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Availity

Revenue cycle management & EDI tool for healthcare industry

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Availity Reviews

Reviews summary

Pros

I love how i can verify insurance and obtains authorizations on so many different insurances all in on place. It's nice how they have both out of net work and in net work benefits.

melissa R.

I do like the convenience and ease of use of the site. The software is very up to date and mostly helpful.

Melissa G.

The experience is a good one and I would recommend this to anyone.

Cassandra L.

Cons

They have nothing to do with denials or claims that has been denied. I will stop here because I run into at least 2 or 3 issues a day for Availity.

Quyen M.

It is an awful site that does not try to do customer service or fix their problem. They try to close your tickets before it is resolved and when you tell them there is an issue.

Quyen M.

I still have the same problem after they say these things.

Quyen M.

Overall rating

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77%
positive reviews
86%
would recommend this app

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105 reviews

recommended

Overall Rating

Increases efficiency and flow of patient care

Reviewed a year ago

Transcript

Claire W.: Hi, my name is Claire. I am the co-owner of our business, and we operate in the chiropractic...

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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Perfect for looking up anyone's insurance

Reviewed 2 years ago

It allows us to get insurance information for our patients pretty seamlessly and makes it super easy!

Pros

What I like most about this software is that you are able to look up insurance for anyone. It gives you details that you need for the service that you are providing without having to always call the insurance themselves to get the information you need.

Cons

What I like least about this product is that if you are looking for specific details about a service sometimes it does not give you what you need. Also, it tends to time out as well as have maintenance issues every now and then.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend8/10

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The program does make a great all in one clearinghouse for medical claims and payments

Reviewed 2 months ago

Honestly I have mixed feelings about using this the way we currently are because of all the problems we have had, and at times, still continue to have. Our account manager has been great working to correct these but I do not think their setup and implementation teams do a very thorough job or we wouldn't be still having issues we are cleaning up from switching.

Pros

I like that the program is easy to use, correct claims, and get payments off of. It makes it nice having one program that functions as a full clearinghouse for claims. Their customer service and account managers are great to work with as well!

Cons

That claims do not stay in there longer than 5 days, EDI setups are not always completed, and payment remits are frequently missing from the listings.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support

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Availity= problems

Reviewed 2 years ago

Awful! It is an awful site that does not try to do customer service or fix their problem. They try to close your tickets before it is resolved and when you tell them there is an issue. They tell you there is no issue.For instance, trying file a dispute on a claim and there is no Dispute option. I get this a lot and they tell me "there is no problem... You can file dispute...It has been resolved..." I still have the same problem after they say these things.

Pros

You can go to Eligibility to claims...most of the time.

Cons

There is a long list. A lot of times you cannot pick options like the secured message, disputes, etc. on claims. Then when you try contact their support team/customer service.They do not try to help you resolve your issues and they close your tickets before it is even solved. I spent over a week trying to explain to them things like your portal supposed to shows claims and Assurance (the support says it was Assurance issue) is where we send claims electronically. They have nothing to do with denials or claims that has been denied. I will stop here because I run into at least 2 or 3 issues a day for Availity.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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Everything in one Place

Reviewed 3 months ago

Availity has navigated me through the process and it seems to be self explanatory. I have never needed customer service and it allows you to update your provider through the system by sending reminders and even shows you in the announcement section. The experience is a good one and I would recommend this to anyone.

Pros

I love this software. Availity is easy to navigate and answers all of your questions under one roof. It is very easy to use and has limited hangups. You can find EOBs, Patient insurance information, documents, informational documents, announcements, and corrections to the facility in which you are registered. There are many ways to find your patients information and if claims were paid. Although we haven't extended out to all of the payors, the ones we do have on file and within the pay spacers, we can find them all. The information is easy to print for patient folders and everything is up to date.

Cons

I have problems often logging in, not because the system can't find me but because when you hit the log in button, it will hesitate or you will have to hit it a couple of times for the system to log in. That is really the only issue I've had with the system.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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I use Availity to check claim and eligibility status for various insurances.

Reviewed 3 years ago

I give it "Extremely likely" to recommend this product to others because some insurance companies will only deal with you through Availity. You just have no other choice. If that were not the case, I would still give it a 7.

Pros

I like that I have access to eligibility and claim status for multiple insurance companies in one place. Some of the companies even let you manage your prior auth/referrals through Availity.

Cons

Sometimes Availity fights with me horribly. I would like to be able to use our billing NPI to check the status of claims for all insurance companies, but most require the provider's NPI and that is just more difficult. Also, a few of our newer provider's NPIs are not loaded so I can't check their claim status at all. That is frustrating because some insurance companies won't give you claim status over the phone.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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A great way to check insurance benefits and claims services

Reviewed 2 years ago

It is a delight to have this option rather than calling in and having to wait on hold for a quick question.

