Quick Answers for Providers

Below are some questions or concerns you may have as you consider joining the Availity Health Information Network.

What exactly is Availity?
Availity is a leading-edge Health Information Network, providing administrative, financial, and clinical services to users ranging from health care providers to health plans and technology partners. Availity optimizes information exchange between multiple health care stakeholders through a single, secure network. We exist to strengthen these direct relationships by delivering trusted information to enable a more collaborative approach to health care operation and delivery in each region.
Availity is owned by competing health plans that joined together to reduce costs by streamlining workflow and eliminating the fees that providers traditionally pay for billing and claims transactions. Our collaborative business model is unique—and it works. In less than 10 years, we’ve become one of the nation’s largest electronic health information networks, processing more than 700 million transactions every year.
What will Availity do for me and my medical practice?
Your practice will save time and money with Availity, enabling real-time access to patient eligibility and benefits, authorizations and referrals, claims, claim status, and remittance. You’ll enjoy valuable clinical as well as financial benefits also by tapping into Availity’s suite of integrated tools, including card swipe access to patient data (CareRead®), patient electronic health records (CareProfile®), electronic prescribing (CarePrescribeSM), patient financial responsibility estimation (CareCost EstimatorSM), and payment processing services (CareCollectSM).
Availity’s one-stop online access allows you and your staff to take care of day-to-day tasks more quickly, boosting your overall productivity and allowing more time to care for patients. And, Availity offers integration with most practice management systems, electronic medical record systems, and hospital information systems to maximize the value of your existing software and streamline workflow.
How can Availity be free?
Participating health plans pay Availity for certain kinds of transactions that health care providers process through our network. This allows health care providers like you to use Availity for free. Providers may even take advantage of a range of optional, value-added services, which may be available for a nominal cost.
Are there any set-up fees, monthly fees, or per-claim fees?
There are no set-up fees, monthly fees, or per-claim fees charged to providers. The standard Availity health plan transactions—including eligibility and benefits, claims, claim status, authorizations and referrals, and remittance—are available at no charge to health care providers. Most value-added transactions, such as electronic prescribing, electronic health records, and patient responsibility estimation are also available at no cost to providers. Some optional services are available at a cost.
Is Availity easy to use?
Yes. Availity’s online network looks and functions like any number of web sites you’re familiar with – and you won’t need any special training. If you’ve ever searched for anything online, then you already know what you need to know to use Availity.
Which health plans support real-time transactions with Availity on the web site?
Click here to search and download this information to your desktop.
What are the technical requirements?
All you need to use our secure online network are:
  • A computer with internet access. High speed is recommended for best results.
  • Microsoft Internet Explorer 6.0 or greater, which supports 128-bit encryption.
  • A 1024 x 768 or greater pixel display for best results.
To participate in the online network, do we need to purchase software?
No. However, our network integrates with most major practice management systems and hospital information systems for batch claims and other transactions. This site allows you to search for technology companies that have successfully tested transactions with Availity. If your company is not on the list, it would be a good idea to contact them. See our technology company partners.
Is Availity a practice management system?
No. Practice management systems, hospital information systems, and billing systems are software products sold separately by various technology companies and vendors. Availity is a free information network that uses the internet to offer a range of products and services. Availity can be seamlessly integrated with these systems so that you benefit from both your software features as well as our services. The level of integration is determined by your system vendor.
Is Availity HIPAA compliant?
Yes. Availity’s procedures and protocols are 100% compliant with the Health Insurance Portability and Accountability Act (HIPAA). In fact, some of our security standards exceed HIPAA requirements. We continuously monitor HIPAA regulations for changes. We continue to develop and enforce extensive HIPAA privacy and security policies and procedures and we play a leadership role in regional and national HIPAA workgroups and other health care forums.
How does Availity protect the privacy and security of health information?
The health information delivered by Availity is completely secure. Information is protected by registration and can only be accessed by designated users. It’s also important to note that Availity does not store health information. It only exchanges the information—in strict compliance with privacy laws and regulations—as necessary to complete the range of transactions performed by participants.
Why does the information vary from health plan to health plan?
Availity supports a real-time, federated model and does not store information. When you conduct a real-time transaction, Availity pings the health plan’s back-end system and returns the latest information available from the health plan. If you notice that certain information is inadequate, please let Availity know about it. Our Alliance and Account Management teams work with our partners to continuously improve the amount and quality of the information available to us.
Does Availity offer broadband internet access?
Not directly. However, Availity has partnered with Bridgevine, an agent for Qwest, AT&T (SBC), Verizon, Comcast, Covad, Time Warner, and more than 40 other major Internet service providers. Availity customers can determine the broadband providers that service their location, and then compare service packages and prices. Special prices and offers have been negotiated for Availity customers. On average, a business customer will save more than 30% over current service costs.
If I already have access to a health plan’s web site, will I need to register to use the Availity® Health Information Network?
Yes. The Availity Health Information Network requires that you register and obtain a user ID and password. Once logged in to Availity’s network, you have the ability to transact with multiple health plans, eliminating the need to visit multiple sites and remember multiple passwords.

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