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  - For Payers
    Simplify complex processes and improve payer-provider collaboration.
    
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    For Payers
    
    Payer Solutions Overview
    Simplify complex processes and improve payer-provider collaboration.
    
    Provider Engagement
    Streamline workflows and improve engagement.
    
    Provider Directories
    Maintain compliance by capturing provider updates at the source.
    
    Interoperability
    Transform data-sharing capabilities and reduce the cost of care.
    
    End-to-End Authorizations
    Ease prior authorization burdens with AI-driven solutions.
    
    Digital Correspondence
    Reduce print and postage costs and replace manual processes.
    
    Payment Accuracy
    Lower admin costs and prevent revenue leakage.
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    Streamline workflows, reduce denials, and ensure accurate payments.
    
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    Healthcare Connectivity
    Facilitate seamless data exchange via X12, REST, and FHIR APIs.
- Products
  Back
  
  Products
  - Availity Essentials
    Streamline provider workflows and improve collaboration.
  - Availity Essentials Plus
    Reach more health plans while streamlining pre-service and billing.
  - Availity Essentials Pro
    Boost efficiency, prevent denials, expedite payments.
  - Availity Fusion
    Enhance clinical data quality for optimized downstream workflows.
  - Availity AuthAI
    Simplify the prior authorization review process.
  - EDI Clearinghouse
    Connect to health plans nationwide.
  - Intelligent Gateway
    Seamlessly connect and exchange administrative data.
  - API Marketplace
    REST and FHIR-based APIs for fast, secure connectivity.
  - Provider Data Management
    Maintain accurate provider directories.
  - Payer-to-Payer Hub
    Streamline data exchange to meet mandatory compliance.
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  Back
  
  Insights
  - Case Studies
    See success stories from our customers.
  - Blog
    Get the latest industry insights.
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  - Essentials Registration & Support
    Get help registering or using Essentials.
  - Training & Education
    Learn about our training courses.
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Simplifying the Prior Authorization Process through Automation

Download the PDF

Manual prior authorization workflows are time consuming and costly for payer and provider organizations and can delay patient access to care. To increase provider visibility into which services require prior authorization and to bring automation to the submission and decision processes, the collaborators in this case study worked together to develop a more automated, self-service solution that allows providers to determine whether a given service requires prior authorization, submit a request, and receive a determination, all within their EMR workflow. The technology has improved efficiency, reduced denials, and increased revenue.

Download the Case Study

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