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AVAILITY IN THE NEWS

Realizing the promise of value-based healthcare will require a level of payer and provider collaboration virtually unheard-of in the recent past—and health information management (HIM) professionals play an essential role in achieving this reality. To achieve success in the new value-based world, both payers and providers must work together to develop the most efficient means of sharing data, managing risk, validating provider credentials, processing claims, controlling costs, and optimizing the consumer experience. However, in the realm of provider data management (PDM), efforts directed towards payer-provider collaboration are expensive and time-consuming...

ANNOUNCEMENTS

Beginning February 10, 2020, Anthem Blue Cross will begin using Availity’s medical attachment functionality to request and obtain medical records from providers during its post-payment claims review (audit) process. To utilize this functionality, providers must opt into the medical attachment functionality through the permissions in Availity’s enrollment center. Providers who have not opted in will continue to receive requests via paper...

AVAILITY IN THE NEWS

Financial information systems are an integral part of the healthcare information technology machine. Without them, healthcare does not get paid for. That’s why healthcare CIOs and CFOs need to keep these invaluable information systems humming—and humming optimally. There’s always room for improvement, so CIOs, CFOs, and other health IT leaders need to know how to optimize these systems so that they are working at peak levels and helping healthcare provider organizations achieve their specific goals...

AVAILITY IN THE NEWS, MANAGEMENT AND LEADERSHIP

Jean Ribault High School is giving students more opportunities through a new partnership that is bringing mentorship inside and outside the classroom. A group of freshmen will be taking part in a new program called “Beyond School Walls.” ...

AVAILITY IN THE NEWS

The cost of prior authorization requirements on physician practices has continued to increase - up 60% in 2019 to manually generate a request to insurers. The just-released CAQH 2019 Index, which concluded that the healthcare industry can save $13.3 billion on administrative waste through the automation of eight transactions (including prior authorizations), said the medical industry could see potential annual savings of $454 million by transitioning to electronic prior authorizations.

AVAILITY IN THE NEWS, FEATURED ARTICLES

Value-based healthcare demands meaningful payer-provider collaboration. However, burdensome administrative processes and inefficient solutions stunt the ability of payers and providers to share data, manage risk, validate credentials, process claims, control costs and optimize the consumer experience. These information bottlenecks are most acute in the area of provider data management (PDM).

AVAILITY IN THE NEWS, PRESS RELEASES

Patients deserve access to the safest, most effective and highest-quality care. To achieve that goal, health insurance providers may use prior authorization – a systematic approach based on clinical evidence and data that ensures patients receive safe and effective treatments. Today, America’s Health Insurance Plans (AHIP), along with several of our member insurance providers, is launching the Fast Prior Authorization Technology Highway (Fast PATH) initiative to improve the prior authorization process...

ANNOUNCEMENTS, PRESS RELEASES

A new paper in JAMA found that 30% of all healthcare spending is wasted. This is not a new story for healthcare professionals, but the sheer size of the waste—$760 billion to $935 billion—can give even the most grizzled industry veterans pause. The authors measured waste in six broad categories: failure of care delivery, failure of care coordination, over-treatment or low-value care, pricing failure, fraud and abuse, and administrative complexity. In five of the domains, the researchers identified potential cost-savings through various efficiency initiatives, technology advancements, and policy prescriptions.

ANNOUNCEMENTS, PRESS RELEASES

Availity, the nation’s largest real-time health information network, named Frank J. Manzella its new Senior Vice President of Corporate Development & Strategy. An experienced healthcare executive and investor with broad strategic expertise and transaction experience, Manzella’s focus will be to provide critical insights and guidance for potential acquisitions designed to significantly expand Availity’s capabilities ...

AVAILITY IN THE NEWS, PRESS RELEASES, ANNOUNCEMENTS

Sixty-seven percent of all provider organizations in the United States attest the accuracy of their provider directories, credentialing, and other demographic data through the industry-leading, multi-payer intelligent portal of Availity, the nation’s largest real-time health information network. So far this year, 263,000 provider organizations, representing almost 1 million physicians, utilized Availity to make more than 7 million updates or corrections to their directories.

AVAILITY IN THE NEWS

Revenue cycle management technology is at the heart of the administrative side of business at every hospital and health system. It is key to daily operations. As such, healthcare CIOs and other IT professionals must take great care when implementing RCM systems. Getting revenue cycle done right – and done right the first time – is imperative. Here, five experts in the field of revenue cycle management IT offer Healthcare IT News readers their expertise when it comes to identifying and deploying best practices for implementing this all-important technology.

