Simplify complex processes and improve payer-provider collaboration.
Simplify complex processes and improve payer-provider collaboration.
Connect to the most providers and HIT partners nationwide.
Improve collaboration with your provider network by automating core workflows.
Help ensure the right care at the right time by transforming the prior authorization process.
Reduce administrative waste by shifting edits early in the claim lifecycle.
Make clinical data work for you by streamlining acquisition, improving quality, and optimizing workflows.
Improve the quality of provider data for use across the enterprise.
Drive cost out of provider communications by digitizing paper correspondence.
Streamline workflows, reduce denials, and ensure accurate payments.
Streamline workflows, reduce denials, and ensure accurate payments.
Improve revenue cycle performance with fast and secure connections to payers nationwide.
Seamlessly deliver complete and accurate healthcare information.
Seamlessly deliver complete and accurate healthcare information.
Scale your organization by connecting with payers and providers nationwide.
Access our portfolio of robust and compliant API connections.
Get the latest industry insights.
See success stories from our customers.
See where we're located.
Find the best way to get in touch.
Get in touch with customer support.
Learn about upcoming industry events.
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 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.
“It is much easier to use and saves time when checking on claims!”
With the solution enabled, you can receive information like the patient’s group number, specific diagnosis codes, and much more. Health plans have more than 300 customizable data fields to ensure 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.
You can find out if your health plan offers this tool by visiting the Availity Essentials Payer List and searching for your health plan. If listed as “available,” that means you have access to information through Availity Essentials and Availity Essentials Pro.
If your health plans don’t yet offer the solution, let them know you’re interested. If you manage claims through an EHR or practice management system, talk to your vendor.