Stop Waiting Days - Get Answers in Minutes on Prior Authorizations

The Health Insurance Privacy and Accountability Act (HIPAA) 278 transaction standard, enacted in the 1990s, was designed to let providers notify health insurers about scheduled admissions and referrals, request prior authorizations, and receive responses from payers through electronic clearinghouses. These are the same clearinghouse practices used to send claims, check claims status, check insurance eligibility, and receive remittance advice. Unfortunately, while clearinghouse practice automation adoption is at the 80 to 90% range, prior authorizations hover around 7 to 10% according to the 2015 CAQH Report.

Hopefully you haven't learned the hard way that these "bare bones" 278 transaction based solutions just haven't work in most cases. Unfortunately, many of these providers invested valuable resources, time and money to no avail and found that pulling their support of these 278 transaction based solutions and reverting back to the manual process of securing authorizations was a better solution.

Come to booth 120, in Las Vegas, or email [email protected] to find out how Availity's payor centric solution (Availity is owned by 26 Blue Cross Plans, including Anthem, Humana, Cigna and Aetna) that leverages a 300K rules based engine , proprietary technology, integration with over 300 payors (including benefit plan consolidators like AIM, eviCore, and Magellan) to create touchless authorizations on 80% of the cases requiring prior authorizations.