Pros

I am able to access Availity and find out the status of claims or check eligibility without having to go through the steps of calling in and waiting on hold. This saves so much time on a daily basis.

Cons

I can't look up a client by name and birth date without the insurance number. This can pose a problem if numbers were inverted. This is a small problem that is usually solved by bringing up the insurance card and double checking.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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Great Application

Reviewed 7 months ago
Pros

This is a great tool for working in reimbursement in healthcare. It has all your payers at your fingers.

Cons

Not much that I do not like. I guess I would have to say that the waiting time for some remits to show.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend3/10

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Could be Much Better, if they cared

Reviewed 2 months ago

Just today, it tells me I have 1 business to verify and update the info for the quarter. But, the business is not listed. So, I try to add the business and its says I can't do it because its already listed. What the?1? This is a portal for many different insurances, which is great, in concept. But, each internal portal for the insurances operates a little differently. For example, one Blue Cross you search claims by group tax id. A different one forces you to search by individual provider NPI. And, don't get me started on Availity customer service. The rep with ALWAYS tell you they don't have an answer and it must be an issue with the insurance. It is never a problem with Availity. We are on the Availity platform, so they should help with the answer. So, what's the provider to do?

Pros

Free. Claims status. Secure email and chat.

Cons

customer service is very bad. I don't like it that each insurance can create its own rules. Availity should insist on consistency.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend8/10

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Availity makes my job easier!

Reviewed 2 months ago

My overall experience with Availity has been a good one. I do not have any complaints at this time.

Pros

I like being able to go online and look up information rather than having to make an actual phone call. My job requires me to answer the phone and check patients in and out. Availity helps make my job easier by allowing me to look up information on my time.

Cons

I have been fortunate in my experiences with Availity. I have not encountered anything that would cause me to dislike this software.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend8/10

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Makes insurance verification and benefits easy

Reviewed 4 months ago
Pros

Easy to navigate benefits and insurance verification. The added feature to verify pre-determination by CPTs is a timesaver. Remittance search easy to navigate. Love being able to see CMS benefits and eligibility. Easy to navigate to payer spaces for additional information.

Cons

Claims search can be cumbersome if you don't have a claim number already. Also, wish more insurance companies available versus having to log in to different portals.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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Major time saver and generates accurate benefits/eligibility information!

Reviewed 2 years ago

Availity has increased productivity and efficiency in the office as a major time saver. In most cases, Availity has replaced the need to call insurance companies and deal with long hold times, inaccurate information, and miscommunication with insurance representatives.

Pros

Availity is a game changer when it comes to checking general patient health insurance policy benefits/eligibility. Phone calls to insurance companies can take up to an hour so the fact that Availity is capable of pulling up the same information in less than a minute is incredibly valuable. Furthermore, when I have compared the information generated through Availity to the details verbally given over...

Cons

There is a feature on Availity that allows you to pull up the actual image of a patient's insurance card, which is really great. It usually doesn't work, however. It would be great if this tool was fully functional and could bring up the ID itself. There are a few major insurance companies that aren't available via Availity, so we end up needing to call for those patients.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend9/10

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Availity hits the mark for most insurance companies, but is inconsistent with others

Reviewed a year ago

I've used Availity for many years as a practicing health care provider and later as the owner/manager of a medical billing company. They've added a tremendous number of insurance companies over the past 3 years in particular and I suspect we'll find that as Availity builds out their back end product many more smaller insurance companies will turn to Availity. Unfortunately the data presented is only as good as what the insurance companies provide so in many cases Availity can't replace a phone call.

Pros

Access to a large number of insurance companies eligibility and benefit information. Integrated claims review/status system. Preauthorization system works well. They listen to their users requests and feedback. They revamped one module to make it "responsive" and made it harder, not easier to use. They listened and rather than rolling back the changes, incorporated them in a new version.

Cons

The different modules could fit/work together better. (although I will admit they are making improvements). Their system doesn't handle many different tax IDs/providers well and has the platform has grown, the red tape and "authorization" bloat makes it difficult/time consuming for 3rd party billers. As a daily user, I'm frustrated with the amount of "white space" between entry fields which requires alot of scrolling. I also am not fond of their new EOB format. It is consistent between carrier and is not print friendly.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend6/10

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Availity Review

Reviewed 2 years ago

I wish some of the other features, like submitting authorizations worked. It has not worked for us since it launched. As far as patients benefits and eligibility though just finding out the basics such as what a patient owes for their visit is a beeze.