AVAILITY IN THE NEWS

Welcome back to Faces of HR. In this space every Friday, we will profile one of your peers, learn about his or her experiences as and feelings about being an HR professional, what the person’s goals are, and how he or she hopes to accomplish those goals—and get to know a little about your peer as a person along the way! Today we’re learning about Jessica Micciche, Senior Vice President and Chief Human Resources Officer at Availity, the nation’s largest real-time health information network.

PRESS RELEASES

Jacksonville, Fla—July 24, 2019—Availity, the nation’s largest real-time health information network, named Jessica Micciche its new Senior Vice President and Chief Human Resources Officer. With 15 years of HR experience in high-tech and manufacturing environments, Micciche is tasked with all aspects of human resources including culture, talent acquisition and management, leadership, human capital analytics, compensation and benefits

ANNOUNCEMENTS, AVAILITY IN THE NEWS, CLAIMS AND PAYMENTS, REVENUE AND COST STRATEGIES

Jacksonville, Fla—June 18, 2019— Black Book Market Research LLC awarded Availity, the nation’s largest real-time health information network, its highest ranking for Ambulatory Claims Management and Physician Clearinghouse Solutions, in a comprehensive survey of more than 1,600 hospital and health system executives, directors, and managers.

AVAILITY IN THE NEWS

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) have proposed new rules designed to give patients greater control over their own data and advance interoperability across the healthcare industry. Should the rule be finalized in its current form, millions of patients will have unprecedented access to and control over their own health information by 2020.

ANNOUNCEMENTS, PRESS RELEASES

IRVINE, Calif.--(BUSINESS WIRE)--Feb. 11, 2019-- For healthcare providers, the laborious process of registering patients, estimating costs, collecting up-front payments, reducing denials and securing overall financial clearance is challenging, requiring the immediate need for efficiency and improved workflow. As deductibles rise, patient demand for cost transparency prior to service is skyrocketing. To meet these needs, NextGen Healthcare, Inc. (NASDAQ:NXGN), the leading provider of ambulatory-only technology solutions, and Availity, the nation’s largest real-time health information network, have collaborated to offer clients NextGen® Pre-Service Solutions.

AVAILITY IN THE NEWS, ANNOUNCEMENTS

In theory, healthcare consumerism is a straight-forward idea: Shifting costs to consumers, typically in the form of high-deductible health plans (HDHPs), will give them an incentive to make informed, judicious decisions about the healthcare services they purchase. In practice, consumers have been slow to shop for health care based on price, despite high enrollment levels in HDHPs, with the National Center for Health Statistics reporting that nearly 40 percent of consumers purchased private HDHPs in 2016, up from 26 percent in 2011.

AVAILITY IN THE NEWS, ANNOUNCEMENTS

medQ, Inc. and Availity announced an agreement to provide Availity Patient Access and AuthPal services through the Q/ris 3000 workflow suite of products. With this integration, Q/ris 3000 will quickly process physician orders, obtain prior authorizations, and verify insurance for all diagnostic imaging procedures. In addition, the Q/ris 3000 integrated app will also calculate how much patients will owe for that exam to ensure they are aware of their financial obligations prior to arrival for the procedure.

AVAILITY IN THE NEWS, FEATURED ARTICLES, ANNOUNCEMENTS

Starting Monday, Jacksonville-based Availity LLC and about 400 employees will operate at its new headquarters offices at Town Center One. Until then, most employees will work from home as the move is completed to the newly constructed building at 5555 Gate Parkway, across Butler Boulevard from St. Johns Town Center.

ANNOUNCEMENTS, AVAILITY IN THE NEWS, PRESS RELEASES

Stamford, CT, June 11, 2018 – FUJIFILM Medical Systems, U.S.A., Inc., a leading provider of Enterprise Imaging and Medical Informatics solutions, announced a new collaboration in its health IT portfolio to enhance access for clinicians and patients. Fujifilm has joined forces with Availity, the nation’s largest payer and provider engagement network, to provide an integrated solution for patient financial engagement and automated insurance pre-authorizations. Both vendors recently attended the RBMA conference and highlighted their new partnership.

ANNOUNCEMENTS, AVAILITY IN THE NEWS, MANAGEMENT AND LEADERSHIP, PRESS RELEASES

Availity, the nation’s largest real-time health information network, named Damien Creavin its new Chief Technology Officer. Availity’s New Chief Technology Officer Brings a Fresh Perspective to Healthcare.

