Clearing house/ Intelligent Gateway
the nations "blues" health plans
what is 70%?
Core solutions are E&B, Claims submission, claim editing, automated claim status, remittance management, denial appeals, reporting, and analytics
What is Essentials Pro?
I need a solution for improving provider data
What is Provider data management?
Availity Payer specific solution that answers the hardest question "is it medically necessary?"
What is AuthAI?
Fusion solves the ever growing need to normalize data from different sources in these formats
What is HL7v2, C-CDA, FHIR?
exclusive gateways with he other commercial & Medicare/Medicaid health plans
what is 40% ?
Data enrichment. I need to get robust results to power cost estimates, authorizations, and more.
What is advanced real time Eligibility (ARTE)?
PDM offers an efficient process to update, validate, and attest to the accuracy of their data
Who is providers?
percent of unnecessary prior authorization requests are providers immediately notified of
what is 100%?
Complements Availity and establishes an integrated data interoperability platform that streamlines data acquisition and delivers clean, actionable, and intelligent data
What is Availity Fusion?
a secure and scalable transaction processing platform that transmits HIPAA and non-standard transactions through a single clearing house network gateway, utilizing AI-based upfront editing to prevent claim errors and reduce retrospective claim re-work
What is the Intelligent Gateway?
I already have a workflow platform and only need to streamline EDI claims processing and connect to a nationwide network of payers
Who is a trading partner?
Requirement set by State and federal regulations on how often payers need to contact providers to verify that the information they are providing their members via provider directories is up to date.
what is 90 days?
percent of submissions that are automated by Artificial intelligence (AI) with no human intervention
what is 78%?
By harnessing this technology, Fusion transforms raw clinical data from its incomplete redundant, inaccurate form into a powerful asset that drives innovation, improves patient care, and maximizes efficiency
Availity's knowledge platform, links together the vast amount of data and content moving through Availity's network to organize the data around individual patients and deliver new intelligence
What is CLAIR?
I need to deliver accurate benefits information directly into EPIC helping me manage costs while reducing denials
What is Real-time Eligibility (RTE)?
PDM is available on this Availity Product
What is Essentials?
Language that Availity Auth AI solution uses to facilitate interpretation of medical policies and clinical documentation, reducing the authorization processing time for our users
what is Natural Language Processing (NLP)?
the data sources for Availity Fusion that drive structures and standardizes multi-format clinical data
What is EHRs, Health information exchanges (HIEs), and labs?
provides a single source for trading partners to connect and exchange administrative data with all payers via batch, EDI, SOAP, and RESTful API connections
what is Availity Clearing house?
I am interested in a workflow automation platform that providers an all-payer clearing house to check for eligibility & benefits, submit cleaner claims, check claim status automatically, prevent denials, and match remits to claims
who is a direct Essentials pro customer?
result from prospective patients who want to schedule an appointment with a physician who is no longer at a service location
what is increased phone calls?
Auth AI made turnaround time reduce from 2.5 days to under this many seconds
what is 90 seconds?
There are five step to Upcycling raw clinical data
What is Normalize, Enrich, Reorganize, Deduplicate, and Summarize (NERD)?