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Eligibility and coverage solutions

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One of the most important things providers can do to optimize the revenue cycle and improve chances of getting paid is to verify patient eligibility and coverage information through a trusted partner.   

Availity has a wide selection of eligibility solutions that address the needs of small medical offices, large hospitals and health systems, and technology vendors.

Web-based eligibility and verification inquiries for small medical offices

Small provider practices want the efficiency of electronic insurance verification checks without the overhead of a practice management system. Availity Essentials™ and Essentials Plus™ allows providers to reach Availity’s nationwide network of payers either for free (Essentials) or for a nominal charge (Essentials Plus).

Learn more about how Availity can help.

Product

Availity Essentials

Streamline provider workflows and improve collaboration.

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Product

Availity Essentials Plus

Reach more of your payers through the Availity Essentials platform.

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Batch and integrated real-time insurance eligibility verification for hospitals and health systems

Availity Essentials Pro™ features a wide range of eligibility solutions, including batch processing, pre-claim eligibility, and an advanced real-time eligibility solution that integrates directly into the provider EHR workflow.

Case Study

How Advanced Real-Time Eligibility helped a major health system obtain a 67% decrease in eligibility denials 

Improved access to patient benefits and a consultative approach made a positive impact on denial rates and collections.

Read the study

Explore the benefits of Availity’s solutions

Product

Availity Essentials Pro

Reach a nationwide network of payers.

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Nationwide payer connectivity for healthcare vendors

Trading partners and other healthcare vendors can leverage Availity’s direct payer connections to send eligibility transactions via X12, SOAP, and RESTful APIs.

Uncover the advantages Availity offers

Product

EDI Clearinghouse

Discover how Availity can help you connect to health plans nationwide with its EDI Clearinghouse.

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Product

API Marketplace

Experience healthcare’s future with Availity’s REST and FHIR-based APIs for fast, secure connectivity.

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