Solution: Improve health care claim and payment processing
Efficient claim and payment processes are key to optimal business health. But too often, medical businesses struggle with these critical business functions – and understandably so. Insurance claim and payment processes are complex enough, then add to that the growing patient financial responsibility that shifts new attention to up-front patient collections. That’s why Availity offers solutions to address every part of the reimbursement process. Whether you need to collect more up front, streamline claim submission or simplify back-end collections, Availity has tools to optimize your revenue cycle.
If you’re a physician practice or hospital, you are tasked with collecting more payments at the point of service, and may not have a systematic approach to address it. At the same time, the increasingly complex reimbursement process associated with submitting health care claims demands more automation, better business intelligence and greater transparency. With the right tools, you can improve up-front patient payments and still tackle payer claim and payment processes to boost your bottom line.
If you’re a health plan, your focus is on increasing the accuracy and efficiency of information exchanged with providers so you can lower overall processing costs. You’re working on streamlining responses to claim- and payment-related inquiries without increasing the burden on your staff’s time or stressing your operational budget.
And if you’re a vendor partner, you are leveraging a health information network that offers the solutions and health plans your customers need, both today and as the market evolves, for processing health care claims and payments.
Our products for claim and payment processing
If you are looking to optimize point-of-service collections, our Patient Access tool is your best bet. Availity gives patient access teams the ability to improve patient payments to achieve more timely and consistent cash flow. Improved cash flow is especially critical as the popularity of high-deductible health plans means more of the payment responsibility moves to patients—and thus physicians and hospitals—to ensure timely payment.
Revenue Cycle Management
To add the highest level of automation and deepest functionality to your claims process, use Revenue Cycle Management. It speeds up your claims and payments by automatically validating patient eligibility and benefits, auditing claims in real time for errors, tracking and reporting on claim status and integrating with your practice management, hospital information or EMR system.
If you need connectivity to exchange high volumes of claim- and payment-related transactions, our Advanced Clearinghouse has you covered. Tap into a comprehensive network of physician practices, hospitals, and health plans to quickly and efficiently exchange claims, remittances, eligibility and benefits and claim status information.
If you need a tool for individual transactions and inquiries, our Web Portal provides real-time access to information from multiple health plans, helps you fill information gaps, reduces claim errors and facilitates accurate payments.