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AVAILITY IN THE NEWS, MANAGEMENT AND LEADERSHIP

Jacksonville, Fla—June 8, 2021— Availity, the nation’s largest real-time health information network, named healthcare and business development veteran Leslie Antunes as its chief growth officer. Antunes will be responsible for driving strategic growth initiatives and leading the business development, sales, client services, marketing, trading partner, account and alliance management teams.

AVAILITY IN THE NEWS

Krisi Hutson, product line developer at Availity, outlines the concept of Balance Billing and how it relates to surprise billing.

AVAILITY IN THE NEWS

Physicians Practice® spoke with Krisi Hutson, the product line director at Availity, to discuss some of the ways in which she has been seeing providers help their patients to avoid surprise billing scenarios.

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According to statistics released by the U.S. Department of Labor, in the early months of the pandemic, the nation’s unemployment rate reached its highest level since the Great Depression, skyrocketing to 14.7 percent in April of 2020, more than tripling from only 4.4 percent in March. While these figures have improved since then, the pandemic has permanently altered the labor market, requiring workers to be nimble, sharp and technologically fluent. Enter the UpSkill Institute at Jacksonville University.

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In this installment, I check in with Lillian Phelps, senior director of product management at Availity to discuss claims management, the relationship between payors and providers, and how technology can help to streamline and automate these communication pathways in a way that benefits everybody.

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Lillian Phelps, Senior Director of Product Management, Availity shines light on the new HHS rules about price transparency for hospitals and health plans. These organizations now need to publish their standard rates as well as their contracted rates along with pricing for bundled services for over 70 specific services. As the nation's largest health information network, Availity works with providers and health plans to enable real-time generation of understandable data for patients and healthcare providers to inform better medical decisions.

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Physician's Practice spoke with Paul Joiner, chief operating officer of Availity, to discuss the implications of an American Medical Association survey and find out how you can improve your prior authorization processes.

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As the COVID-19 pandemic has gripped the world, many providers have adopted an all-hands-on-deck approach and mentality for treating COVID-19 patients, stretching their resources to the breaking point. We have heard about the frontline heroes who have sacrificed their own health and safety to treat patients and, in less-fortunate scenarios, comfort patients in their last moments as they were quarantined from loved ones. What has been less recognized is the work and sacrifice put forth by providers’ back-office staff. Many back-office workers have had to transform their operational practices after shifting to “work-from-home” mode to avoid potential exposure and minimize traffic to hospitals and physicians’ offices.

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Where are vaccine supply chains, value-based care, AI, telehealth and other trends headed next year? C-suite leaders from an array of vendors weigh in on provider/payer relations, the healthcare workforce and more.

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What trends are healthcare execs watching out for in 2021? We gathered predictions from executives at companies across the industry to compile a collection of the key topics to keep an eye on in the coming year. Topics ranged from behavioral health needs to data analytics to the social determinants of health.

AVAILITY IN THE NEWS, PRESS RELEASES

Availity, the nation’s largest real-time health information network, announced today that it has earned the honor of becoming a Great Place to Work-Certified™ company, a distinction rooted in the tremendous talent, energy, and generosity of its associates.

AVAILITY IN THE NEWS, PRESS RELEASES

Availity, the nation’s largest real-time health information network, and Regence, a family of regional health plans serving members in Oregon, Washington, Idaho and Utah, announced today the results of their collaboration to improve the pre-authorization process through the implementation of new tools that allow for real-time, electronic and automated pre-authorization.

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Unemployment remains high, but talent is still in scarce supply for many companies. CEOs share their strategies for attracting the best and brightest.

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Insurance claim denials are a costly and time-consuming burden on every hospital and health system. But you can avoid most denials by taking the proper steps. Avoiding the most common types of denials — duplicate claims, medical documentation, timely filing, etc. — can add tens of thousands of dollars to a hospital's bottom line. Revenue cycle management experts discussed how to prevent recurring denials in an Oct. 19 webinar hosted by Becker's Hospital Review and sponsored by Availity.

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First, the good news: While a new federal mandate requiring health plans to build an online shopping tool for members will be a heavy lift for some payers, most major health plans already offer online cost estimator tools. That will give them a leg up compared to payers that will have to build tools from scratch, according to industry experts.

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While providers have many legitimate concerns about the PA process, it remains an important tool to help ensure that the care patients obtain is safe, effective, and necessary. Given the nature of the prior authorizations process, it’s inevitable this practice will lead to some level of provider abrasion; however, the healthcare industry is taking steps to reduce the burden prior authorizations create.

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Jacksonville University is working to help address the primary care shortage we’re facing throughout the state of Florida. Action News Jax looked into a new scholarship program that’s hoping to expand the access to healthcare through nurse practitioners. Dr. Laurie Buschini is a nurse practitioner at JU’s new student health center. Over the summer, she joined a new online pilot program so she could get the credits she needed to treat people without an attending doctor to supervise her.

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Physician's Practice®, talks with Paul Joiner, Chief Operating Officer of Availity, about the state of prior authorizations and recent data from the American Medical Association.

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Availity, a locally headquartered health information network, announced it is partnering with Jacksonville University to set up a scholarship fund for nurse practitioners who could practice independently under a new state law. It also addresses Florida's shortage of primary care physicians. “Forty-eight percent of physicians in Florida are expected to retire in the next 10 years," according to the Florida Association of Nurse Practitioners. "Florida needs an estimated 3,000 to 5,000 primary care providers over the next five to 10 years. Medical schools cannot graduate enough physicians to meet the need."

