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Availity, LLC, is a multi-payer, joint-venture company. Availity optimizes the flow of information between health care professionals, health plans, and other health care stakeholders through a secure internet-based exchange. The Availity Health Information Network encompasses administrative, clinical, and financial services, supports both real-time and batch transactions via the web, business to business, and electronic data interchange (EDI). It's fast and efficient. A single, secure login enables you to exchange information and conduct health care transactions with such payers as Florida Blue, HCSC, Humana, Wellpoint, Aetna, CIGNA, and more. For more information, including online demonstrations or to register, please visit the Availity website or call (800) AVAILITY (282-4548).
Through Availity we are striving to meet our goal of reducing costs in the Florida health care market, simplifying provider workflow, improving patient experience, and providing Health Insurance Portability and Accountability Act - Administrative Simplification (HIPAA-AS) compliant solutions.
The following standard health care capabilities are offered at no charge:
- Eligibility and Benefits (E&B)
- Authorizations and Referrals
- Electronic Claim Submission
- Claim Status Inquiry
- Electronic Remittance Advice (ERA)
Value added capabilities include the following:
- Real Time Claim Adjudication (RTCA)
- Claim Reconciliation Tool (CRT)
Note: For detailed information regarding all of the above electronic transactions and more, please refer to the Self-Service Tools section of the Manual for Physicians and Providers. For Availity registered providers, you may access Availity through their secure login on the Availity website.
Availity conducts one-hour training using web and phone conferencing tools, allowing you to attend using the Internet and your phone. Availity refers to these training sessions as "webinars." Live webinars require registration and are offered on a scheduled basis.
In a live webinar, you can view the trainer's actions in the application and hear instructions as the trainer demonstrates how to submit transactions in the Availity Health Information Network. At the end of the webinar, the trainer offers a live question and answer period.
Live Webinar Registration
For registered Availity users, login on the Availity website, then click Free Training in the top global navigation bar to view the current Availity Webinar Schedule and register for a specific session.
On-demand webinars are recorded training session that you can access anytime. They do not require registration. For questions about webinars or other Availity services call (800) AVAILITY (282-4548).
Process Eligibility and Claims Now
The administrative solutions offered through Availity help you process eligibility and claims data immediately.
With Availity you can swipe a member’s ID card through CareRead® and automatically populate the system with the member’s information. Once you are in the system, you have the ability to:
- Check Eligibility and Benefits
- Request Authorizations and Referrals
- Submit a Claim
- Process a Real-Time Claims Adjudication
- Check a Claim Status
- Appeal a Claim Electronically
- Reconcile Claims
To learn more about the administrative solutions available to you, visit the Availity website.
Make More Informed Clinical Decisions
Through Availity’s Patient Care Summary® you have the ability to access two years of a patient’s health care claim information from multiple payers. This clinical information can complement your medical records and be viewed at the point of care for more informed health care decision-making. You’ll receive care reminders from us to help you identify opportunities to improve the health of your patient.
Process and Receive Payments
Through Availity you can process patient payments, receive claim payments and receive electronic remittance advice all online.
Check Financial Responsibility
CareCalc® is the innovative tool in Availity that enables you to determine an estimate of a Florida Blue member’s financial responsibility in real-time. You can access the member’s out-of-pocket responsibility whenever they need it–prior to a visit, at the point of service or after they check out.
Via Availity your office staff can complete credit and debit transactions in real-time for copays or known deductibles and collect information for processing a future payment. Through the system you can accept American Express, Discover, MasterCard, Visa, PIN-less debit cards and paper checks. You can also set-up recurring payments, installment payment plans, hold payment information for post-adjudication payment processing, void/credit payments, perform end-of-day settlements and run customized reports.
Receive Claim Payments
You can choose to receive your claim payments through electronic funds transfer (EFT). These funds will be directly deposited into your bank account much faster than by check.
Receive Electronic Remittance Advice
Receive your 835 electronic remittance advice through your Availity mailbox. Learn more about how to register for this service.