Skip to site content
New to Availity? Get Started

Are you getting the best claim status information?

If not, ask your health plans about Enhanced Claim Status.

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.

Better data 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. 

Participating health plans

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.

Ask your health plans to implement Enhanced Claim Status

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.