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Availity’s foundation—and reputation—is built on decades of innovation in revenue cycle management and administrative and financial workflow improvements between health plans and providers. All in the interest of the ultimate consumer—the patient.

After a two-year pause due to the pandemic, Availity Connects returned. More than 227 friends, customers, and colleagues from health plans, vendor partners, and provider organizations across the country reunited on Amelia Island, FL, to define healthcare’s path forward in the new normal.

Value-added transaction capability delivers a dynamic provider experience, helps reduce administrative inefficiencies, and accelerates Availity’s omni-channel strategy

As the product line manager for Availity Editing Services, I talk with a lot of health plans about how they can improve their clean claim rate by taking advantage of the editing capabilities in Availity’s Intelligent Gateway.

Ms. Hutson is a product line director for Availity's pre-service capabilities. She leads a team of 11 product line managers and product owners who work to enhance the eligibility and benefits transaction within Availity's revenue cycle management solution.

July 7, 2021 -- Novo Holdings A/S (“Novo Holdings” and “NH”), a leading international investor in healthcare and life sciences, today announced a strategic minority investment in Availity, one of the largest healthcare data and administrative networks connecting payers and providers throughout the United States.

Does it ever feel like the language around healthcare transactions is purposely confusing? Do you find yourself googling terms…and still not understanding what they mean? It’s not you. It’s us—the healthcare IT industry. We need to do a better job explaining our business processes in clear, simple language. Availity’s new EDI 101 series is our attempt to reduce confusion by explaining things as simply as possible.

Insurance claim denials are a costly and time-consuming burden on every hospital and health system. But you can avoid most denials by taking the proper steps. Avoiding the most common types of denials — duplicate claims, medical documentation, timely filing, etc. — can add tens of thousands of dollars to a hospital's bottom line. Revenue cycle management experts discussed how to prevent recurring denials in an Oct. 19 webinar hosted by Becker's Hospital Review and sponsored by Availity.

Telemedicine is finally having its moment. It’s long been viewed as a potential way to reduce healthcare costs and drive better coverage among underserved areas, but utilization hasn’t kept pace with expectations. According to Peterson-KFF Health System Tracker, in 2018, 2.4% of large group enrollees who had an outpatient office visit had at least one telemedicine visit, which was up from 1.6% in 2017...

COVID-19 has forced most healthcare organizations to restructure the ways they operate. Practices and hospitals not on the frontlines of fighting the pandemic have seen reduced—or non-existent—in-person patient visits, and perhaps an increase in telehealth visits. As we head into summer, many states have started loosening shelter-at-home restrictions, and patient volume is beginning to increase for non-urgent and elective procedures. But it’s possible that many organizations won’t see a return to pre-COVID levels for some time.

With a precipitous drop in volume, some organizations are going back to basics from a revenue cycle standpoint. All healthcare organizations are suffering financially during the COVID-19 epidemic. Hospitals are on the front lines of treatment while also seeing precipitous drops in volume and business. The pandemic is also threatening the financial health and long-term stability of clinics and specialty practices. Primary care physician practices are no exception, but strategies have emerged that could help them weather the storm…

Availity, the nation’s largest real-time health information network, announced today that it has launched a COVID-19 Provider Resource Center that consolidates links to updates from more than 50 payers for information about patient eligibility, coding, claims processing, telehealth guidelines and more. The new COVID-19 Provider Resource Center connects providers directly to payer updates, while enabling better collaboration between providers and payers...

Even in the most technology-savvy provider offices, there may be lingering paper-based manual processes eating away at your bottom line. Perhaps you work with a payer that only accepts paper forms for secondary or Worker’s Comp claims. Or maybe your business requires regular printing and faxing of documentation to support your electronic claims.

Revenue cycle management technology is at the heart of the administrative side of business at every hospital and health system. It is key to daily operations. As such, healthcare CIOs and other IT professionals must take great care when implementing RCM systems. Getting revenue cycle done right – and done right the first time – is imperative. Here, five experts in the field of revenue cycle management IT offer Healthcare IT News readers their expertise when it comes to identifying and deploying best practices for implementing this all-important technology.

We may never completely eliminate denials, but there are ways to proactively prevent them, particularly recurring denials caused by your claim workflow. From small practices to large Epic health systems, we see a surge in customers working to dramatically reduce error rates, improve cash flow, and reduce write-offs.

Jacksonville, Fla—June 18, 2019— Black Book Market Research LLC awarded Availity, the nation’s largest real-time health information network, its highest ranking for Ambulatory Claims Management and Physician Clearinghouse Solutions, in a comprehensive survey of more than 1,600 hospital and health system executives, directors, and managers.

There’s a fun phrase about dental practices: “When the front office hums, the back-office dances.” How does the front office hum? Let me paint you the picture—the front office staff is answering phones, greeting patients who walk in, and working their daily schedule.

