Because payment reform and competition are driving changes to the information that health plans and providers need to exchange, Availity is transforming its Health Information Network to meet the needs of the "next generation" health plan.
The Availity Health Information Network® is extending its proven ability to drive workflow efficiencies and cost reductions to an evolving set of payment models—while simultaneously accelerating your ability to solve problems today.
By adding clinical documentation capabilities to the network, health plans, technology partners and providers using Availity will have access to several advantages to improve quality, help facilitate better outcomes, and reduce cost. Our combination of capabilities and network connectivity helps health plans, partners and providers:
- Obtain, exchange and automate real-time information that supports value-based payment initiatives like PCMH, ACO and P4P
- Infuse care management processes with real-time hospital inpatient information
- Achieve tighter information integration between physician and hospital systems
- Decrease pended claims, rejections, and resubmissions due to errors
- Improve auto-adjudication rates
- Reduce unnecessary calls to health plan call centers
- Facilitate compliance with government mandates and incentive programs
Availity's suite of capabilities includes:
Inpatient Information Exchange: Enables the real-time exchange of patient admission, authorizations, concurrent review, lab results and discharge information between hospitals and health plan case management staff.
Medical Attachments: Allows physician practices and hospitals to track and respond to health plan requests for documentation electronically.
Clinical Summaries: Facilitates authorized and automated extracts and submissions of information from physician EMRs to health plans for HEDIS reporting and Medicare star ratings, reducing the need for manual chart reviews.
EMR Integration with Availity® CareProfile®: Integrates patient care history information sourced from the health plans with physician EMRs, providing physicians with a more holistic view of the patient.