Solution: Clinical Connect

Availity Clinical Connect simplifies and automates the exchange of clinical information with one integrated platform to streamline the evolving revenue cycle process for health plans and providers.

Today’s health care information exchange is largely characterized by EDI/HIPAA transactions and traditional revenue cycle management tools. Payment reform is driving changes in the information providers and health plans must exchange. Availity Clinical Connect automates the costly, manual exchange of clinical data when and where it’s needed.

Automate Authorizations

Hospital and Professional Authorizations

  • Automates the authorization process for providers and health plans
  • Centralizes authorization management within a single portal
  • Reduces administrative costs
  • Eliminates phone and fax communications with online chat and attachments
  • Improves revenue cycle by reducing claim denials

Care Reminders

Facilitates more fully-informed clinical decisions

  • Delivers care gap or coding gap messages to providers at the point of care
  • Complements and improves health plan-provider communication programs
  • Supports providers in meeting value-based program requirements
  • Leads to improved patient outcomes and lower costs
  • Supports patient-focused messaging efforts

Encounter Summaries

Ambulatory Medical Record Extract

  • Automates extraction of data for HEDIS quality reporting from physician EHRs to health plans
  • Reduces the need for manual chart reviews, phone calls, emails, and faxes

Hospital Information Exchange

Electronic Census/Notice of Admission

  • Delivers HL7 admission/discharge/transfer (ADT) and lab transactions to the recipient’s health plan
  • Improves early-intervention care management programs
  • Lowers administrative costs for chart retrievals
  • Reduces readmissions with improved coordinated care
  • Prevents claim denials for incomplete documentation

Medical Records Acquisition

Unstructured Clinical Documentation

  • Automates manual chart-pull and clinical documentation processes
  • Automates the match of attachments to claims
  • Lowers operating costs by centralizing attachment requests and eliminating paper
  • Reduces claim adjudication and adjustment time

Patient Care Summaries

Payer-Based Health Record

  • Reduces the risk of duplicate therapies within the clinical workflow
  • Strengthens the health plan-provider-patient relationship
  • Mitigates potential medical errors
  • Improves the care intake process