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Optimize revenue cycle management with Availity Essentials Pro™

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As healthcare grows more complex, hospitals and medical practices require revenue cycle management solutions that streamline critical workflows, prevent denials, and expedite payments without overburdening existing staff.

Availity Essentials Pro™ is a revenue cycle solution that simplifies claim and payment processing through an integrated, all-payer clearinghouse that features robust pre-service, post-service, and post-adjudication capabilities.

Prevent downstream revenue cycle errors with pre-service capabilities

Pre-service tasks such as insurance eligibility verification, securing prior authorizations, and clarifying patient financial obligations are fundamental components of a resilient and efficient revenue cycle. Essentials Pro’s automated pre-service tools include: 

  • Real-time and batch eligibility and benefits throughout the claims lifecycle 
  • Prior authorization solution integrated into the provider EHR workflow
  • Denial prevention and denial management to help drive ROI 
  • Patient financial clearance with demographic, coverage, and responsibility data

Efficiently manage claim activities with AI and automation

Manual claim management processes hinder efficiency, financial stability, and patient care. Essentials Pro simplifies electronic claim management for providers, reducing errors and offering analytical tools to enhance insights. Advanced claim management features include: 

  • Automated claim submission for all claim types 
  • AI-powered predictive editing that analyzes claims for errors
  • Advanced edit/error management to help reduce back-end denials 
  • Real-time claim tracking to swiftly identify and rectify issues

Take a proactive approach to manage denials for faster payments

Providers want more effective ways to identify and prevent denied claims so they can reduce administrative rework and lost revenue associated with them. Essentials Pro helps them do this with:  

  • Remittances solutions for receiving and managing payment information 
  • Denial management tools to identify denial patterns and streamline appeals workflows
  • Patient financial statements and payments in a consolidated platform 
  • Advanced analytics and custom reporting on operations

Learn more about how Availity can help

Product Feature

Epic Integration

Availity seamlessly integrates with Epic for patient management, claims management, optimized workflows, and revenue cycle support.

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Solution

Claim and Claim Status

Reduce denials and get paid quickly and accurately.

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Product

Availity Essentials

Learn how Availity can help your health plan streamline provider workflows and improve collaboration.

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Product

Availity Essentials Plus

Learn how Availity can help you reach more health plans while streamlining pre-service and billing.

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Case Study

How Advanced Real-Time Eligibility helped a major health system obtain a 67% decrease in eligibility denials 

Improved access to patient benefits and a consultative approach made a positive impact on denial rates and collections.

Read the study

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