Availity Blog

Availity Blog

Actionable insights for medical business professionals

Availity helps healthcare providers and health plans connect, making it easier to share clinical, financial, and administrative information. We value your business and respect the security of your patient data, which is why we’re introducing additional authentication measures.

We may never completely eliminate denials, but there are ways to proactively prevent them, particularly recurring denials caused by your claim workflow. From small practices to large Epic health systems, we see a surge in customers working to dramatically reduce error rates, improve cash flow, and reduce write-offs.

Even in the most technology-savvy provider offices, there may be lingering paper-based manual processes eating away at your bottom line. Perhaps you work with a payer that only accepts paper forms for secondary or Worker’s Comp claims. Or maybe your business requires regular printing and faxing of documentation to support your electronic claims.

Countless businesses and healthcare organizations miss out on their portion of available settlement proceeds each year. On average, only about 20% of eligible entities collect their share of any given settlement fund. In many cases, the proceeds represent a significant amount that is added right to your bottom line. While settlements vary, one constant is that a claim must be submitted in order to collect any money. This is where a Settlement Recovery Service can help.

Consumers with health insurance, both independent and employer sponsored, rely on insurers’ provider directories to make choices about their plans and find physicians that are right for them. Directories include vital information such as essential contact details, distance from public transportation, accessibility for individuals with disabilities, languages spoken by practitioners and staff members, and more.

The healthcare industry still has a big paper problem. According to one report, faxes account for almost 75 percent of all medical communication.

Health plans are committed to reducing waste and inefficiency, but the healthcare industry as a whole still spends too much time and money manually managing administrative transactions. One report found that faxes account for almost 75 percent of all medical communication, and the 2017 CAQH report predicted administrative costs would reach $315 billion by the end of the year. These costs are driven largely by the continued reliance on phone calls, fax, and mail to manage claims transactions.

Countless businesses and healthcare organizations miss out on their portion of available settlement proceeds each year. On average, only about 20% of eligible entities collect their share of any given settlement fund. In many cases, the proceeds represent a significant amount that is added right to your bottom line. While settlements vary, one constant is that a claim must be submitted in order to collect any money. This is where a Settlement Recovery Service can help.

The RISE conference in Nashville was a great opportunity to learn about new approaches to analytics and member engagement, as well as to hear about many of the creative initiatives health plans are implementing to improve quality scores and meet the complex web of risk adjustment requirements for Medicare Advantage, ACA, and Medicaid.

What’s the current state of payer-provider collaboration, and what does the future hold? Big questions to be sure, but we tried to find answers during a recent Availity-sponsored SmartBrief webinar featuring healthcare industry expert Jay Eisenstock of JE Consulting.