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Jacksonville University will partner with Jacksonville-based Availity to provide educational opportunities for nurse practitioner s who want to offer independent primary care. Availity, a health care IT company, will make a $100,000 donation to establish the Availity Nurse Practitioner Scholars Fund at JU.

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No one likes going to the doctor, but after months of searching, Jerry Finster finally found Dr. Bob Wallace. “I just kind of took a stab in the dark, came over and met with him, and it worked out fabulous,” Finster said. At 72 years old, Finster says it’s important he has a doctor he can trust. “It’s just to have a source of good guidance that helps you take care of any particular needs you might have,” he explained. But that’s not always easy, especially because Florida ranks last in the nation for access to primary care physicians, according to Jacksonville University.

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Responding to a new law that will allow nurse practitioners to operate independent primary care practices, Jacksonville University is rolling out a program that will allow nurse practitioners to get needed credits for free. Scholarships for the program are funded by a $100,000 donation from Jacksonville-based Availity, a health care IT company that provides the technological infrastructure to connect providers and insurance companies.

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The health-information network company Availity has donated $100,000 to Jacksonville University to establish a scholarship fund for advanced registered nurse practitioners who could practice independently from physicians under a new state law.

AVAILITY IN THE NEWS, PRESS RELEASES, FEATURED ARTICLES

With a $100,000 donation from Availity to establish the Availity Nurse Practitioner Scholars Fund at Jacksonville University, qualified nurse practitioners (NPs) may begin to earn the educational credits needed to offer independent primary care without an attending doctor, as outlined under a new state law.

AVAILITY IN THE NEWS, PRESS RELEASES, FEATURED ARTICLES

COVID-19 has seemingly reached into every corner of American healthcare, with new procedures, regulations and safety precautions required to keep patients and caregivers safe and protected from the virus. Wearing masks and social distancing are crucial, but these low-tech strategies are hardly new; versions were used during the 1918 flu pandemic.

AVAILITY IN THE NEWS, PRESS RELEASES, FEATURED ARTICLES

In theory, health care consumerism is a straight-forward idea: Shifting costs to consumers, typically in the form of high-deductible health plans (HDHPs), gives them an incentive to make informed decisions about the health care services they purchase. In practice, consumerism represents a significant challenge to providers’ bottom lines. A recent report reveals that for 74% of providers, patient collections take over a month. Further, 66% of providers said patient receivables are a primary revenue concern. Part of the problem is many providers’ patient collection processes do not align with consumer preferences. For example, 88% of providers reported relying on manual and paper-based transactions for patient collections, but 46% of consumers prefer electronic communication for medical bills, while 65% prefer to pay medical bills via online portals or mobile apps.

ANNOUNCEMENTS, PRESS RELEASES

The COVID-19 pandemic has led payers and providers to embrace electronic encrypted documents and other technology — and that has fostered greater collaboration between them. As the U.S. healthcare system makes gradual and persistent strides towards value-based care, success within this new payment model depends on greater collaboration between payers and providers. Until recently the pace of this engagement has been slow. However, the COVID-19 pandemic has caused an acceleration in payer and provider collaboration.

ANNOUNCEMENTS, PRESS RELEASES

Since the emergence of value-based care, the need for greater collaboration between healthcare’s traditional adversaries, payers and providers, has received lots of attention but results have sometimes been less tangible. Now, as a result of the COVID-19 pandemic, payer – provider collaboration has accelerated at an unprecedented rate within the health industry ecosystem.

ANNOUNCEMENTS, PRESS RELEASES

In a recent interview with HIMSS TV, Russ Thomas discussed how Availity led conversations with providers and health plans during COVID-19 to ensure that the latest information needed for processing claims and billing was being shared between both parties.

AVAILITY IN THE NEWS, FEATURED ARTICLES

Doctors didn’t attend medical school to spend their waking hours managing or waiting for prior authorizations (PA), but these days it feels like that’s all they are doing. A recent American Medical Association survey found that 90 percent of responding physicians believe that the “administrative burden related to PA requests has risen in the last five years, with most saying it has ‘increased significantly.’” As healthcare continues its acceleration toward value-based reimbursement models, payers may begin to require even more PAs as they seek greater cost controls...

ANNOUNCEMENTS, PRESS RELEASES

With a precipitous drop in volume, some organizations are going back to basics from a revenue cycle standpoint. All healthcare organizations are suffering financially during the COVID-19 epidemic. Hospitals are on the front lines of treatment while also seeing precipitous drops in volume and business. The pandemic is also threatening the financial health and long-term stability of clinics and specialty practices. Primary care physician practices are no exception, but strategies have emerged that could help them weather the storm…

AVAILITY IN THE NEWS, ANNOUNCEMENTS, PRESS RELEASES

Availity, the nation’s largest real-time health information network, announced today that it has launched a COVID-19 Provider Resource Center that consolidates links to updates from more than 50 payers for information about patient eligibility, coding, claims processing, telehealth guidelines and more. The new COVID-19 Provider Resource Center connects providers directly to payer updates, while enabling better collaboration between providers and payers...

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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...

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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.” ...

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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“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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