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Reduce denials, prevent inaccurate claim payments, and improve provider engagement

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Payment integrity activities are among the biggest drivers of administrative costs as payers must identify incorrectly paid claims and recover those funds from providers. Availity’s Payment Accuracy offers a better approach by improving claim accuracy early in the claim lifecycle with prospective, rather than retrospective, claims editing.

Leverage AI and automation to prevent avoidable denials

Availity’s Payment Accuracy offerings combine rich content with sophisticated edit technology and AI capabilities to ensure claim edits are applied as early as possible in the claim lifecycle. Payment Accuracy editing packages include:   

  • Claim Scrubbing
  • Clinical and Analytics 
  • Payer Guidelines

Shift left to accelerate administrative cost savings

Availity’s Payment Accuracy is built on the concept of “shifting left.” This means moving the evaluation of claims as early as possible in the claim lifecycle to prevent the waste and abrasion that happens when inaccurate claims reach the payer.

By evaluating claims at the Intelligent Gateway, before the claim reaches the payer, Payment Accuracy reduces phone calls related to pended or denied claims and helps prevent prompt-payment penalties.

Putting Payment Accuracy to work in your organization

Interested in best practices for implementing a successful Payment Accuracy program in your organization? Check out this Availity Connects webinar replay.

Case Study

Payment Accuracy Helps Reduce Medicaid Denials

Learn how one national payer prevented claims with errors and improved provider satisfaction

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Case Study

Payment Accuracy Helps Payer Realize Administrative Savings

A regional payer achieved measurable savings by implementing a small number of edits

Read the study

Learn more about how Availity can help

Product

Intelligent Gateway

Learn how Availity can help you seamlessly connect and exchange administrative data with providers and other trading partners.

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It’s time to find a better way with Availity.