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Integrated Claims Clearinghouse to Optimize Epic Workqueues

 

With your organization’s investment in Epic, your number one priority when evaluating claim clearinghouse vendors is selecting one that can smoothly integrate and support your optimization needs downstream. Many vendors claim to offer this support, but the reality often falls short. Availity Essentials Pro consistently ranks highly with Epic customers and offers a deeply integrated experience and expertise both during your implementation and beyond. We strive to be the single vendor of choice for revenue cycle automation within Epic—saving you time and money and helping you achieve great results.

 

Manage your revenue cycle without leaving Epic

Availity has a long history of working with Epic clients in hospitals and physician practices across the country. The Essentials Pro deep integration with Epic delivers an end-to-end seamless workflow where users never have to leave the Epic environment. With integrated workflow tools and real-time revenue cycle data in Epic, you get cleaner claims, faster claim status, and quicker payments.

Our experience working with Epic helps streamline all phases of the lifecycle—from development and implementation to testing and support.

Our clients count on us to support their business by:

  • Lowering first-pass error rates
  • Decreasing preservice denials
  • Optimizing workflows
  • Simplifying EDI enrollments
  • Enhancing the system post implementation

See how this large academic medical system re-purposed FTEs and reduced time-to-payment with real-time 276/277 claim status.

Reduce Denials by Supporting Front-desk Staff

Payer denials are on the rise, and one of the most effective ways to prevent them is to ensure registration and front-desk staff have the most current information, either before or at the point of service. The Availity Essentials Pro revenue cycle solution connects directly to Epic’s Prelude patient registration module and delivers high-quality critical payer and patient data including:

  • Batch and real-time eligibility (RTE) via 270/271 with value added details like member ID cards and gaps in care
  • 278 R (authorization request), I (authorization inquiry), and N (notice of admission)
  • Propensity to pay, which includes credit score & address verification

See why UNC Health chose Availity Essentials Pro.

Why Availity

The Availity team has extensive experience working with Epic across all disciplines, including development, implementation, testing, and support. Our clients know they can count on us to support their business with workflow, automation, and system optimization enhancements.

 

Powerful claims management for Hospital and Professional Billing (HB and PB)

Availity delivers deep integration with Epic’s Claim Reconciliation Database (CRD), allowing you to truly manage your revenue cycle from end to end.

  • View claim status, correct clearinghouse edits, and resubmit the claim through a Workqueue—all from within the Epic system or Availity Essentials Pro.
  • Use best-in-class claim scrubbing for both HB and PB claims, including AI-powered predictive edits, all-payer connectivity, and advanced 276/277 claim status update feeds to Epic.
  • Leverage Availity real-time eligibility (an industry gold standard) prior to claim submission to prevent pended claims or denials. Eligibility-related errors are returned back to Epic Claim Edit Workqueues.

Other features include a number of hospital-specific editing packages, electronic worker’s comp claims, integrated dental claims, customized Epic postback rules, electronic attachments, Medicare FISS integration, and more.

Access our detailed product brochure for a complete listing.

Epic and Prelude are registered trademarks of Epic Systems Corporation.

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