Learn about Availity

Availity  is a portal for providers and staff that simplifies provider transactions, such as eligibility and benefits inquiry, claims submission, claims status inquiry and authorizations.

Find these tools on Availity

Patient registration:

• Get real-time patient eligibility and benefits reports, including current and historical coverage information, plus detailed coinsurance, copayment, and deductible information.
• Submit secure online authorizations or check the status of existing ones with our Interactive Care Reviewer (ICR).

Prior authorization:

The ICR tool in Availity is the Anthem Blue Cross and Blue Shield Medicaid (Anthem) utilization management (UM) feature that allows providers and staff 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 authorization requests quickly by attaching clinical documents for review.
• Automatically authorize more than 40 common procedures.

You can access the ICR from the Availity Portal home page.

Claims and billing:

• Find everything you need to take care of patient billing, including claim submissions, claim status, detailed payment information, claim payment disputes and appeals.
• Attach medical records and documents electronically when needed to support a pending or denied claim.

Payer Spaces applications:

• Research procedure code edits and receive edit rationale via Clear Claims Connection.
• Locate important policies and forms in the Education and Reference Center.
• View images of Anthem paper remits 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 reports such as member rosters in Provider Online Reporting.

Note: Your organization's Availity administrator must complete a separate registration process and grant access to users in the organization in order to access certain tools like member panel listings and member reports. 

You can confirm who has Availity administrator access in your organization any time via your Availity account dashboard.

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.