Learn about Availity

Did you know Availity simplifies provider transactions, such as claim submissions and prior authorization requests, administrative and clinical data exchange, and payer tools? Availity’s secure multi-health plan portal gives you easy access to health plan information.

Availity Offers

Patient registration:

• Get real-time patient eligibility and benefits, including current and historical coverage information
• Submit secure, online prior authorization requests or check the status of existing ones with our Interactive Care Reviewer (ICR)

Prior Authorizations:

Interactive Care Reviewer (ICR) is the Wellpoint innovative utilization management (UM) tool that allows you to:

• Submit prior authorization requests, clinical information and receive status updates without having to pick up a phone or fax any information
• Have instant access to all submission records from any location at any time of day
• Create and submit UM prior authorization cases quickly by attaching clinical documents for review
• Automatically authorize more than 40 common procedures

Claims and payment:

• Find everything you need to take care of your patient’s needs, including claim submissions, detailed payment information, and claim payment disputes
• Submit your medical records electronically when requested to support a pending or denied claim, including an itemized bill and requested medical records

Payer spaces Wellpoint applications:

• Use this digital alternative to making a phone call and get questions answered through a real-time, online discussion with Chat with Payer
• Research procedure code edits and receive edit rationale with Clear Claim Connection
• Access job aids, reference guides, and educational videos through Custom Learning Center
• Locate important policies and forms in the Education and Reference Center
• Complete estimated due date and visit information for expecting patients through the Maternity application
• View images of Wellpoint paper remits from the past 24 months in Remittance Inquiry
• Get a thorough snapshot of your patient’s health and treatment history that now includes gaps in care and care reminders with Patient360
• Access your proprietary reports such as member rosters in Provider Online Reporting

Learning opportunities

Find learning opportunities to assist with administering your patient’s health plan using Availity Essentials multi-payer features and payer spaces applications. Use the library of self-paced courses and instructor-led training sessions, available 24/7 at no cost. Be prepared with the knowledge to assist our members.