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Prior authorizations for providers

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Prior authorizations continue to be a major source of frustration for providers and patients. The process still relies primarily on phone calls and faxes, which prevents timely access to care and often leads to denied claims.   

Availity is leveraging responsible artificial intelligence (AI) and automation to build the next generation of prior authorization solutions designed to streamline the process and reduce patient care delays.

Web-based prior authorizations

Availity lets providers manage the authorizations process for multiple payers in a single location—Availity Essentials. With Authorizations in Essentials, providers can:

  • Find out if an authorization is required before submitting it
  • Create an authorization using an easy-to-complete form  
  • Electronically attach supporting medical documentation
  • Review pending authorizations for all health plans through a dashboard
  • Send an authorization-related message to the health plan

Learn more about how Availity can help.

Product

Availity Essentials

Learn how Availity can help your health plan streamline provider workflows and improve collaboration.

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EHR-integrated prior authorizations

Provider organizations that manage a high-volume of prior authorizations want to keep staff in their primary workflow as much as possible. Availity Essentials Pro’s Authorizations solution allows staff to remain in their primary workflow while they:

  • Check whether an authorization is required
  • Initiate an inpatient or outpatient authorization 
  • Submit a completed authorization to the payer 
  • Receive up-to-date authorization statuses

Explore the benefits of Availity’s RCM solutions

Product

Availity Essentials Pro

Boost efficiency, prevent denials, expedite payments with Availity Essentials Pro End-to-End RCM.

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Case Study

End-to-End Prior Authorizations Using FHIR APIs

To address pain points within the prior authorization process, a collaborative initiative was launched by Humana, athenahealth, and Availity.

Read the study

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