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Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Differentiators
Keywords
Media
Company details

Categories

Solutions

Description

Product Description:
Most of the payers you’ll find on Essentials offer real-time authorizations. Just start with the basic information, and we’ll pre-populate as many of the fields as we can, and in just a few minutes you’ll have an answer that’s straight from the payer. We’re also working with several leading payers to simplify the process even more, with a question-and-answer format rather than the on-screen forms. Our new dashboards let you quickly check the status of all the auths requested by your office. For selected payers, you can even provide unsolicited attachments that you know the payer will need for approval. Once the visit is over, it's time to start the paperwork that gets you paid: claims.
About Availity:

Availity, L.L.C. provides Internet-based health information exchange services. It optimizes the flow of information between health care providers, health plans, and other health care stakeholders through an Internet-based exchange. The company offers commercial and government health plan transactions; and CareRead, which swipes patients' magnetic stripe-enabled member ID cards through a three track card reader connected to the computer to automatically populate the fields on Web transaction pages. It also provides CareProfile, which allows to access electronic health records; patient communication, which connects physicians and patients online, and supports patient-initiated appointment and referral requests; and CarePrescribe, an electronic prescribing solution that provides access to up-to-date patient specific medication history and coverage, therapeutic equivalent and lower cost alternative options, and real-time drug interaction checks. In addition, the company offers CareCost Estimator, which determines a patient's financial responsibility in real-time at the point of care; and CareCollect, which collects patient's responsibility through a card swipe, including combination member ID cards for high deductible plans, debit cards, and credit cards. It serves various health care providers, including physician offices, hospitals, integrated delivery networks, pharmacies, laboratories, imaging centers, and other ancillary providers. Availity, L.L.C. was founded in 2001 and is based in Jacksonville, Florida.

Product Description:
There’s a wealth of powerful data within your EHR—you just need real-time insights and seamless integration to make it actionable. Our Prior Authorization solution, powered by Waystar’s Hubble: - Automatically verifies, initiates, statuses and retrieves comprehensive authorization details - Enables efficient, intelligent automation by initiating authorizations at twice the speed of manual processes - Integrates directly with all major HIS and PM systems - Provides end-to-end authorization platform, including authorizations submissions for unscheduled admissions, as well as auto-generating ABNs or Notice of Non-coverage forms for Medical Necessity - Adapts to constantly shifting payer rules and requirements - Was built and is maintained by our in-house team of experts
About Waystar:

Waystar delivers innovative technology that simplifies and unifies healthcare payments. The company’s cloud-based platform helps healthcare providers across all care settings streamline workflows, improve financial performance and bring more transparency to the patient financial experience. Waystar solutions have been named Best in KLAS or Category Leader by KLAS Research 16 times (across multiple product categories) and earned multiple #1 rankings from Black Book. The Waystar platform is used by more than half a million providers, 1,000 health systems and hospitals, and 5,000 payers and health plans—and integrates with all major hospital information and practice management systems. On an annual basis, Waystar’s AI-powered solutions process $5B in patient payments, generate $4B in out-of-pocket estimates and process claims representing approximately 40% of the U.S. patient population. For more information, visit www.waystar.com.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Use Cases

Description:
  • Connect free to payers
  • Submit EDI Transactions
  • Revenue Cycle Management
  • Patient Access Management
Pediatric use cases:

None provided

Users:

Patients, Providers, Payers, Partners

Description:

With over 300+ payers and a broad array of deployable service lines and patient types, we provide a full cycle automation solution for prior authorization: from pre-scheduled prior auth submission, status checking and denial prevention worklist alerts, as well as medical necessity verification and notification of admission.

Pediatric use cases:

None provided

Users:

Pre-service financial clearance teams, auth cert teams, any prior authorization staff doing medical necessity as well as authorization for services at acute care facilities or OP areas.

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Other

Hardware Compatibility:

Desktop, Other

Integrations:

None provided

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

None provided

Hardware Compatibility:

None provided

Client Types

None provided

Differentiators

Differentiators vs EHR Functionality:

N/A

Differentiators vs Competitors:
  • 2 Million providers on platform
  • 200+ B2B Partners
  • 45% of all covered lives carried exclusively through Availity
  • 1.2 Million Daily Logins
  • 100% of US Health Plans on the platform
  • 112 Million covered lives carried exclusively through Availity
Differentiators vs EHR Functionality:
Many hospitals, health systems, and IDNs have invested in billion dollar EMR/EMRs which are an extraordinary vehicle for clinical and billing functions -- but lack the ability to elevate automation in key business areas such as prior authorization. This is due to their lack of payer connections and the absence of advanced intelligent software. Together, Waystar brings the intelligence that powers today's EMR/EHR platforms and automation efforts.
Differentiators vs Competitors:
With nearly a decade in the business of automating prior authorizations, we are known for our internal expertise when it comes to payers, process change, and technology. We believe pushing the envelope in know-how across all 3 is what gives our clients the edge on automation. With more payer connections, more relationships with payers, and greater flexibility in accessing payer data we can access the best and most timely data. We not only seamlessly integrate with EPIC but offer full-stack integration capabilities or a powerful stand-alone application -- all because each patient access team is different. And powered across our Hubble platform (a blend of RPA, machine learning, NLP, and advanced auth rules) we are well positioned to power your automated enterprise.

Keywords

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Company Details

Founded in 2001

Founded in 2000

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