Quickly access your patient’s entire insurance picture across multiple payers, and highlight the unique details critical to you. Save time, increase claims acceptance and reduce accounts receivable days.
Exclusive Intelligent Eligibility module
Intelligent Eligibility allows you to automatically identify and highlight important coverage details, and data mismatches. It streamlines manual business processes such as: validating Medicaid HMOs, checking for Medicare secondary payers and part C/Advantage info, highlighting plans or groups that require a referral or prior authorization, flagging restricted coverages, and more.
Strong regional track record
Since 2001, Healthia Exchange (formerly Optum Healthia Exchange) has provided Midwest states the only complete and comprehensive technology for accessing health insurance eligibility and benefit information for MN payers, including those without EDI capabilities. Healthia Exchange is now part of Availity, the nation’s largest health information network.
Integration with providers’ existing systems
Availity Healthia Exchange uses the standard x12 270/271 EDI transaction set and easily integrates into most practice management and hospital patient accounting systems. Several third-party vendors have developed custom workflows and intelligent routing to map eligibility data flows into the right system work queues.
Sample of commonly used validation rules: