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In the March/April 2023 issue of Healthcare Innovation, Linda Perryclear, Availity’s Senior Director of Product Management, says that predictive editing tools can help health systems move from denials management to denials prevention.

Availity earned a place on Becker’s Hospital Review’s list of RCM companies to know thanks to Essentials Pro, Availity’s EMR- and PM-agnostic solution that simplifies claim and payment processing while delivering intelligent reporting and analytics that pinpoint revenue cycle trends.

Availity presented scholarships earned by students from Jean Ribault High School, during a ceremony held at Availity HQ. The event was part of the Beyond School Walls program, a long-standing partnership between Availity, Big Brothers Big Sisters of Northeast Florida, and Ribault to connect students one-to-one with mentors from Availity. News 4 covered the story as part of their Positively Jax segment.

Availity was named one of the most promising digital companies in healthcare by CB Insights, a market analyst firm that provides market intelligence on private companies and market activities. The firm’s fourth annual report, Digital Health 150, is a list of the top private companies transforming healthcare with digital technology.

At Emids Healthcare Summit last month, Availity CEO Russ Thomas moderated the Creating Health panel. Joining Russ to discuss the underlying data challenges of achieving whole-person healthcare was Quantum Health CEO Zane Burke, WHOOP Strategic Advisor Ellen Reilly, and Homeward CEO Dr. Jennifer Schneider.

As high-deductible health plans and other out-of-pocket health costs proliferate, hospitals and medical groups struggle to develop strategies that improve cash flow and satisfy patients. Availity's Kristina Hutson shares providers' best opportunities to do both.

Krisi Hutson, Availity’s senior director of product development, sat down with HIMSS TV’s Bill Siwicki to explore the benefits and opportunities of automated pre-service clearance processes, including price transparency and member eligibility, for hospitals and group practices.

Critical decisions made by people in moments of incredible pressure can be the decisive factor in avoiding the worst-case scenario….

Provider directory management (PDM) can be a significant and expensive administrative burden for health plans and providers. Although the healthcare industry spends nearly $3 billion annually to maintain provider directories, they are notoriously inaccurate.

Steven Loeb speaks with Russ Thomas, CEO of Availity, about how technology is radically changing healthcare: the way we screen, treat and measure progress and outcomes and how we are creating productivity that drives economic costs down while improving are overall health.

Availity associates, friends, and family raise nearly $3,000 for the American Heart Association during the 2022 First Coast Heart Walk. Check out the mention in HISTalk.

In this episode of WTF Health, Availity’s CEO Russ Thomas and Diameter’s President and COO, Mary Lantin, join Jessica DaMassa to share details on this exciting acquisition and this BIG vision for scaling up the fight against healthcare’s massive spending on administrative waste.

Mary Lantin, President and COO Diameter Health joins the HIT Like a Girl podcast to discuss the recent acquisition of Diameter Health by Availity, how the companies will fit together, and how the deal will impact the market.

Russ Thomas, CEO of Availity & Mary Lantin, President and COO Diameter Health join our Slice of Healthcare host Jared S. Taylor to discuss how Availity’s acquisition of Diameter Health will disrupt healthcare and the value of actionable, real-time, and precise data to the healthcare industry.

Joint technology solution will deliver an integrated data interoperability platform that streamlines data acquisition and delivers clean, actionable, and intelligent data.

Availity’s foundation—and reputation—is built on decades of innovation in revenue cycle management and administrative and financial workflow improvements between health plans and providers. All in the interest of the ultimate consumer—the patient.

The group will bring together health plan and provider stakeholders for a series of meetings to understand how their organizations are preparing for the NSA and to identify what role Availity should play.

We know Zoom can’t take the place of getting together on Amelia Island. Still, it does allow us to stay in touch as we continue the work of improving payer-provider collaboration.

After a two-year pause due to the pandemic, Availity Connects returned. More than 227 friends, customers, and colleagues from health plans, vendor partners, and provider organizations across the country reunited on Amelia Island, FL, to define healthcare’s path forward in the new normal.

Value-added transaction capability delivers a dynamic provider experience, helps reduce administrative inefficiencies, and accelerates Availity’s omni-channel strategy

Becker's Healthcare is pleased to release the "150 Top Places to Work in Healthcare | 2022" list, which highlights hospitals, health systems and healthcare companies that promote diversity within the workforce, employee engagement and professional growth. The organizations featured on this list offer benefits and opportunities for employees to build successful careers above and beyond the average healthcare provider or company; they encourage professional development and promote leadership from within.

As the product line manager for Availity Editing Services, I talk with a lot of health plans about how they can improve their clean claim rate by taking advantage of the editing capabilities in Availity’s Intelligent Gateway.

In recent years, Big Tech has gotten a bad rep. But of course many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing Russ Thomas.

Availity, the nation’s largest real-time health information network, announced today that Nathan von Colditz has joined the company as Chief Strategy Officer (CSO). In his role, von Colditz is responsible for leading Availity's corporate strategic activities and positioning the organization for both long-term and short-term initiatives.

Availity, the nation’s largest real-time health information network, announced today that Bobbi Coluni has joined the company as chief product officer (CPO). In her role, Coluni is responsible for leading Availity's product design and management, developing innovative solutions, and launching products for the healthcare market.

Availity, the nation’s largest real-time health information network, today announced a strategic alliance with PriorAuthNow, the leading real-time prior authorization network that connects providers and payers, to form the healthcare industry’s largest integrated prior authorization network.

Patient and provider experiences have to be top-of-mind in the year ahead, with special attention to stressed hospital workers and underserved populations, healthcare vendor leaders say.

The changes brought to the industry in 2020 amid the pandemic continued to weigh on the minds of healthcare executives throughout 2021.And, as they look ahead to the coming year, they're expecting similar themes to carry forward: interest in virtual care, the ongoing pandemic response and a greater focus on patients' social needs. Hear from 12 industry leaders on what they're watching in 2022.

As healthcare continues to emerge and innovate from the disruptions of the COVID-19 pandemic, MGMA presents these 22 industry leaders and their insights and predications on what medical practices should keep their eyes on for digital health in 2022.

Patient Experience is not just a buzz phrase. It is a major driver of health IT innovation. The healthcare industry to say the least is doing a little catch up to other industries when it comes to how their customers or patients interact with their entities.

Ms. Hutson is a product line director for Availity's pre-service capabilities. She leads a team of 11 product line managers and product owners who work to enhance the eligibility and benefits transaction within Availity's revenue cycle management solution.

Availity, one of the nation’s largest real-time health information networks, is proud to be Certified™ by Great Place to Work® again. The prestigious award is based entirely on what current associates say about their experience working at Availity. In a survey from Great Place to Work, 94% of Availity associates said it’s a great place to work – 35 points higher than an average U.S. company.

Fast Healthcare Interoperability Resources (FHIR) is helping to transform healthcare by enabling payers and providers to share information more effectively.

The market for mobile health applications is exploding, but many applications fail because they don’t take into consideration how the user’s experience with the application is affected by their environment.

The No Surprises Act legislation, which is scheduled to go into effect on January 1, 2022, is a complex piece of legislation that will significantly impact health plans, providers, and patients in 2022 and beyond. To help our stakeholders better understand the law and prepare for its implementation, we chose it as a topic for our last Availity Connects, Virtual session...ppp

In this First Coast Connects podcast episode, Chief Technology Officer Jack Hunt speaks with Melissa Ross about the acceleration of digital transformation during the pandemic and beyond.

Jacksonville, Fla—October 19, 2021— Availity, one of the nation’s largest real-time health information networks, announced today that Jim McNary has joined the company as chief operating officer (COO). As COO, McNary is responsible for leading cross-departmental operations, refining business processes, and maintaining alignment throughout the company for both organic and inorganic initiatives. Availity’s technology, product management, implementations, and strategy/corporate development teams will report to McNary.

October 4, 2021— At Availity, we strongly support the intent and purpose of the 'No Surprises Act' to provide federal consumer protections against surprise medical bills. Like any piece of legislation, success will depend upon the implementation of the law. Availity is prepared to offer guidance and leadership to help ensure the success of the No Surprise Act.

Seemingly overnight, we had to figure out how to onboard new hires in a completely remote environment due to the COVID-19 pandemic. Sixteen months later, we have now defined and implemented a smooth and thorough process, and our organization is determining the best and safest route for associates to begin utilizing the office again.

Jacksonville, Fla—July 20, 2021— Availity, one the nation’s largest real-time health information networks, announced today that Frank Petito has been appointed chief financial officer. In his new role, Petito is responsible for leading Availity’s financial and accounting teams and serves as a strategic partner to the organization’s board of directors and executive leadership team regarding organic expansion, mergers and acquisitions, and capital markets opportunities.

July 7, 2021 -- Novo Holdings A/S (“Novo Holdings” and “NH”), a leading international investor in healthcare and life sciences, today announced a strategic minority investment in Availity, one of the largest healthcare data and administrative networks connecting payers and providers throughout the United States.

Availity names Leslie Antunes as Chief Growth Officer. Antunes brings over 30 years of experience and innovation in emerging, entrepreneurial, and high-growth companies across sales, leadership, and partner development.

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.

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

Does it ever feel like the language around healthcare transactions is purposely confusing? Do you find yourself googling terms…and still not understanding what they mean? It’s not you. It’s us—the healthcare IT industry. We need to do a better job explaining our business processes in clear, simple language. Availity’s new EDI 101 series is our attempt to reduce confusion by explaining things as simply as possible.

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.

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.

Availity’s strength lies in the diversity of our people, with each associate bringing something unique to the organization. By celebrating our differences and learning more about each other, we will continue to grow stronger.

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.

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.

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.

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.

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.

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, 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.

We are proud to announce that Availity has been certified as a Great Place to Work! Great Place to Work® - the global authority on workplace culture - used rigorous, data-driven methodology on U.S. Availity associates, confirming that seven out of 10 associates have a consistently positive experience working for Availity.

Coverage identification tools help providers find active member coverage by sending multiple eligibility inquiries (270) to payer networks until they get a hit. But for many payers this increased traffic is affecting real-time network performance and causing time-out errors for providers who need to check eligibility at the point of service.

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.

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

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.

COVID-19 has left many communities shattered; businesses on the brink of closure, some already completely shut down, and unemployment rates reaching double digits in many states. To help our communities, Availity launched Operation Give Back, which gave associates $50 gift cards through the Achievers platform to support local businesses in their communities.

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.

What have we learned from the early response to the pandemic, and what changes could we see in healthcare as a result? Find out in the new Availity eBook, The COVID-19 Effect: Health Plan and Provider Insights from the Early Pandemic Response.

October is National Cyber Security Awareness Month and as healthcare professionals, we play an important role in protecting the safety and security of healthcare data. Unfortunately, it’s becoming an increasingly difficult battle to maintain the integrity of healthcare data. In 2019, 510 healthcare data breaches of 500 or more records were reported—up more than 196% from 2018, which resulted in 12.55% of the United States population’s health records being exposed, impermissibly disclosed, or stolen.*

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.

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.

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.

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."

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.

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.

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.

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.

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.

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.

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.

It’s always nice to find little shortcuts that saves you time. Like taking a little-known side street that bypasses a heavy traffic area. Or picking the perfect window of time to get in and out of the grocery store quickly.

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.

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.

In January of 2018, the American Medical Association, along with stakeholders from many other payer and provider organizations, released a consensus statement on the importance of reforming the prior authorization process. Almost two years later, however, the news doesn’t seem to be improving. A recent report published by Medical Group Management Association (MGMA) found that medical group practice leaders believe their regulatory burden, particularly prior authorizations, is getting worse, not better.

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.

Telemedicine is finally having its moment. It’s long been viewed as a potential way to reduce healthcare costs and drive better coverage among underserved areas, but utilization hasn’t kept pace with expectations. According to Peterson-KFF Health System Tracker, in 2018, 2.4% of large group enrollees who had an outpatient office visit had at least one telemedicine visit, which was up from 1.6% in 2017...

COVID-19 has forced most healthcare organizations to restructure the ways they operate. Practices and hospitals not on the frontlines of fighting the pandemic have seen reduced—or non-existent—in-person patient visits, and perhaps an increase in telehealth visits. As we head into summer, many states have started loosening shelter-at-home restrictions, and patient volume is beginning to increase for non-urgent and elective procedures. But it’s possible that many organizations won’t see a return to pre-COVID levels for some time.

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...

Because many of us are using the lull in our normal routines to brush up on skills or learn new ones, we thought this would be a good time to remind you that Availity features a wide range of online courses to help you get up to speed on our offerings. Whether you’re new to Availity and want a deep dive into the different workflows, or you’re a long-time user looking for specific productivity tips, our course catalog has something for everyone.

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…

The economic downturn caused by the COVID-19 crisis has forced many companies to pause hiring or implement temporary furloughs. At Availity, we are very fortunate. Our business remains strong, and we are continuing to hire for roles across the organization. But our temporary, all-remote status means we’ve had to quickly re-engineer many of our hiring and onboarding processes...

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...

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.

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...

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...

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...

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.” ...

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.

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).

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...

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.

As Product Line Manager, it’s my job to try different approaches for gathering better feedback from our users. That’s why, when I was first tasked with redesigning Availity’s Remittance Viewer tool, I started with a customer advisory board. This insider channel helped me elicit raw feedback from my target audience. Additionally, daily reports and in-person provider usability studies have helped increase my understanding of our users’ pain points. The result is a redesigned, shiny new Remittance Viewer Tool.

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 ...

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.

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.

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.

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

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.

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.

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.

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.

In a recent webinar, we discussed the importance of patient satisfaction and how it can impact the revenue of your practice. Understanding patient satisfaction is valuable for providers who want their patients to keep coming back. Here’s how practitioners can keep retention high and ultimately grow their practice.

