Quick Answers for Providers

What exactly is Availity?
Availity is a secure health information network that connects physician practices, hospitals and other providers of care with health plans and other information partners. Through this network connectivity, we facilitate the electronic exchange of business and clinical information (like claims and lab data), simplifying physician access to the information you need to run your practice more efficiently and effectively.
Our approach is to simplify your interactions with health plans and other information partners, enabling a more collaborative approach to health care.
What will the Availity® Health Information Network do for me and my medical practice?
Your practice will save time and money with Availity, since our network enables real-time access to patient eligibility and benefits, authorizations and referrals, claims, claim status, and remittances. You can also enjoy valuable clinical and business benefits by tapping into Availity's suite of integrated tools, including card swipe access to patient data (Availity® CareRead®), longitudinal patient care records (Availity® CareProfile®), patient financial responsibility estimation (Availity® CareCost EstimatorSM), and payment processing services (Availity® CareCollect®).
Availity's one-stop online access allows you and your staff to work anywhere you have Internet access, 24 hours a day, seven days a week. You can take care of day-to-day tasks more quickly, boosting your overall productivity and allowing more time to care for patients. And, since Availity offers integration with most practice management systems, electronic medical record systems, and hospital information systems, you'll be able to maximize the value of your existing software investments.
Do I have to pay to use Availity?
Participating health plans pay Availity for certain kinds of transactions that health care providers process through our network. Their subsidy allows health care providers like you to use Availity's basic services at no charge, and enables you to choose from a range of additional value-added services for a greatly reduced cost.
For physicians and health care organizations seeking a complete revenue cycle solution, Availity offers RealMed, its full suite of revenue cycle management services.
How do I begin using Availity?
Individuals and organizations can access the Availity Health Information Network through the Availity Web portal (website) or via electronic data interchange (EDI) through a practice management system, electronic medical record system, or hospital information system. For either scenario, organizations and their authorized users must first register with Availity. Registration is free and takes only a few minutes of your time. Click here to begin the registration process.
Are there any set-up fees, monthly fees, or per-claim fees?
There are no set-up fees, monthly fees, or per-claim fees charged to providers for using Availity's basic services. The standard health plan transactions, including eligibility and benefits, claim submission, claim status, authorizations and referrals, and remittances, are included in our basic services and are available at no charge to health care providers. Some value-added transactions, such as access to electronic patient care records and patient responsibility estimation are also available at no cost to providers, while other optional services are available for a nominal cost.
RealMed is a premium revenue cycle management solution for practices that would benefit from automated health care transactions associated with patient registration, billing and collection, claims follow-up and posting. Click here to find out more about RealMed.
Is Availity easy to use?
Yes. Availity's Web portal looks and functions like any number of websites you're familiar with – and you won't need any special training. If you've ever searched for anything online, then you already know what you need to know to use Availity.
Which health plans support real-time transactions with Availity on the web site?
Click here to search and download this information to your desktop.
What are the technical requirements?
All you need to use our secure online network are:
  • A computer with internet access. High speed is recommended for best results.
  • Microsoft Internet Explorer 7.0 or greater (supports 128-bit encryption).
  • A 1024 x 768 or greater pixel display for best screen visibility.
To participate in the online network, do we need to purchase software?
No. The Availity Health Information Network integrates with most major practice management systems and hospital information systems for batch claims and other EDI transactions. And the Availity Web portal is available around the clock and around the world, on any computer with internet access.
Click here for a list of technology partners who can successfully send and receive transactions using the Availity network. If your preferred practice management, billing or hospital information system vendor is not on the list, it may be a good idea to contact them.
Is Availity a practice management system?
No. Practice management systems, hospital information systems, and billing systems are software products sold separately by various technology companies and vendors. The Availity Health Information Network exchanges information to and among those systems and their end users. Availity can be seamlessly integrated with these systems so you derive maximum benefit from both your software features as well as our services. The level of integration is determined by your system vendor.
Is Availity HIPAA compliant?
Yes. Availity's procedures and protocols are 100% compliant with the Health Insurance Portability and Accountability Act (HIPAA), and Availity is HITRUST certified. We continuously monitor HIPAA regulations for changes. We continue to develop and enforce extensive privacy and security policies and procedures, and we play a leadership role in regional and national workgroups and other health care forums that address emerging security concerns.
How does Availity protect the privacy and security of health information?
All information delivered across the Availity Health Information Network is secure. Access is protected by registration and is limited to designated users.
Availity Health Information Network stores some health information so you can search certain payment history, but primarily exchanges the information. In both cases, Availity remains in strict compliance with privacy laws and regulations, as necessary to complete the range of transactions performed by participants.
Why does the information vary from health plan to health plan?
When you conduct a real-time transaction on our network, Availity sends a request to the health plan's information system and returns the most current information available. Not all health plans provide the same level of detail on their responses. Although Availity aims to standardize the information returned, it is simply not possible for all health plans to accommodate that goal due to their own internal capabilities for information exchange.
If you notice that certain information is insufficient for your purposes, please let Availity know. We work continuously with our health plan partners to improve the amount and quality of the information available to us, and their abilities to do so are increasingly progressive.
If I already have access to a health plan’s web site, will I need to register to use the Availity® Health Information Network?
Yes. The Availity Health Information Network requires that you register and obtain a user ID and password. Once logged in to Availity's network, Web portal users have the ability to transact with multiple health plans, eliminating the need to visit multiple sites and remember multiple passwords. EDI customers have access to password-protected mailboxes and reports for their transactions.

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