ANNOUNCEMENTS, AVAILITY IN THE NEWS, PRESS RELEASES, CLAIMS AND PAYMENTS

Availity, the nation’s largest HITRUST-certified health information network, and IDS, a leader in healthcare cloud information management services, announced the successful integration of Availity’s pre-service authorization and patient access solutions into AbbaDox RIS, the cloud-based health information management platform developed by IDS.

AVAILITY IN THE NEWS

George Orwell wrote, “To see what is in front of one’s nose needs a constant struggle.” This is health care’s problem. We have spent — and will continue to spend — billions of dollars developing, buying and marketing state-of-the-art technology designed to create care that is transparent, cost-effective and patient-centered. However, in our pursuit of the future, we’re overlooking foundational elements that make the health-care system patients deserve more difficult to achieve.

FEATURED ARTICLES, MANAGEMENT AND LEADERSHIP, PRESS RELEASES

The Integrated Healthcare Association (IHA) announced their selection of Gaine Healthcare and Availity as the technology vendors for the launch of the statewide Provider Directory Utility (PDU). The first of its kind in the state, the PDU will offer a centralized, cloud-based platform for providers and health plans to update, manage, and exchange their provider data.

AVAILITY IN THE NEWS

eHealth Initiative released their final report, The Role of Technology in Value-Based Care & Patient Engagement, which gained insight, from an industry perspective, on the impact of healthcare reimbursement policies on technology and revenue cycle. Twelve executives, primarily from provider organizations and health information networks (HINs), were interviewed for this research project. Analytics were a prominent theme and interviewees felt strongly about the value of data in improving patient outcomes.

PRESS RELEASES

Availity, the nation’s largest real-time health information network, praised the recent announcement by physicians, pharmacists, medical groups, hospitals and health plans to streamline the prior authorization processes.

AVAILITY IN THE NEWS

Data Dimensions, a leader in business process automation, and Availity, the nation’s largest real-time health information network, now offer the workers’ compensation market a new way to connect payers and providers by leveraging Availity’s Provider Engagement Portal as part of Data Dimensions’ Shared Services solution. This multi-payer platform serves as an entry point for providers who require secure access to their payers regarding clinical and administrative transactions.

AVAILITY IN THE NEWS

Thanks to a new relationship with Availity, LLC, Amedisys, Inc, one of the nation’s leading home health, hospice and personal care providers, is processing authorizations more efficiently – and less costly. Previously, Amedisys processed every authorization for managed care claims manually, through either a website or a phone call, requiring 15 to 20 minutes per claim. As a result, authorizations often took too long to complete, thus raising administrative costs and at times, delaying patient care. To address those longstanding challenges, Amedisys forged a relationship with Availity, the nation’s largest real-time health information network. Availity electronically synthesizes and shares data in real-time between providers and health plans nationwide.

AVAILITY IN THE NEWS

Prior authorizations may be as popular among providers as ants at a picnic, but they have become a common and necessary part of the reimbursement process. As a result, being able to manage prior authorizations efficiently is critical to maintaining a healthy revenue cycle and avoiding issues such as denied claims, administrative waste, excessive staff turnover and, of course, patient dissatisfaction.

PRESS RELEASES

Florida Gov. Rick Scott presented the Governor’s Business Ambassador Award to Availity, the nation’s largest real-time health information network, for Availity’s contributions to Florida’s economic vitality. The Governor’s Business Ambassador Award is given to individuals and businesses in recognition of their efforts to create jobs and opportunities within the state. Founded in Jacksonville in 2001, Availity employs more than 400 Floridians, and has created 130 new jobs in Florida in just the past two years.

AVAILITY IN THE NEWS

Prior to the introduction of the electronic health record CMS (Medicare) and other health plan administrators relied upon claims data. Now the mandate of meaningful use has made clinical data available via the electronic health record. Physicians disparage the EHR because of its disruption of the clinical encounter and inefficiency in data entry. Few would deny the enormous data collection which has taken place.

AVAILITY IN THE NEWS

As you are likely aware by now, CMS’ final rule on Emergency Preparedness Requirements for Medicare and Medicaid Providers and Suppliers went into effect on November 15, 2016 and will be implemented on November 15, 2017. This final rule establishes national emergency preparedness requirements for Medicare and Medicaid participating providers and suppliers to plan adequately for both natural and man-made disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems.

PRESS RELEASES

Availity, the nation’s largest real-time health information network, announced today that it has received a significant growth equity investment led by Francisco Partners, a leading technology-focused private equity firm, with additional investment from Availity’s existing investor group.

