Health plan solutions

Work smarter, with
greater collaboration

Whether you support traditional or emerging payment models – or both – we help you quickly and easily get the information you need from providers to process, pay and respond to claims and claims inquiries. We also enable physician practices and hospitals with self-service tools, reducing the time your staff spends responding to calls.

As the industry shifts from fee-for-service compensation models to value-based payments, the primary business challenge for health plans remains the same: reduce administrative costs while improving performance, and do it all while maintaining a strong and collaborative provider network. Overlay that with the new challenge of collecting HEDIS and STAR information to support top-line growth, and you have your hands full. We’re helping you do it all by combining our strengths in administrative cost reduction with innovative workflow solutions.

The bottom line:  Availity keeps your providers satisfied and gives you the information you need to build a healthier business.

Solutions for health plans

Simplify provider connectivity

Connect and communicate quickly, easily and securely to your provider network

Improve payment accuracy and efficiency

Improve auto-adjudication, denial and pend rates with more complete, reliable data

Increase provider self-service

Reduce time spent answering information-related calls

Expand the success of value-based payment

Share the information you need to support both fee-for-service and value-based payment programs

Leverage one system

Trust Availity to help you implement and benefit from one revenue cycle management system with flexible, scalable tools.