What is Availity?

Successful teamwork in patient care relies heavily on ongoing connectivity and access to current information. It is becoming ever more important to facilitate the flow of this information with insurance companies. Availity streamlines the collaboration with payers, assisting providers from the initial step of confirming a patient's eligibility all the way to resolving reimbursements. Healthcare professionals seek quick and easy access to details regarding health plans. With Availity Essentials, a free service supported by health plans, providers can take advantage of real-time data exchanges with many of the payers they regularly interact with. Moreover, Availity offers a premium service called Availity Essentials Pro that is designed to enhance revenue cycle performance, reduce claim denials, and secure patient payments more efficiently. By utilizing Availity as your reliable source for payer information, you can concentrate your efforts on providing high-quality patient care. Their electronic data interchange (EDI) clearinghouse and API solutions allow providers to seamlessly incorporate HIPAA transactions and other vital functions into their practice management systems, leading to improved operational efficiency. This holistic method not only supports healthcare providers in their operational tasks but also reinforces their ultimate goal of prioritizing patient well-being and satisfaction.

Screenshots and Video

Company Facts

Company Name:
Availity
Company Location:
United States
Company Website:
www.availity.com

Product Details

Deployment
SaaS
Training Options
Online Training
Webinars
Support
Web-Based Support

Product Details

Target Company Sizes
Individual
1-10
11-50
51-200
201-500
501-1000
1001-5000
5001-10000
10001+
Target Organization Types
Mid Size Business
Small Business
Enterprise
Freelance
Nonprofit
Government
Startup
Supported Languages
English

Availity Categories and Features

Revenue Cycle Management Software

Accounts Receivable
Claims Management
Collections Management
EHR/EMR Integration
For Healthcare
ICD-10 Compliance
Insurance Verification
Medical Billing
Patient Portal
Patient Registration
Patient Scheduling
Payment Processing

Medical Billing Software

Claims Processing
Claims Scrubbing
Code & Charge Entry
Compliance Tracking
Customizable Dashboard
Dunning Management
Invoice History
Patient Eligibility Checks
Practice Management
Quotes/Estimates
Remittance Advice

Hospital Management Software

Accounting Integration
Appointment Management
Appointment Scheduling
Bed Management
Billing & Invoicing
Claims Management
In-Patient Management
Inventory Management
Medical Billing
Out-Patient Management
Patient Records Management
Physician Management
Policy Management
Revenue Management

Availity Customer Reviews

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  • Reviewer Name: A Verified Reviewer
    Position: Psychologist
    Has used product for: 1-2 Years
    Uses the product: Yearly
    Org Size (# of Employees): 1 - 25
    Feature Set
    Layout
    Ease Of Use
    Cost
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    Would you Recommend to Others?
    1 2 3 4 5 6 7 8 9 10

    F-

    Date: Jan 13 2024
    Summary

    Availity walked me through a Provider Enrollment form and then realized I was already enrolled. Then the tech support told me Availity doesn't do what I wanted and referred me back to MHN. This was after 30 minutes. The tech didn't know the webpages nor what Availity does. I told the tech that the level of competence of both Availity and MHN was rather low. This is when I re-discovered PMS. Working with Availity is like being buried up to your waist in quicksand. The only other site with this many problems, with equal levels of dysfunction is CAQH. It took them years to work out the bugs, which they still have. I'd wait for Availity, but by then I'll be dead.

    Positive

    I liked how difficult it was to log on and how long I had to wait to talk to a real person. I like how the site boasts how much it does for providers and organizations and how long it take, navigating webpages that don't give a clue to how to solve even a simple problem.

    Negative

    Web pages are bulky, and are quirky. Buttons don't work unless I do something else unrelated. Instructions are neither intuitive, nor even clear when provided. Availity does not play well with other children; in this case, coordinate with MHN (a big insurance company). MHN referred me to set up ACH.

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  • Reviewer Name: A Verified Reviewer
    Position: CEO
    Has used product for: Less than 6 months
    Uses the product: Daily
    Org Size (# of Employees): 1 - 25
    Feature Set
    Layout
    Ease Of Use
    Cost
    Customer Service
    Would you Recommend to Others?
    1 2 3 4 5 6 7 8 9 10

    Time consuming and awful

    Date: Apr 09 2024
    Summary

    Frustrating- nothing works as they say - the patients are not kept on CLAIR after eligibility search- the download from EMR feature does not work.

    Positive

    Free- difficult to look up eligibility and i have to say that being free is all that is good regarding this product.