PRESS RELEASES, AVAILITY IN THE NEWS

Availity today announced its recognition as one of the Achievers 50 Most Engaged Workplaces™ in North America. The annual award, issued by Achievers, an industry leading provider of employee recognition and engagement solutions, commends top employers that display leadership and innovation in engaging their workforces.

AVAILITY IN THE NEWS

Administrative costs make up about 15% of all healthcare expenditures—well over $300 billion annually, according to the 2016 index report from the California Association for Healthcare Quality. Outdated, manual processes and rejected claims eat up a large portion of this cost. The key to reducing administrative costs lies in refining these processes and changing with the times, according to industry leaders. Here are five strategies to consider implementing at your organization.

AVAILITY IN THE NEWS

Payers and providers have for decades stayed in their silos, leading to a more fractured and adversarial healthcare system. That relationship, however, is starting to soften for many in the industry. Payer-provider partnerships put the two groups on the same team in hopes of reducing costs and improving care and outcomes through sharing data and better communication.

AVAILITY IN THE NEWS

Although collaboration between payers and providers will be critical if they are to succeed in transitioning to value-based payment models, they continue to struggle with information exchange in the current fee-for-service environment. That’s the finding of a new survey of 40 health plans and more than 400 practice- and facility-based providers, which found significant communication gaps between the stakeholder groups.

AVAILITY IN THE NEWS

Online and multi-payer portals are viewed as promising solutions to improve communications between payers and providers while also mitigating costs, yet these tools are underutilized. While 60 percent of payers prefer the use of online portals as the primary means of communication with providers, it seems providers are less enthusiastic, as only 39 percent of practice-based providers and 40 percent of facility-based providers strongly support online portals as a primary source, according to a survey by Availity.

PRESS RELEASES

A survey conducted by Availity, the nation’s largest real-time health information network, found that while payers and providers want to collaborate more closely on value-based care initiatives, such partnerships remain vulnerable to poor data transparency, competing business goals, and significant administrative burdens.

AVAILITY IN THE NEWS

Healthcare industry trends such as growth in data analytics and high-deductible health plans are causing payer and provider relationships to evolve. With this evolution comes the need for greater communication and collaboration between the two sides. A recent Availity survey of 40 health plans and 400 practice- and facility-based providers found 53 percent of payers "strongly agree" providers and health plans need to collaborate to be profitable.

PRESS RELEASES

Mark Martin, Director, Payer and Vendor Portfolio at Availity, the nation’s largest real-time health information network, will take part in a panel discussion titled “Solving the Inaccuracy and Inadequacy of Provider Directories” at WEDI 2017, May 15-18, in Los Angeles.

AVAILITY IN THE NEWS

In an era of shrinking reimbursements, it's more important to capture every dollar owed to your practice as far forward in the process as possible. It's a matter of time and money. According to a 2016 Kaiser Family Foundation study, average deductible and co-insurance costs have seen the biggest increases between 2004 and 2014, and continue to grow while copays are continuing to decline. The shift toward high deductible health plans has fueled that rise.

ANNOUNCEMENTS, AVAILITY IN THE NEWS, PRESS RELEASES

Availity, the nation’s largest real-time health information network, announced the launch of its automated prior authorization platform, which eliminates the cost, time, and administrative burdens associated with manual authorization processes.

AVAILITY IN THE NEWS, FEATURED ARTICLES

A myriad of factors stand in the way of health care organizations using data analytics to boost reimbursement. As hospitals transition to a value-based reimbursement model, data analytics may play a leading role. However, with an overwhelming wealth of information being generated each day, key decisions must be made to ensure the captured data are truly of benefit.

FEATURED ARTICLES

The Centers for Medicare & Medicaid Services (CMS) released a report in January on the accuracy of provider directories, the online lists provided by insurers and used by health plan enrollees to find in-network doctors or select a plan in which their preferred caregiver participates.

FEATURED ARTICLES

For health insurance companies, an accurate, easy-to-update standardized database for network provider data is the Holy Grail. Along with being a major source of frustration for members, inaccurate provider information negatively impacts claims processing, provider credentialing and the ability to ensure compliance with network adequacy rules. It also can create obstacles for providers that want to create a value-based benefit approach.

AVAILITY IN THE NEWS

In a time of healthcare consumerism and high-deductible health plans, the patient has become a major revenue source for healthcare organizations. But without strong point-of-service patient collection strategies, providers could be seeing their payments walk right out the door with their patients.

