Simplify complex processes and improve payer-provider collaboration.
Simplify complex processes and improve payer-provider collaboration.
Streamline workflows and improve engagement.
Maintain compliance by capturing provider updates at the source.
Transform data-sharing capabilities and reduce the cost of care.
Ease prior authorization burdens with AI-driven solutions.
Reduce print and postage costs and replace manual processes.
Lower admin costs and prevent revenue leakage.
Streamline workflows, reduce denials, and ensure accurate payments.
Streamline workflows, reduce denials, and ensure accurate payments.
Seamlessly deliver complete and accurate healthcare information.
Seamlessly deliver complete and accurate healthcare information.
Facilitate seamless data exchange via X12, REST, and FHIR APIs.
Streamline provider workflows and improve collaboration.
Reach more health plans while streamlining pre-service and billing.
Boost efficiency, prevent denials, expedite payments.
Enhance clinical data quality for optimized downstream workflows.
Simplify the prior authorization review process.
Connect to health plans nationwide.
Seamlessly connect and exchange administrative data.
REST and FHIR-based APIs for fast, secure connectivity.
Maintain accurate provider directories.
Streamline data exchange to meet mandatory compliance.
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Have you ever checked the status of a claim electronically—through a provider portal, an EHR or practice management system, or a billing system—and received a response that left you thinking, “Well, this isn’t very helpful.” You wanted to avoid calling the health plan, but the vague response left you no choice.
When you receive complete claim status information, you’re less likely to have to call the health plan. That’s what Availity’s Enhanced Claim Status is designed to do. It’s an API transaction health plans can enable to enhance the standard electronic claim status response (X12 278/288) with richer, more contextual information. For providers, the information is automatically included in the response, so you don’t have to do anything different or look somewhere else.
“It is much easier to use and saves time when checking on claims!”
With Enhanced Claim Status enabled, you can receive information like the patient’s group number and subscriber relationship, the date a check was cashed, specific diagnosis codes, and much more. Health plans have more than 300 data fields they can customize to make sure their providers are getting accurate and informative results. Many health plans are using Enhanced Claim Status to provide more specific denial codes, so providers can save time by knowing exactly what to correct before resubmitting the claim.
You can find out if your health plan offers Enhanced Claim Status by visiting the Availity Essentials Payer List and searching for your health plan. If Enhanced Claim Status is listed as “available,” that means you have access to this rich claim status information through Availity Essentials and Availity Essentials Pro. Many health plans are in the process of implementing Enhanced Claim Status, including commercial, Medicaid, and dental plans, so check back to see updates.
If your health plans don’t yet offer Enhanced Claim Status, let them know you’re interested. Essentials users can use the Feedback button on the Claim Status application. If you manage claims through an EHR or practice management system, talk to your vendor about having more health plans participate.