Optimize your revenue cycle with less effort
As the business of healthcare becomes more complicated, hospitals and physician practices need solutions that make it faster and easier to manage critical workflows throughout the entire revenue cycle, prevent denials, and receive payments faster without placing an additional burden on existing staff.
Availity’s Revenue Cycle Management (RCM) solution simplifies claim and payment processing while delivering intelligent reporting and analytics that pinpoint revenue cycle trends. Availity RCM integrates with almost any PM or EMR system and helps you optimize workflows to get the most from your technology investments. Our RCM team has vast experience helping practices, hospitals, and health systems of all sizes maximize profitability—from small providers with simple in-house systems to large, specialty Epic integrations.
Pre-service data quality
Many issues related to claim denials and patient payment can be traced back to problems at the front of the revenue cycle. Availity RCM helps you address these gaps with integration tools that eliminate manual processes and speed up your registration process.
- Eligibility and Benefits—Automatically check eligibility and benefits in real time, before a patient visit or admission, including co-pays, deductibles, and co-insurance. With an all-payer solution, you see payer information in a consistent and easy-to-understand format.
- Patient Collections—Give your patients a branded online payment option that allows you to process credit cards through the application.
- Self-pay Eligibility Verification—identify potential patient coverage options under Medicaid and major payers with this additional module.
- Authorization Services—a better way to manage prior authorizations
Powerful post-service claims management
You can’t let mistakes during the claim submission process affect your ability to get paid. Availity RCM helps prevent errors, while providing analytical tools that improve organizational insight.
- Claims Submission—Submit claims in batch or one at a time in standard and non-HIPAA standard formats and receive real-time notification and line-item, detail-level tracking.
- Edit/Error Management—Before claims are submitted, identify errors in real time such as those related to HIPAA compliance, eligibility, NPI, and payer-specific rules.
- Claim Status and Tracking—Automatically track claims in real time, match payments from 835s back to claims submitted, and search for unpaid, delayed, or pended claims, as well as claim histories for proof of timely filing.
- Remittance—View or print claim payments, and receive ERA files in formats that allow your practice management system to automatically post payments and easily track remits received.
- Patient Collections—Improve post-visit collections with the ability to scrub addresses to ensure accurate delivery and with an online branded payment portal.
- Analytics and reporting—Get integrated status, payment and claim detail, and historical information in a single database, and view data that is focused on batch-level controls and error patterns, so you can focus on root cause.
Denial prevention vs. denial management
Don’t just manage denials—take active steps to prevent them. Availity RCM offers a suite of products and services to give you flexibility in developing end-to-end denial strategies that fit your organization.
Additional modules to increase your RCM power
Availity RCM offers several additional modules to further empower your revenue cycle management:
- Take claims submission functionality to the next level with several options including: Secondary Claim Management, Drop-to-Paper for primary or secondary claims, Workers’ Compensation, All-Payer Attachments, Enhanced Medicare solutions, and Dental claim submission.
- Integrate the process of printing pre-collection letters and patient statements, and deliver a single source to integrate claim status, payment, and claim detail and history information with Patient Statements.
- Need further help with remittances? Denial Management helps you identify denial patterns; EOB to ERA Conversion creates ERAs from paper payments that can be automatically posted by your practice management system; Remit Reconciliation Services automatically matches the EFT with the ERA and releases remits when reconciliation is complete; and Lockbox Services automates the process of depositing, posting, and managing paper payments.
