Trust your transaction processing to the industry leader
Why manage multiple EDI vendors when you can have all the services you need with one trusted partner? Availity is the industry-leading EDI gateway for dental and health plans. We process more than 3 billion transactions annually, representing 40 percent of commercial healthcare claims nationally.
Our Availity Intelligent Gateway is a HITRUST-certified, scalable, and powerful platform that processes core HIPAA transactions, including eligibility and benefits, claims, remits, claim status, authorization and referrals, and admission/discharge/transfer and lab. These can be processed through batch and real-time (B2B) channels. Additionally, health plans can notify and engage providers in non-standard format through the Availity Provider Engagement Portal.
As healthcare EDI becomes increasingly commoditized, partnering with an industry leader like Availity can help health plans reduce administrative costs associated with duplicative personnel, IT hardware, and transaction pricing. Additionally, Availity’s position in the market and unique ownership structure means that health plans don’t have to worry about network disruptions caused by industry consolidation.
Advanced Claims Editing
Advanced Claims Editing is a comprehensive solution that reviews and edits claims before they reach the health plan adjudication system.
With our Availity Insights reporting solution, health plans can better understand performance through data analytics, custom reports, and dashboards.
Availity has developed its own set of APIs that developers, vendors, and health plans can use to securely access the Availity network. This speeds time to market for solutions and reduces the complexity of supporting HL7 and X12 transactions.
Trading Partner Management
Our trading partner management service allows health plans to focus on their core business while Availity manages the technical and logistical issues associated with EDI. We can assume responsibility for all EDI partner contracting, technical connectivity, maintenance, trading partner support, and project support around regulatory mandates and industry changes.
Availity’s Data Hosting service allows health plans to leverage the Availity network without having to invest in technology upgrades to support HIPAA-compliant eligibility and benefits (270/271) and claim status (276/277) transactions. Availity hosts the health plan eligibility and benefits and claim seed data on the plan’s behalf, offering a seamless experience for providers.