Availity Blog

Claims Editing: Finding the Sweet Spot


9.22.2016 By AVAILITY


Availity Access provides a glimpse into the people behind our products. It features commentary on challenges facing the healthcare industry and how Availity can help providers and health plans better share healthcare information.

In this episode, we discuss the problems caused when payers and providers each build their own solutions to manage patient data. Payers build portals and providers implement PMS systems for data storage. Fast forward to the current state and each provider may have to log in to 25 separate payer portals. This creates usage fatigue, maintenance costs, set up costs, etc. for each side.

Clay Robertson, Business Solutions Expert for Availity, joins us to discuss potential solutions to the “missed connections” challenge. When payers and providers use a clearinghouse for the most common workflows --- claims submission, eligibility verification, patient statements, etc. each side sees benefits.

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