    Negative

    Clair does not keep my patients that I looked up in eligibility and I have to reenter everything- very time consuming and frustrating.
    To get assistance you need to submit a case- and that can only be on a specific patient claim- not regarding an issue with filing all claims.

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  • Reviewer Name: Kathleeen H.
    Position: Administrator
    Has used product for: 1-2 Years
    Uses the product: Daily
    Org Size (# of Employees): 1 - 25
    Feature Set
    Layout
    Ease Of Use
    Cost
    Customer Service
    Would you Recommend to Others?
    1 2 3 4 5 6 7 8 9 10

    Worst customer service ever

    Date: Feb 13 2024
    Summary

    The worst! Absolutely no customer service and the webinars for training are terrible. There is no way to get any help and more and more payers are requiting we use it.

    Positive

    Nothing there is not one thing I can think of that makes this platform worth taking the time to use. If it worked and was intuitive or they had customer service maybe it would be worth trying.

    Negative

    Everything. Their training is poor, the site is not intuitive, More payers are requiring us to use it to get benefits, prior authorizations and look at claims, but most of the time I cant either find the payer on the site or get the claim information. when I put in a support ticket they don't answer what you asked and then close the ticket before you have time to answer.

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  • Reviewer Name: Sudabeh Jasmine Z.
    Position: Clinician-Psychotherapist
    Has used product for: 2+ Years
    Uses the product: Weekly
    Org Size (# of Employees): 1 - 25
    Feature Set
    Layout
    Ease Of Use
    Cost
    Customer Service
    Would you Recommend to Others?
    1 2 3 4 5 6 7 8 9 10

    Worst provider service I ever worked with

    Date: Apr 12 2023
    Summary

    It appears as if their right hand doesn't know what the left hand does.

    Positive

    Zero; after 2 years work, my experiences is frustration. The Availity system is the worst system I ever worked with. It seems as the system set the way to avoid payment to provider or make it so hard that provider to give up the payment. I have multiple payments that has not paid even after negotiating 10% of my rate.

    Negative

    I am a provider for over 25 years. The Availity system is the worse system I ever work with. It seems as the system set the way to avoid payment to provider or make it so hard that provider to give up the payment. I have multiple payments that has not paid even after negotiating 10% of my rate.

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  • Reviewer Name: Jamie N.
    Position: Biller
    Has used product for: 6-12 Months
    Uses the product: Weekly
    Org Size (# of Employees): 1 - 25
    Feature Set
    Layout
    Ease Of Use
    Cost
    Would you Recommend to Others?
    1 2 3 4 5 6 7 8 9 10

    Availity is absolutely horrendous to use and to get assistance

    Date: Nov 01 2023
    Summary

    I dread having to call them. I can not ever get an answer or solution to my problem. This is the worst company.

    Positive

    There are absolutely no pros to this system or the people that work for it. This system is horrible.

    Negative

    I am not able to get providers singed up and after calling numerous times to help no one knows anything. This is one of the most frustrating systems I have ever used. Avoid it at all costs.

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  • Reviewer Name: Eoin G.
    Position: Owner/Manager
    Has used product for: 2+ Years
    Uses the product: Daily
    Org Size (# of Employees): 1 - 25
    Feature Set
    Layout
    Ease Of Use
    Cost
    Customer Service
    Would you Recommend to Others?
    1 2 3 4 5 6 7 8 9 10

    Availity Tried to be all things for all Insurance companies

    Date: Jun 18 2020
    Summary

    I've used Availity for many years as a practicing health care provider and later as the owner/manager of a medical billing company. They've added a tremendous number of insurance companies over the past 3 years in particular and I suspect we'll find that as Availity builds out their back end product many more smaller insurance companies will turn to Availity. Unfortunately the data presented is only as good as what the insurance companies provide so in many cases Availity can't replace a phone call.

    Positive

    Access to a large number of insurance companies eligibility and benefit information. Integrated claims review/status system. Preauthorization system works well. They listen to their users requests and feedback. They revamped one module to make it "responsive" and made it harder, not easier to use. They listened and rather than rolling back the changes, incorporated them in a new version.

    Negative

    The different modules could fit/work together better. (although I will admit they are making improvements). Their system doesn't handle many different tax IDs/providers well and has the platform has grown, the red tape and "authorization" bloat makes it difficult/time consuming for 3rd party billers. As a daily user, I'm frustrated with the amount of "white space" between entry fields which requires alot of scrolling. I also am not fond of their new EOB format. It is consistent between carrier and is not print friendly.

    Read More...
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