Availity Eligibility Benefits Claims Management
Provider Engagement Portal

Improve provider engagement with a multi-payer portal

Availity’s Provider Engagement Portal is a multi-payer platform where providers can securely access a wide range of financial, administrative, and clinical transactions for many health plans. Providers benefit from having a single location and consistent workflow to process transactions, while health plans can reduce administrative overhead and costs associated with maintaining an in-house portal.

Availity’s robust functionality helps improve collaboration between health plans and providers in the following areas:

Registration

Availity’s streamlined registration and onboarding process captures critical data which identifies the relationships among provider organizations, individual providers, and administrative users. This insight helps health plans better reach the appropriate individual within a provider organization.

Communications and Notifications

With Availity’s segmentation and profiling capabilities, health plans can deliver the right information to the right provider using the following communication tools:

  • Notifications: Delivers specific, targeted messages that users see as soon as they log on.
  • News and Alerts: Provides timely updates to users in a dedicated feed.
  • Payer Spaces: Allows health plans to deliver proprietary information and tools in a payer-branded area.
Patient Management

Availity’s patient-centered approach allows providers to recall a patient who has been seen before and gather up-to-date information about eligibility and benefits, past provider interactions, and patient-related messages from health plans.

Claims Management

Availity makes it easy for providers to manage all elements of the claims process, including submitting, checking the status, and reviewing remittances. The Provider Engagement Portal also includes value-added features such as denial appeals and overpayment recovery.

Authorization and Referral Management

The prior authorization process is one of the biggest pain points for both providers and health plans. Availity makes it faster and easier to determine if an authorization is required and to request one. Providers can also submit supporting documentation and check on the status.

Provider Data Management

Availity’s Provider Data Management solution allows health plans to capture updated demographic data by identifying mismatches and allowing providers to correct and attest to the information in their workflow.

Clinical Data Management

Availity’s Clinical Data Management can minimize the phone calls, faxes, and the dreaded chart chase associated with risk and quality initiatives by notifying providers about existing care gaps.

Features

  • Electronic transactions provides a secure platform where providers can submit ANSI, HIPAA, and HL7 transactions, as well as perform eligibility and benefit inquires, check claim status, and track remittance. 
  • Multi-payer portal ensures a consistent workflow for all participating health plans, which allows providers to have the same user experience.
  • Standard payer content for transactions that are consistent across all health plans, as well as the opportunity to leverage Payer Spaces for branded, plan-specific content.
  • Robust infrastructure allows health plans to capture, store, and access critical information without having to invest in significant technology major investments in their own storage technology.

Benefits

  • Operational savings from reduced rework associated with pended, denied, or contested claims.
  • Improved provider satisfaction by delivering real-time, accurate information when and where they need—in their existing workflow.
  • Claim payment savings by avoiding overpayments caused by duplicate claims, duplicate lines, or overstated levels of care.
  • Improved risk and analysis through customized reports and business insights.
  • Better collaboration with providers by allowing them to access proprietary information and processes within their existing workflow.
Request a Demo

Request a Demo

Request More Info
See how Availity’s Provider Engagement Portal can improve health plan and provider collaboration.
Request More Info