In a recent webinar TSYS coordinated with Availity, we discussed the importance of understanding today’s patients and their unique expectations. This understanding is measured by patient satisfaction, which gives providers valuable insights into the effectiveness of their care. Increasing patient satisfaction has become a major initiative for practitioners because it’s directly linked to patient retention. Here are the 5 components of improving patient satisfaction at your dental practice.

A key to patient engagement is keeping your clients as informed as possible about their options for treatment, medications, recovery, and all other aspects of the healthcare system. A practice that is fully engaged with their patients works more efficiently, from setting up follow-up visits to receiving electronic reminders about appointments, and this personalized engagement is now expected. Digital communication is not something you can disregard—patients want personalization and the ability to speak to their health practitioner on the platforms they us

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.

There’s a fun phrase about dental practices: “When the front office hums, the back-office dances.” How does the front office hum? Let me paint you the picture—the front office staff is answering phones, greeting patients who walk in, and working their daily schedule.

“Inform before you perform.” Does your office have a written financial policy? If not, you should. This policy should be presented to and signed by all patients, especially at the time of their first appointment. This sets the ground rules. Keep a copy of the signed document in their patient records. Your financial policy should include all payment options and treatment should not commence until the payment arrangements are settled. A successful policy is one that is clearly presented and consistently enforced.

The General Data Protection Regulation (GDPR) governs the privacy and security of personal data collected from the European market, effective May, 2018. Outside of the European Union (EU) and the European Economic Area (EEA), it only applies to those processing personal data of EU/EEA subjects for the purposes of offering goods or services or monitoring subjects’ behavior in the EU/EEA, but the law has had a major impact worldwide. While the primary objective of GDPR is to increase the protection and privacy of individuals’ data, it has produced a host of unintended privacy consequences, including its effect on ICANN and the WHOIS database.

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.

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.

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.

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.

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.

Claim submissions are the most common electronic transactions in healthcare, edging out even eligibility and benefits checks, which are often still performed by phone. It’s clear that submitting claims electronically leads to faster payments and fewer denials, at less cost to providers and payers, however six percent of claims are still submitted via paper.

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.

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.

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.

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.

CMS’s recent report on the state of provider directories identified three challenges facing health plans. Recent blogs covered the first two challenges: the issue of contractual versus resource constraints and the lack of internal audits by health plans to verify provider information. A third problem creating directory inaccuracies is that health plans rely on providers to reach out and tell them when information changes. From the report: “MAOs cannot assume that they will be informed when a change in provider location occurs; instead, MAOs need to implement routine processes that drive more accurate information reflected in their directories.”

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.

The second problem CMS identified in its report on provider directories was a lack of internal audits by health plans to verify provider information. The report faulted health plans for outsourcing the audit process, stating “Medicare Advantage Organizations (MAOs) placed full faith in credentialing services and vendor support, and even in provider responses...” and “if MAOs had implemented routine oversight of their processes for data validation, errors in the provider directory would have become apparent.”

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.

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.

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.

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.

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.

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.

CMS has identified three drivers of directory deficiencies: group vs. provider-level data, lack of internal audits, and reliance on provider-led notifications. We've outlined these issues in an infographic.

In its second annual report on the state of provider directories, the Centers for Medicare and Medicaid Services (CMS) found that 46 percent of all directory entries reviewed contained at least one error that makes it difficult for patients to find doctors in their networks.

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.

Join the Availity Clinical Solutions team in the Music City! ViVE is the healthcare industry’s curated event experience for senior digital health leaders focusing on the business of healthcare systems. For 2023, Availity Clinical Solutions is proud to participate as a featured exhibitor in the interoperability focused InteropNow! Pavilion. Join us as we introduce clinical data Upcycling through Availity Fusion (formerly Diameter Health Fusion).

IMAGINE Success at the AAOE 2023 conference! The AAOE Annual Conference is hosted by the American Alliance of Orthopedic Executives (AAOE), an organization dedicated to providing education and resources to administrators and the staff of orthopedic practices and other musculoskeletal groups.

The HIMSS Global Health Conference Exhibition is the most influential health information technology event of the year, where 40,000+ professionals throughout the global health ecosystem meet to build relationships during lively networking events, learn from experts in hot topic education sessions and discover innovative health tech products to solve their greatest challenges.

Availity is proud to sponsor the Imagine Software conference in San Antonio, Texas. The event is an experience dedicated to collaboration, training, and networking. Hone your skills within Imagine's community of clients, partners, and industry leaders! Share best practices, learn about new offerings, including ImagineOne, and get direct access to the Imagine team. Stop by the booth, meet the Availity team of Betty Amos and Dan Arevalo to gain valuable insight into what the future holds for always improving solutions and how Availity Essentials Pro can streamline your revenue cycle.

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