Access real-time information and get instant responses in a consistent format, regardless of the payer. Best of all, health care providers get this access at no cost. So go ahead and start exploring how you can use the Availity Web Portal during your patient check-in, in the exam room, checkout, billing, or wherever you might benefit from easy, instant access to health plan information.
Availity’s Web Portal gives you the tools you need to drive measurable and meaningful organizational improvements, and enjoy the vitality of a healthy business. Whether you’re a medical practice, hospital or billing service, the Availity Web Portal can help you quickly and easily:
- Access patient eligibility and benefits
- Obtain real-time authorizations, patient care summaries and care reminders
- File individual medical claims or upload batches, check claim status and remittance
- Process patient payments for enhanced collections
Get the billing and payment information you need quickly and accurately, using the Availity Web Portal. You don’t have to juggle logins for multiple websites. Access multiple health plans through a single, secure, easy-to-use site.
Easy access and implementation
- With completion of a simple online registration form, you can begin to access the Web Portal right away.
- Access the Web Portal through availity.com.
- Free expert training is available through live and on-demand webinars, local workshops, and knowledgeable Client Services representatives.
A secure, compliant network
- Adherence to the highest industry standards for security, including HIPAA compliance.
- Support for industry standard initiatives contributing to the improvement of the health care industry, including a HITRUST certified clearinghouse, EHNAC health care network accreditation, and CAQH CORE Phase One and Two certified clearinghouse.
- Industry leadership in regulatory compliance, including contributing to WEDI guidelines for health care information exchange and investments in data center security.
Submit and receive HIPAA transactions
Whether you’re a medical practice, hospital or billing service, the Availity Web Portal can help you quickly and easily:
- access patient eligibility and benefits, and make fewer phone calls to payers
- obtain real-time authorizations, patient care summaries and care reminders
- check claim status and remittance, and reduce or eliminate paperwork and phone calls
- file individual medical claims or upload batches
- process patient payments for enhanced collections
Professional and facility medical claims
Submit claims for both professional and facility transactions, in real-time, using the convenience of the Web Portal.
Access commercial and government payers
- Manage your daily transactions with government payers, including Medicare and Medicaid.
- Access many of the nation’s largest payers, including Aetna, Blue Cross and Blue Shield plans (including Florida Blue and Blue Cross and Blue Shield of Minnesota), Cigna, HCSC, Humana, WellPoint – and state/regional plans. View our payer list.
- Get single sign-on access so you don’t have to manage logins for multiple payers’ portals.
Eligibility and benefits
The eligibility and benefits tool within the portal allows you to collect the information you need accurately and quickly. Verify a patient’s eligibility and benefits information and receive a response from the payer with confirmation of benefit detail, including co-payments and deductibles.
Referrals and authorizations
Submit requests for referrals, authorizations or status inquiries through the portal for procedural inpatient or specialist visits. Additionally, verify a patient’s authorization for appointments over multiple days or visits. You will receive a response from the payer indicating the parameters of the authorization, along with a referral/authorization number (if authorization was processed automatically).
The portal is a great resource for organizing and managing professional and facility claims. You can check claim status, submit a claim and receive remittance advice.
Additional Web Portal business solutions
- Card swipe allows automated data entry through a payer-deployed, magnetic stripe membership card. Simply swipe a patient’s ID card through a card reader connected to your computer’s USB port. Card swipe leverages the Workgroup for Electronic Data Interchange (WEDI) Health Identification Card specification and supports eligibility and benefits and real-time claims transactions, as well as other Availity integrated services, including: patient care summary, patient cost estimator, and patient payments.
- Claim reconciliation allows you to reconcile your accounts receivable by reviewing enhanced claim status results from multiple health plans within parameters you determine, such as date range or payment status.
You need information that goes beyond what is available in the standard HIPAA transactions, and Availity delivers it. Use the Web Portal to access these tools from patient check-in to payment collection, and streamline workflows for your entire office.
Patient care summary
- View up to 24 months of your patient’s care history, including diagnosis, procedures, lab services and prescription claims for services rendered by all providers involved in your patient’s care.
- Secure clinical information based on payer claims records helps you improve coordination and continuity of care by eliminating duplicate or unnecessary services, and providing indicators of under-use, overuse or misuse of medical services.
- Receive patient-specific care reminders to perform annual exams or tests, and help promote patient compliance with best practices in health care.
Patient cost estimator
- Estimate your patient’s financial responsibility at the point of care and reduce accounts receivable.
- Minimize late and unpaid balances, and decrease administrative costs associated with repeat billing.
- Help your patients become better health care consumers by educating them about their financial responsibility so they can make better-informed decisions.
- Improve cash flow by collecting patient balances at the time of service by quickly and easily processing credit card, PIN-less debit card and checks.
- Integrate with your existing billing system for easy uploads of information and automated payment posting.
- Set up recurring payments, void payments or issue credits, and convert paper checks into electronic transactions.
- View, search or print your electronic remittance advice for all your payers, and reduce your reliance on paper statements for monthly reconciliation.
- View check summaries and claim status detail in a consistent format across payers.
- Streamline your accounts receivable for enhanced revenue cycle management.
PROVIDER READINESS TO SUPPORT VALUE-BASED PAYMENT MODELS
As health care reform gains momentum, the industry shift toward value-based payment models is accelerating. These emerging models compensate physicians based on patient care and outcomes rather than services rendered, putting the focus on quality over volume.