“Inform before you perform.” Does your office have a written financial policy? If not, you should. This policy should be presented to and signed by all patients, especially at the time of their first appointment. This sets the ground rules. Keep a copy of the signed document in their patient records. Your financial policy should include all payment options and treatment should not commence until the payment arrangements are settled. A successful policy is one that is clearly presented and consistently enforced.

In theory, healthcare consumerism is a straight-forward idea: Shifting costs to consumers, typically in the form of high-deductible health plans (HDHPs), will give them an incentive to make informed, judicious decisions about the healthcare services they purchase. In practice, consumers have been slow to shop for health care based on price, despite high enrollment levels in HDHPs, with the National Center for Health Statistics reporting that nearly 40 percent of consumers purchased private HDHPs in 2016, up from 26 percent in 2011.

medQ, Inc. and Availity announced an agreement to provide Availity Patient Access and AuthPal services through the Q/ris 3000 workflow suite of products. With this integration, Q/ris 3000 will quickly process physician orders, obtain prior authorizations, and verify insurance for all diagnostic imaging procedures. In addition, the Q/ris 3000 integrated app will also calculate how much patients will owe for that exam to ensure they are aware of their financial obligations prior to arrival for the procedure.

Stamford, CT, June 11, 2018 – FUJIFILM Medical Systems, U.S.A., Inc., a leading provider of Enterprise Imaging and Medical Informatics solutions, announced a new collaboration in its health IT portfolio to enhance access for clinicians and patients. Fujifilm has joined forces with Availity, the nation’s largest payer and provider engagement network, to provide an integrated solution for patient financial engagement and automated insurance pre-authorizations. Both vendors recently attended the RBMA conference and highlighted their new partnership.

eHealth Initiative released their final report, The Role of Technology in Value-Based Care & Patient Engagement, which gained insight, from an industry perspective, on the impact of healthcare reimbursement policies on technology and revenue cycle. Twelve executives, primarily from provider organizations and health information networks (HINs), were interviewed for this research project. Analytics were a prominent theme and interviewees felt strongly about the value of data in improving patient outcomes.

Availity, the nation’s largest real-time health information network, praised the recent announcement by physicians, pharmacists, medical groups, hospitals and health plans to streamline the prior authorization processes.

Prior authorizations may be as popular among providers as ants at a picnic, but they have become a common and necessary part of the reimbursement process. As a result, being able to manage prior authorizations efficiently is critical to maintaining a healthy revenue cycle and avoiding issues such as denied claims, administrative waste, excessive staff turnover and, of course, patient dissatisfaction.

Recently, three trends have aligned to signal highly favorable conditions in the independent radiology space for the coming year. These trends are: (i) a resurgence of the patient steerage debate; (ii) an increase in patient consumerism; and (iii) advances in pre-service technology that could significantly improve practice efficiency. Independent radiology centers that take steps now to prepare will be in an enviable position next year and better able to capitalize on these trends.

Florida Gov. Rick Scott presented the Governor’s Business Ambassador Award to Availity, the nation’s largest real-time health information network, for Availity’s contributions to Florida’s economic vitality. The Governor’s Business Ambassador Award is given to individuals and businesses in recognition of their efforts to create jobs and opportunities within the state. Founded in Jacksonville in 2001, Availity employs more than 400 Floridians, and has created 130 new jobs in Florida in just the past two years.

Availity, the nation’s largest real-time health information network, announced today that it has received a significant growth equity investment led by Francisco Partners, a leading technology-focused private equity firm, with additional investment from Availity’s existing investor group.

Availity today announced its recognition as one of the Achievers 50 Most Engaged Workplaces™ in North America. The annual award, issued by Achievers, an industry leading provider of employee recognition and engagement solutions, commends top employers that display leadership and innovation in engaging their workforces.

If you’re a healthcare provider still processing most claims manually, you know first-hand the challenges this presents. First, you deal with a lot of paper—from spreadsheets to claims forms to sticky notes— just to keep track of what you billed, what got paid, and what got denied. Second, you spend a lot of time communicating with the payers to track down claims, follow up on payments, and reissue remittances. Automating these processes sounds good, but what kind of results can you really expect?

Availity, the nation’s largest real-time health information network, announced the launch of its automated prior authorization platform, which eliminates the cost, time, and administrative burdens associated with manual authorization processes.

“How well does this vendor integrate with Epic?” It’s an increasingly important question among hospitals and health systems that run Epic and are considering a new claims and clearinghouse solution. It was one of the questions Community Health Network—a non-profit health system with more than 200 sites of care throughout Central Indiana—asked as it sought to consolidate the number of revenue cycle solutions in use across the organization.

Because patients are paying more out of pocket for their healthcare, you might be focusing on improving patient collection processes. While that’s critical, it’s also important not to lose sight of the other side of the revenue equation—the payer. Elizabeth Woodcock, MBA, FACMPE, CPC, an expert on medical practice operations and revenue cycle management, shares her thoughts on how to approach denials in your organization.

In this episode of Availity Access, Jeff Chester, Availity’s Chief Revenue Officer and Senior Vice President, discusses what he sees as the big healthcare trends in 2017.

 
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