EDI Clearinghouse
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The Availity advantage

 

As healthcare EDI transactions become increasingly commoditized, working with an industry leader like Availity has advantages. Availity helps providers, vendors, and other clearinghouse customers simplify EDI clearinghouse costs and increase overall efficiency. Availity’s position in the market and unique ownership structure enable submitters to enjoy more free EDI transactions and worry less about network disruptions caused by industry consolidation.

 
EDI Clearinghouse Infographic

EDI Clearinghouse Basics

Before we get into the details, let’s clarify a few terms. Click here to view the infographic.

 

If you’re confident with EDI terms, just scroll to the next section.

The Availity Network: Your Connection to Payers Nationwide

Availity is the nation’s largest real-time health information network with connections to more than 20,000 payers nationwide, including government payers like Medicaid and Medicare. With Availity’s EDI Clearinghouse service, providers can easily reach more of their health plan partners. To explore our full list of payers, log in to the Provider Engagement Portal and view the Payer List.

Availity - Where Healthcare Connects
EDI V5

Availity EDI Clearinghouse Plans: Base and Comprehensive

Many payers in the Availity network sponsor EDI transactions through Availity, while other payers do not, so we only pass on transaction fees to submitters when necessary. We offer the largest network of free payer transactions in the industry and competitively priced access to the rest of the payer market. All submitters—providers, vendors, and other clearinghouse customers—can select the network plan that’s right for their organization.

Getting started is easy:

For Providers, vendors, or billing services that submit less than 2000 transactions a month, Availity offers two EDI Clearinghouse options for connecting to payers, shown on the left. Our EDI Clearinghouse Service allows you to submit batch files via your claims processing software to health plans. These plans are exclusive to EDI transactions and do not affect the list of payers you see in the dropdown list on the Provider Engagement Portal. If you would like to select the base or one of the comprehensive plans, click here.

*Note: You need a portal account to access the selection tool. If you need to register for a portal account, click here. All new portal customers are automatically enrolled in the Base Plan, and have the option to upgrade to receive additional payer connections.

For vendors or other high-volume submitters (typically more than 2000 transactions a month) who require additional configuration options or already have direct clearinghouse connections, we offer additional contracts to suit your needs. Fill out the contact us form below to connect with our trading partner management team.

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Your EDI Clearinghouse and More

Regardless of which EDI plan you choose, your organization gains an efficient and cost effective way to submit healthcare transactions. Need more than EDI Clearinghouse alone? Availity offers other ways for providers and submitters to connect:

EDI Transaction
 
 

To get more information on EDI Clearinghouse, fill out the form below and someone will connect with you.

 
 
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