What is Availity and and How is it Helpful for Insurance Billing?

Availity is a great free tool for mental healthcare providers who are billing insurance. Through the Availity portal, you can establish secure HIPAA compliant connections to payers so that you can perform eligibility and benefit checks for your patients, submit claims, receive ERAs, and more. Availity is also at the forefront of advancing technology in the healthcare industry. If you are a provider accepting insurance, we recommend setting up an account with Availity or following their social accounts so that you can stay up to date on advancements made in the industry.

Who Operates Availity?

Availity is a third party entity that serves as a bridge between healthcare providers and insurance providers. Their goal was to eliminate the gap between insurance companies and providers by providing real time information regarding claim status, eligibility, and payment.

Who Should Have an Availity Account?

If you are a provider who is accepting insurance, we recommend that you set up an account with Availity! They work with thousands of insurance providers, and even if the insurance company that you are credentialed with has not yet partnered with Availity, you will be the first to know when they do if you already have an account!

By setting up an account with Availity you get industry news and updates from the company sent directly to you. You can verify that the insurance company you are credentialed with partners with Availity using this directory search. If you can find the payer in the directory of Availity partners, we highly recommend that you have an account.

If you’re intimidated by learning another portal, they have plenty of tutorials and a large support team that can help you learn and make the most of the platform.

What Can I Do With My Availity Account?

Eligibility Checks

Use the Availity portal to check eligibility and benefits for your patients in advance of their session with you so that you can be informed and prepared to explain what a patient will owe you for the session, and what will be covered by insurance.

View Fee Schedule Information

If you are missing a copy of your Fee Schedule, you may be able to access the information through the Availity portal. Utilize the Fee Schedule Listing under Claims and Payments to input all necessary information and search for fee schedule information.

Claim Submission

Submit claims through Availity to participating insurance companies. Claims can either be submitted directly in the portal, or by establishing an EDI connection between Availity and your EHR.

Check Claim Status

Follow ups on claims in Availity are easy! You can view the Claim Status section of the portal and learn where each claim is at in the process.

Receive ERA

Availity allows you to set up ERA delivery directly to your EHR, or you can view ERAs in the portal. This allows you to see how claims were processed and paid out, or learn more information about why a claim was denied.

View Payment Status

Through Availity you can check the status of a claim payment. You can get a clear picture of funds that will be coming into your practice.

Sign Up for EFT Payment

If you have not yet signed up for electronic payment, you can do so through Availity! Say goodbye to waiting for checks through the mail and hello to easy direct deposit!

How Does Practice Solutions Utilize Availity?

Practice Solutions uses Availity the same way that you would, we just provide the opportunity for you to spend what would be administrative time with your patients instead. We handle all of the claim submission, follow up, payment posting, and eligibility checks for you so that you can run your practice worry free! Our billers have their own Availity accounts. We provide instructions on how to add a Practice Solutions Biller as a user to your organization in Availity so that they have the necessary permissions to perform eligibility checks, establish EDI and ERA connections, receive ERAs, and submit and follow up on claims.

If handing your billing tasks over to a trusted and experienced professional sounds like a sigh of relief, we encourage you to contact Practice Solutions! We’ll put you in touch with one of our team members who can give you an overview of what a working relationship with Practice Solutions would look like, and can answer any questions.