Streamline provider workflows, improve collaboration, and reduce administrative waste

Payers across the country have selected Availity Essentials™ as their exclusive provider portal, leveraging the power of Availity’s network – 3 million credentialed providers processing 13 billion transactions a year—to reach 170 million covered lives instantly.

By taking advantage of a multi-payer provider portal, you can redirect staff toward high-impact work—boosting Stars/HEDIS scores, launching value-based-care programs, staying audit-ready, fixing provider-data accuracy, and containing costs.

With Availity, you leverage:

• Robust security infrastructure
  Industry-leading 5-day recovery, with an air-gapped backup environment that ensures business continuity for 95 % of payers and 3.4 million providers, even after catastrophic cyber events.
• Role-based registration
  Access and permissions are tied to each user’s job function, so a biller, coder, or front-desk rep sees only the tools and data they need.
• Multi-payer approach to product innovation
  New capabilities (e.g., API-powered prior auth, enhanced claim appeals) are co-designed with peer health plans and rolled out to the entire network, eliminating one-off development costs.
• Ongoing product training and communications
  On-demand tutorials, live webinars, and in-portal tips keep providers up to speed.
• Collaboration with peer health plans on best practices
  Payers share compliance insights and benchmark workflows, strengthening the shared roadmap for everyone.

A proven track record of reducing call center volume and increasing provider satisfaction.

Providers: Get started with Essentials

If you’re a healthcare provider and want to register to use Essentials to work with your payers, visit our training site to get started. Gain real-time access to eligibility, claims status, remittance details, appeals, and more-all in one centralized portal.

Essentials Provider Workflows

Availity’s ongoing investments in the following administrative workflows reduces provider reliance on manual processes to drive adoption.

Eligibility and Benefits

• Verify patient eligibility and benefits in real-time
• View member ID cards
• Send care reminders
• Access additional benefits information
• Estimate patient costs

Prior Authorizations

• Check authorization requirements
• Track status via authorization dashboard
• Submit prior authorizations with medical attachments

Claims and Remittance Management

• Submit claims electronically
• Check claim status
• Attach supporting medical documentation
• View remittance
• Submit and track claim appeals
• Communicate on claim overpayment

Communication and collaboration

• Receive and send secure messages and notifications
• Eliminate paper-based communication with the Digital Correspondence Hub
• Engage via plan-specific Payer Spaces

Case Study

Mitigating Cost and Abrasion with Electronic Claims Submission

One of the largest health insurance plans in the South and Availity, the nation’s largest real-time health information network, recently collaborated to eliminate the submission of paper claims by the health plan’s provider network.

How a Health Plan Closed Care Gaps and Increased Provider Engagement with Electronic Clinical Quality Validation

A leading health plan partnered with Availity to implement a fully digital solution for capturing clinical data and collaborating with providers. The result: reduced fax-based outreach, faster execution of quality programs, and improved provider satisfaction through stronger digital engagements.

It’s time to find a better way with Availity and build the foundation for smarter, more connected care through a trusted, scalable multi-payer provider portal.