Availity news center

News Center

Availity, the nation’s largest real-time health information network, announced the launch of its automated prior authorization platform, which eliminates the cost, time, and administrative burdens associated with manual authorization processes.

The Centers for Medicare & Medicaid Services (CMS) released a report in January on the accuracy of provider directories, the online lists provided by insurers and used by health plan enrollees to find in-network doctors or select a plan in which their preferred caregiver participates.

For health insurance companies, an accurate, easy-to-update standardized database for network provider data is the Holy Grail. Along with being a major source of frustration for members, inaccurate provider information negatively impacts claims processing, provider credentialing and the ability to ensure compliance with network adequacy rules. It also can create obstacles for providers that want to create a value-based benefit approach.

In a time of healthcare consumerism and high-deductible health plans, the patient has become a major revenue source for healthcare organizations. But without strong point-of-service patient collection strategies, providers could be seeing their payments walk right out the door with their patients.

Health plans have long supplied their members with provider directories to assist in finding in-network physicians who are accepting new patients. But what should be a helpful aid often isn't, due to outdated or just plain wrong data. Not only is this frustrating for patients trying to find an available provider, it can cost them more than they anticipated if they end up incurring out-of-network fees for a physician they thought was in-network.

A tiny change to how a small hospital uses technology is resulting in big savings of between $3,000 and $10,000 a month. Iroquois Memorial Hospital, a 25-bed facility in the eastern Illinois town of Watseka faced a problem.

As patient financial responsibility continues to increase in a more consumer-focused healthcare environment, more hospitals are shifting healthcare revenue cycle management strategies to improve patient collections. Iroquois Memorial Hospital in Illinois is one of these healthcare organizations.

Availity, the nation’s largest real-time health information network, announced that it will be using the HL7® FHIR® standard for sharing critical data between payers and providers, including patient eligibility and benefits, lab tests, diagnoses, medical attachments, ADT, and other healthcare information.

Availity, the nation’s largest real-time health information network, announced the availability of a low-cost online education series that will help physician practices meet HIPAA training requirements.