03/15/1968
Gender
Female
Plan Effective
Jan 1 2026 – Dec 31 2026
Relationship
Self
Member ID: W000123456Group #: SAMPLE-001Plan: Aetna Open AccessType: HMO
Plan Maximums and DeductiblesOut of NetworkIn NetworkAll Networks
Information / Details
Individual
Family
In Network
Annual Deductible
$500 / Calendar Year
$0 Remaining
$1,000 / Calendar Year
$0 Remaining
In Network
Out of Pocket
$3,000 / Calendar Year
$1,500 Remaining
$6,000 / Calendar Year
$4,000 Remaining
Benefit Information
Medical Care - 1
Professional (Physician) Visit - Office - 98 $30 copay
Hospital - Outpatient - 50 Auth Info Available
Urgent Care - UC
Vision (Optometry) - AL
1

Pick the payer

Organization is already set to your practice — choose the patient's insurance from the Payer dropdown (Aetna).

Built by VeriPhy Health · recreation with invented sample data — no real patient information appears anywhere.