Transcript Title

The Availity Health
Information Network
®
Streamline your workflow
Denise Pulcifur
04/12/2013
Availity
Agenda
Availity and your practice
Getting started
About Availity
What is
Availity?
Availity and RealMed
a powerful, combined network
Nationwide presence
• 350,000+ Physicians
Clinical
Exchange
Multi-Payer
Portal
• Access to 1,200+ Payers/
4,100 connections
Revenue
Cycle Management
• 575+ PMS Vendor Partners
• 2,700+ Hospitals
About Availity: Multi-Payer Portal
Why Availity?
The Availity Multi-Payer Portal
Clinical
Exchange
Multi-Payer
Portal
Revenue
Cycle Management
• Multiple payers
• One website
• One log-in
About Availity: Multi-Payer Portal
Availity Multi-Payer Portal
Secure access to the health plans you need most.
Anthem
Other Blue Plans
Aetna
Cigna
Humana
Medicare
USFHP
Universal Healthcare
WellCare
Availity and your practice
Exam Room
The Availity Portal
Improving Your Workflow
Back Office
•
•
Speed up claims
processing
Make fewer calls
to health plans
Front Office
•
•
Collect payments up
front: better cash flow
begins at the front
door
Access patient
information in real-time
•
•
Include more patient
information when making
treatment decisions
Receive care messages
and alerts
Availity and your practice
Front Office Solutions
Real-time access to:
• Eligibility and Benefits
• Availity® CareCollect®
Front Office
Exam Room
Back Office
Availity and your practice
Front Office Solutions
Availity CareCollect
®
®
• Collect patient payment at the time of the visit
• Streamline post-visit billing processes: set up
recurring payments and automate posting
• Run customized reports
Front Office
Exam Room
Back Office
Availity and your practice
Exam Room Solutions
Availity CareProfile
®
®
• Review patient history across multiple providers,
including diagnoses, prescriptions and lab results
• Save as much as 5 minutes per encounter on
patient intake
Front Office
Exam Room
Back Office
Availity and your practice
Back Office Solutions
• Real-time claim submission
• Real-time claim status review
• Availity® Remit Reader
SM
Front Office
Exam Room
Back Office
Availity and your practice
Back Office Solutions
Remit Reader
SM
• Access accurate ERA information
quickly and easily
• View detailed summaries of checks, claims
• Streamline the accounts receivable
process
Front Office
Exam Room
Back Office
Availity and your practice
Offerings by Health Plan
Connecticut Offerings by Health Plan
Anthem
Aetna
Cigna
Humana
Medicare
Wellcare
Eligibility & Benefits
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Claim Status Inquiry
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Web-entered Claims Submission
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Authorizations and Referrals

CT
Medicaid

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CareRead® (card swipe)

CareProfile® (health record)

CareCollect® (payment collection)

CareCost EstimatorSM (patient responsibility
estimator)

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Clinical Alerts/Messages

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Online Remittance Advice

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Remit ReaderSM

Real-time Claim Adjudication

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Secure Messaging

Specialty Pharmacy & Imaging Precertification
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Getting Started
What next?
Visit availity.com
to register
Accessing Anthem plans requires one more step—
check your Anthem registration guide for details.
Getting Started
What next?
• PCA completes registration
• After registration, PAAs can
– Add and maintain users
– Maintain organization
– Run reports
What’s a PCA?
What’s a PAA?
PCAs, or Primary Controlling
PAAs, or Primary Access
Authorities, have the legal
Administrators, function as
authority to sign agreements
the link between your
for your organization.
organization and Availity.
Availity and RealMed
a powerful, combined network
Thank you
Clinical
Exchange
Multi-Payer
Portal
Revenue
Cycle Management
Denise Pulcifur
Market Specialist, CT, NH, ME
207.310.0631
[dpulcifur]@availity.com
www.availity.com
(800) 282-4548