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Availity Denial Management

Where healthcare connects.

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Overview

Availity operates one of the largest real-time health information networks, connecting a diverse range of payers and providers. Their Revenue Cycle Management solutions include tools for both denial prevention and management. The platform leverages AI to identify potential claim issues before submission and provides automated workflows to manage and appeal denials. Availity offers a free, multi-payer portal (Essentials) and a more advanced clearinghouse solution (Essentials Pro) for comprehensive RCM.

✨ Key Features

  • Large, multi-payer network connectivity
  • AI-driven claim edits for denial prevention
  • Automated denial and appeal workflows
  • Real-time eligibility and benefits verification
  • Claim status tracking
  • Remittance processing

🎯 Use Cases (3)

Provider organizations of all sizes needing to connect with multiple payers. RCM teams looking to automate claim editing and denial follow-up. Healthcare IT companies wanting to integrate payer data via APIs.

✅ Best For

  • Streamlining communication and transactions between providers and a wide range of health plans.
  • Reducing denials through pre-submission claim editing.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Organizations that do not need multi-payer connectivity.

💻 Platforms

Web API

🔌 Integrations

Extensive list of EHR and PM systems API Marketplace for custom integrations

🛟 Support Options

  • ✓ Email Support
  • ✓ Live Chat
  • ✓ Phone Support
  • ✓ Dedicated Support (Essentials Pro tier)

🔒 Compliance & Security

✓ SOC 2 ✓ HIPAA ✓ BAA Available ✓ SSO ✓ SOC 2 Type 2 ✓ EHNAC ✓ CAQH CORE

💰 Pricing

Contact for pricing
Free Tier Available

Free tier: Availity Essentials is a free, web-based portal with core RCM functions.

Visit Availity Denial Management Website →