Availity News

Availity Adds Enhanced Claims Status to RESTful API


5.10.2022 By Availity


Jacksonville, FL — May 10, 2022 — Availity, the nation’s largest real-time health information network today announced that Enhanced Claims Status, a multi-payer RESTful API that enriches standard claim status transactions with granular, actionable information, is now available to Availity’s trading partner network.

Enhanced Claim Status allows participating payers to enhance their standard X12 277 claims status response with more than 300 customizable information fields. It is currently available through Availity Essentials, the company’s flagship health plan solution, as well as Availity Essentials Pro, the company’s revenue cycle management solution.

“Enhanced Claims Status provides accurate, transparent information to guide provider action and help accelerate their payments,” said Bobbi Coluni, Availity’s Chief Product Officer. “Enhanced Claims Status reflects the market’s demand for value-added content and Availity’s commitment to accelerate our robust omni-channel strategy, making information accessible via all channels.”

Claim status requests are a frequent source of abrasion between health plans and providers because X12 276/277 transactions lack sufficient and descriptive data providers need. As a result, providers rely on health plans’ call centers to close gaps in claims status responses, increasing administrative burdens and causing unnecessary delays in claims management processes.

RESTful APIs have steadily grown in popularity because they support the exchange of rich, value-added content. Unlike robotic process automation—or “screen-scraping”—methods, APIs ensure that communications of protected health information between health plans and providers remain seamless and reliable across all channels, while maintaining high levels of security, accountability, and user authentication.

Availity runs several transactions on RESTful API, including eligibility, claims status, and now Enhanced Claims Status. Availity plans to announce additional value-added transactions to RESTful in the near future.

More than a dozen Availity health plan customers use Enhanced Claims Status. This feature is now available to trading partners in the Availity network. For questions or more information, please contact the Availity Partner Management Team.

Providers can start their journey with Availity today by creating a free account on Availity Essentials. Visit Availity.com to learn more about Availity Essentials, Availity Essentials Plus, and Availity Essentials Pro.


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