Payment Accuracy | Availity

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:

HIPAA (Snip levels 1-7)
Claim scrubbing
Clinical and analytics
Pre-service
Risk adjustment

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? Watch this webinar, which was originally presented at Availity Connects 2025.

Case Study

How a Large National Payer Reduced Medicaid Denials

Claims with errors are returned to the provider with an easy-to-understand explanation.

Read the study

Case Study

Upfront edits help a national health plan reduce Medicaid claim denials by 30%

Availity Editing Services identifies and deploys targeted edits, reducing claim errors.

Read the study

Case Study

How one health plan realized more than $1 million in administrative savings with upfront claims editing

A regional health plan needed a solution that would reduce the costs associated with claims rework without increasing provider abrasion.

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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Prevent post-adjudication revenue leakage with payment accuracy solutions

Leverage AI and automation to prevent avoidable denials

Shift left to accelerate administrative cost savings

Putting Payment Accuracy to work in your organization

How a Large National Payer Reduced Medicaid Denials

Upfront edits help a national health plan reduce Medicaid claim denials by 30%

How one health plan realized more than $1 million in administrative savings with upfront claims editing

Learn more about how Availity can help

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

Solutions

For Payers

For Providers

For HITs

Resources

Insights

Partner Resources

Payer Lists

About

Connect

Prevent post-adjudication revenue leakage with payment accuracy solutions

Leverage AI and automation to prevent avoidable denials

Shift left to accelerate administrative cost savings

Putting Payment Accuracy to work in your organization

How a Large National Payer Reduced Medicaid Denials

Upfront edits help a national health plan reduce Medicaid claim denials by 30%

How one health plan realized more than $1 million in administrative savings with upfront claims editing

Learn more about how Availity can help

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