AVAILITY IN THE NEWS

Health plans have long supplied their members with provider directories to assist in finding in-network physicians who are accepting new patients. But what should be a helpful aid often isn't, due to outdated or just plain wrong data. Not only is this frustrating for patients trying to find an available provider, it can cost them more than they anticipated if they end up incurring out-of-network fees for a physician they thought was in-network.

AVAILITY IN THE NEWS

A tiny change to how a small hospital uses technology is resulting in big savings of between $3,000 and $10,000 a month. Iroquois Memorial Hospital, a 25-bed facility in the eastern Illinois town of Watseka faced a problem.

AVAILITY IN THE NEWS

As patient financial responsibility continues to increase in a more consumer-focused healthcare environment, more hospitals are shifting healthcare revenue cycle management strategies to improve patient collections. Iroquois Memorial Hospital in Illinois is one of these healthcare organizations.

PRESS RELEASES

Availity, the nation’s largest real-time health information network, announced that it will be using the HL7® FHIR® standard for sharing critical data between payers and providers, including patient eligibility and benefits, lab tests, diagnoses, medical attachments, ADT, and other healthcare information.

PRESS RELEASES, ANNOUNCEMENTS

Availity, the nation’s largest real-time health information network, announced the availability of a low-cost online education series that will help physician practices meet HIPAA training requirements.

AVAILITY IN THE NEWS

“Give the lady what she wants,” was the mantra of Marshall Field, the 19th century retail titan whose eponymous Chicago department store was world-renown for delivering outstanding customer experiences (CX). Today, digital communication and service technology have opened a world of endlessly creative possibilities for CX built on many of the same innovations that Field pioneered 150 years ago, including identifying consumer preferences and offering transparent and consistent pricing.

PRESS RELEASES

Availity, the nation's largest real-time health information network, announced today its recognition as one of the Achievers 50 Most Engaged Workplaces™ in North America. This annual award recognizes top employers that display leadership and innovation in engaging their workplaces.

PRESS RELEASES

Availity, the nation’s largest real-time health information network, announced today it has achieved full accreditation with the Healthcare Network Accreditation Program (HNAP) for Electronic Health Networks (EHN) from the Electronic Healthcare Network Accreditation Commission (EHNAC).

AVAILITY IN THE NEWS

The public is being primed to take on more financial responsibility for their healthcare costs, with unprecedentedly high deductibles and co-insurance among the most notable drivers. It’s expected that even more employers will offer these high-deductible plans in 2016, compelling employees to pay for an even larger portion of their healthcare services. That is, if they schedule them at all.

PRESS RELEASES

Availity, the nation’s largest real-time health information network, announced the release of a free eBook to help hospitals and physician practices rethink the management of their revenue cycle as increasing numbers of patients take on greater financial responsibility for the care they receive.

AVAILITY IN THE NEWS

Under pressure from federal and state regulators to improve the timeliness and accuracy of provider directories, health insurers are looking to software vendors for answers. In this article from Health Data Management, Availity CEO, Russ Thomas, explains how Availity is working with America’s Health Insurance Plans to address inaccurate provider data with their Provider Data Management solution.

PRESS RELEASES

Florida health insurers are going live with a provider directory workflow solution from Availity, the nation’s largest real-time health information network, to increase provider data transparency and enhance collaboration with their provider networks.

PRESS RELEASES

Children’s Home Society of Florida, Buckner Division hosted its annual “Under the Tent” awards luncheon today to recognize and honor outstanding individuals and organizations for their work in the interest of underserved children.

PRESS RELEASES

Availity, the nation’s largest real-time health information network, announced the launch of a dynamic application for delivering member assessments. The Member Assessment application is part of the company’s innovative Revenue Program Management (RPM) solution, which increases payer and provider collaboration while reducing the inefficiencies currently associated with gathering and managing quality and risk-related information about patients.

AVAILITY IN THE NEWS

Many physicians’ offices and hospitals struggle with legacy EHRs that lack the improved functionality of their more technologically advanced iterations. Most of these legacy systems don’t integrate well with third-party applications, and many are built as silos not capable of communicating with other systems.

PRESS RELEASES

Availity, the nation’s largest real-time health information network, today announced that its Revenue Cycle Management solution was a top-ranking Customer-Rated KLAS Reviewed vendor in the Claims and Clearinghouse category of the 2015/2016 Best in KLAS: Software and Services report.

PRESS RELEASES

Availity, the nation’s largest real-time health information network, continued to position itself as a proven and trusted leader for information exchange between health plans and providers, with a number of significant industry endorsements and certifications, as well as a growing body of knowledge for its network of over one million engaged providers, hospitals, vendor partners and health plans nationwide.

 

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