The success of a payer’s provider engagement strategy depends on the ability to seamlessly connect and exchange administrative data with providers and other trading partners. Availity’s Intelligent Gateway—part of the Availity platform—securely and reliably processes more than 13 billion transactions annually across the healthcare ecosystem.
Healthcare continues to be a top target for cybercriminals, but payers can mitigate risk by reducing the number of inbound connections and consolidating transactions through a secure, trusted gateway. The Intelligent Gateway monitors all inbound transactions and serves as a critical protection point for payers.
Availity integrates rich editing content into the Intelligent Gateway, helping to prevent claims with errors from reaching the payer’s adjudication system. By returning claims with errors to the provider to be fixed, payers can avoid administrative rework and prompt pay penalties.
The Intelligent Gateway processes core HIPAA X12 EDI transactions through SOAP, RESTful API, and batch modes, as well as value-added transactions delivered through RESTful APIs. Availity also supports HL7® FHIR® API standards for Payer-to-Payer Data Exchange and Prior Authorizations in compliance with CMS’ Advancing Interoperability and Improving Prior Authorization Processes Final Rule.
As a designated gateway partner, Availity manages the technical connections and contractual aspects of trading partners, allowing payers to refocus internal resources.
Product
Discover how Availity can help you connect to health plans nationwide with its EDI Clearinghouse.
Solution
Discover how Availity helps vendors and trading partners facilitate seamless data exchange via X12, REST, and FHIR APIs.
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