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

Our single platform approach provides immediate visibility into revenue cycle opportunities, tackling some of today's biggest challenges with the following Productized Analytics Suite Modules:

  • Workforce Quality Insights (WQI) – Links front-office actions to financial KPIs
  • Patient Access Insights (PAI) – Enhances financial experience pre-service
  • Revenue Integrity Suite (RI) – Reduces denials and compliance risks
  • Productivity Analytics (PA) – Improves staff productivity in real-time
  • Cost Insights (CI) – Targets controllable costs
  • Business Office Suite (BOS) – Unifies patient accounting data
About MedeAnalytics:

Founded in 1993, MedeAnalytics is an innovation-focused company. Over the past three decades, we have worked tirelessly to reimagine healthcare through the power of data—and helped thousands of organizations achieve their potential along the way.

Leveraging state-of-the-art analytics and data activation, MedeAnalytics delivers actionable insights that support payers, providers, employers, and public entities as they navigate the complex healthcare landscape.

Using artificial intelligence and machine learning alongside the most advanced data orchestration in the industry, we empower organizations to optimize their resource allocation, experience superior patient outcomes, and achieve population health management goals.

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

Product Capabilities

360° View of Enterprise: Integrates clinical, financial, operational and claims data for a longitudinal view across disparate data sources, encompassing front, middle and back-office functions.

Medeanalytics' Data Science Factory is always generating new components and services to help you automate workflows, detect anomalies, assess risk, anticipate trends, and close care gaps.

MedeAnalytics helps users identify key outliers in their data and distribute the right actionable information to the right people – at the right level – throughout the enterprise. Users easily navigate through scorecards, dashboards, key performance indicators, critical success factors, and other key reporting features. In seconds, they can zoom from high-level KPI’s down to fine-grain transaction detail; from the Executive perspective to the view from any cubicle.

HITRUST Certified, NCQA Certified, AICPA SOC, TRUSTe Certified Privacy Patent-pending technology and industry critical certifications (HEDIS® certified, Data Aggregator Validator (DAV) designation pending)

MedeAnalytics' API ecosystem seamlessly integrates into multiple clearinghouses, payment processors and other third-party tools to bring all applicable registration tools into one platform, resulting in improved operational and financial efficiencies.

MedeAnalytics Innovative solutions help RCM leaders like you predict the denial, the fix, the dollars, and the deposit date – all before the 835 ever arrives. Here’s how we’re driving measurable impact: Accelerated Cash Flow • Predict denials before submission • Reduce Days in A/R • Accelerate cash flow by up to 30 days Increased Recovery Rate • Address issues proactively, not reactively • Fewer write-offs, reduced denials • Improve recovery rate by 20% Reduced Administrative Costs • Focus staff on high-priority denials • Lower labor costs • Save 20 minutes per denial on research & resubmission Revenue Optimization • Prioritize high-dollar claims based on predicted payment likelihood

MedeAnalytics performance analytics consists of real-time insight into quality, how to capture workflow issues at the registrar level to prevent downstream denials, organizing patient data longitudinally.

Patient Access Intelligence is a flexible workflow platform incorporating all aspects of the financial clearance process into a simple task-based work list to support centralized, distributed and hybrid revenue cycle models. With a robust API ecosystem, we seamlessly integrate multiple clearinghouses, payment processors and patient engagement tools to fortify your revenue cycle against data compromises and outages.

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:

None provided

Pediatric use cases:

None provided

Users:

None provided

EHR Integrations

Integrations:

None provided

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Other

Hardware Compatibility:

Desktop, Other

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Pop health platform, Home health, Behavioral health, Community based organizations, ADT, Access +/or revenue cycle, Credentialing, Website / public online sources, Other

EMR Integration & Relevant Hardware:

Recommended, but not required

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose, Point Click Care

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:
  • Detailed and summary level reporting for different views to serve multiple purposes; 
  • Standard and ad-hoc reporting allowing clients flexibility to slice/dice based on unique corporate needs;
  • Incorporation of MedeAchieve across entire RCM portfolio to incorporate metric tracking into key enterprise initiative tracking;
  • Worklisting available throughout the RCM workflow;
  • Vendor flexibility – Plug & play any vendor into existing Mede workflows;
  • Robust rules engine to drive efficiencies and streamline workflows;
  • Integration of AI Agents to streamline and reduce manual entry;
  • Predictive analytics using AI intelligence;
  • Focus on productivity analytics to highlight and stratify registrar performance;
  • Integrated Financial Clearance Workflows to maximize revenue generation

Differentiators vs Competitors:

Enterprise Analytics - MedeAnalytics helps users identify key outliers in their data and distribute the right actionable information to the right people – at the right level – throughout the enterprise. 

MedeAnalytics can measure revenue and practice performance across the entire system. Our approach to organizing data into a patient longitudinal record has led to improved financial, operational, and even clinical performance.

Our Integrated MedeAchieve solution improves strategy execution with action plans that define your objectives, align staff around shared goals, and track progress in a closed­ loop system.

Keywords

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Company Details

Founded in 2001

Founded in 1993

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