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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:

Agentic AI employees for healthcare

Explore our custom AI employees for critical back office, revenue cycle, and administrative healthcare workflows. Some of our most popular include full automations for:

  1. Prior authorizations
  2. Claims processing
  3. Insurance verification
  4. Payment posting
  5. Patient enrollment
  6. Denial management
  7. Claim scrubbing
  8. Credentialing
  9. Charge reconciliation

How Magical works

Fully automate rev cycle workflows

Use an AI employee trained specifically in revenue cycle management to automate entire processes end-to-end. (No human oversight required.)

Lower your cost to collect

Unlock the efficiency of a machine. Magical pulls patient patient data directly from one system into another, to minimize insurance denials and delays.

Built for enterprise security

Maintain the highest levels of security and privacy. We never store any personal health info on our servers. 

Daily Automated Testing | Automation Logs | SOC2 & HIPAA Compliant

Best-in-class reliability

Get over 90% success rates on end-to-end automations of any complex workflow. Magical uses multi-agent evaluation infrastructure to ensure your automations are running smoothly. 

Performance monitoring

Dive into complete logs of every single step of every single automation to give your team clear visibility into success rates and edge cases. 

Who we are

A blended team of 40+ technology and healthcare experts. Not only will you be working with agentic AI engineers, but also seasoned rev cycle experts. 

Why we’re trusted

Over 100,000+ companies—including WebPT, Phreesia, SonderMind, and Curalta—trust Magical automations for the following reasons:

  1. Fast: 1 week average implementation time
  2. Reliable: 90%+ average success rate end-to-end
  3. Proven: 100% agentic automation (no bots)
  4. Scalable: Magical runs entirely on virtual machines
  5. Interoperable: Magical can rapidly integrate with any system
  6. Compliant: Magical is SOC 2 and HIPAA-compliant
About Magical:

Magical is an agentic AI platform that fully automates complex workflows in just one week. Put your back office on autopilot with AI employees that use human-like decision-making and best-in-class reliability. 

Who we are

A blended team of 40+ technology and healthcare experts. Not only will you be working with agentic AI engineers, but also seasoned rev cycle experts. 

Why we’re trusted

Over 100,000+ companies—including WebPT, Phreesia, SonderMind, and Curalta—trust Magical automations for three key reasons:

  1. Fast: 1 week average implementation time
  2. Reliable: 90%+ average success rate end-to-end
  3. Proven: 100% agentic automation (no bots)

About the technology

Fully agentic

Magical AI agents use reasoning models, real- time data retrieval, and goal-based execution to make your automations more reliable than traditional rule-based approaches. They can adapt to changes on the fly, and learn from failures. 

Best-in-class reliability

Get over 90% success rates on end-to-end automations of any complex workflow. Magical uses multi-agent evaluation infrastructure to ensure your automations are running smoothly. 

Performance monitoring

Dive into complete logs of every single step of every single automation to give your team clear visibility into success rates and edge cases. 

Scalable

Magical runs entirely on virtual machines

Interoperable

Magical can rapidly integrate with any system

Compliant

Magical is SOC 2 and HIPAA-compliant

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

Make your workflow automations self-driving Traditional automations (RPA) is rigid and fragile, like driving manually to a destination using printed directions. If you miss a turn or make an error, everything quickly breaks. Agentic AI is like a self-driving car that understands your goal and the nuance it takes to get there. This is intelligent automation that course-corrects, identifies shortcuts, and gets smarter over time.

Magical is SOC 2 and HIPAA-compliant

Verify patient insurance in seconds—not hours—with your new AI employee for eligibility and benefits verification. Fully automated verifications Magical AI employees log into payer portals, search for patient eligibility, and pull coverage details—automatically and accurately. Real-time benefit checks Automatically verify deductibles, co-pays, and plan-specific benefits so your team is never in the dark. Catch problems before they become denials Identify inactive policies or mismatched details upfront, so you can fix issues before submitting claims.

Identify, fix, and resubmit denied claims—automatically—with an AI employee that never misses a deadline or a denial reason. Auto-identify denials at scale Magical reviews ERAs, EOBs, and payer responses to flag and categorize denials in real time. Fix root-cause errors instantly Whether it’s a coding mismatch, missing modifier, or eligibility issue—Magical uses context-aware logic to correct and prepare clean resubmissions. Automate appeals and resubmissions Magical navigates payer portals, fills out appeal forms, and resubmits claims—without human input.

Set up an AI employee to automatically monitor the status of all prior authorizations and keep them up-to-date.

Use an AI employee to verify all information and flag any potential errors for human review. If the request looks clean, you can enable your AI employee to automatically submit it.

Automatically open and extract information from any PDF or patient file, as part of the overall workflow automation process.

Use an AI employee to automatically complete forms more reliably than any RPA bot. Get pixel-perfect precision in any EMR or insurance portal, as well as independent AI judges to verify successful form completions.

Eliminate manual data entry and reduce denials by over 50% with your new AI employee that specializes in prior authorizations. Automate prior auths end-to-end using AI Magical reliably moves patient information from your EHR and submits directly into insurance portals and prior authorization systems. Export information to any authorization form Magical recognizes information on insurance portals and automatically maps it to the right fields, getting smarter over time. Human-in-the-Loop Verification Magical combines AI automation with human verification to maintain complete accuracy and compliance in your prior authorization process.

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:

Use case dependent

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:

Desktop

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:

None provided

Differentiators vs Competitors:

None provided

Keywords

Images

No images provided

No images provided

Videos

1 of 2

edit-media

No videos provided

Downloads

https://www.availity.com/essentials

No content provided

Alternatives

Company Details

Founded in 2001

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