Pros

I like the ease of verifying benefits for our patients. It's quick and easy. Easily accessible. Never really have to worry about the site being down like other websites.

Cons

I do not like how they generalize the authorization benefits. Many patients it lists that authorization is required, however, when we call the company specified, they will tell us no authorization is required. I wish it were more true to each specific plan and not just generalized. We waste a lot of time on the phone to find out that an authorization it truly not required. Also, their tracking of benefits, most of the time does not work. We have had patient use up all their allotted benefits, and the website will still show they have all their visits remaining, when they truly do not.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend9/10

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Insurance Benefit information at your fingertips!

Reviewed 2 years ago

We are highly satisfied with Availity. The login process is simple, multiple users are allowed, we can search and use the software with ease. Information provided is accurate. Very satisfied

Pros

For years, our office would call the individual insurance companies to obtain insurance benefit information for our services. This would hold up a phone line, it would tie up our staff from providing the best service to our patients in the office... it wasn't a good situation. I was introduced to Availity a few years ago and have been impressed ever since. I can easily review patient benefits without skipping a beat in our conversation. A couple of key data entries and I can easily review and discuss with the patient what their financial responsibility would be for our care. Printer friendly too - which means we can supply all office staff with the pertinent information or give a copy to the patient.

Cons

The only con to Availity is that I wish they were enrolled with MORE insurances. There are still a few insurance companies that are not enrolled with Availity and that makes it difficult. I am so accustomed to using the software with patients, it is difficult to comprehend how tedious it is to call IVR options for non-enrolled insurances.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend9/10

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Super Helpful and a Great Time Saver!

Reviewed 2 years ago

Availity is a super helpful tool that saves you from having to deal directly with patient's insurance companies. It's a big time saver!

Pros

Availity was used in my previous office to check medical insurance benefits for our patients. When I first started there my job was to call the insurance companies directly and check to see what fertility benefits the patients had. This was a complete nightmare and sometimes I would be on the phone for a couple of hours checking benefits for one patients...and sometimes I never got the info I needed. It was SO time consuming and frustrating. When Availity came along - it allowed me to check their benefits in a matter of seconds. A few insurance companies are not on Availity - so occasionally you still have to call.

Cons

Availity customer service do not seem to be very helpful when you need to call directly. I also somehow ended up calling a different department at Availity and could never get transferred top the area that I needed. I just stopped calling Availity. If I needed info and had to call - I just called the Insurance company directly instead.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend6/10

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Availity for Chiropractic Practice

Reviewed 2 years ago

Overall my experience with availity is positive. It is convenient to be able to check benefits from multiple insurance companies in one place. Customer service has been good when needed.

Pros

Availity allows you to check patient insurance benefits for multiple insurance companies. It is convenient to be able to check the majority of benefits in one place. One of my favorite features is the ability to add patients into the system so you don't have to re-enter their information every time you need to check benefits.

Cons

Availity doesn't always provide the necessary benefit information. We often have to call the insurance company to get the necessary details. Sometimes the benefit information provided on Availity is different from the information given over the phone. Acupuncture benefits are often incorrect, so we must call to verify for every patient who gets acupuncture treatments.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend7/10

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Availity

Reviewed 3 years ago
Pros

pros for Avalility are being able to pull insurance verifications for certain insurance like Florida Blue, and print remits for checks we receive with the EOB attached. its pretty easy to use but the page does seem a little busy so sometimes it can take you a minute to find the link you need to click on if its not one you use all the time. it very easy to setup new employees with access and to do a password reset. the informartion given on the verifications is very helpful and gives more than some of the

Cons

i recevie emails telling me i hav med dos request when i do not use the clearinghouse portion of the software, then a few days later i will get an email saying i dont need to send anything.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend9/10

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Saves crucial time and gives real-time insurance details

Reviewed 2 years ago

This software allows us to discuss financial details with the patient that increases their understanding and maximizes our time with them.

Pros

This software allows us to pull real-time insurance plan coverage that is customized to our specific niche in the industry. This allows us to discuss financial details with the patient that increases their understanding and maximizes our time with them.

Cons

With a few smaller insurance plans (i.e. HealthChoice), we've learned the hard way that the information Availity shows is consistently incorrect. It will show a patient has a copay, when in reality they need to meet a deductible first. Initially, it created real difficulty and embarrassment regarding patient financials.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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Simple and Easy Program

Reviewed a year ago

We use Availity daily to check eligibility for patients, check claims status, look up payments, and submit appeals. I find it to be the most useful insurance portal for these purposes that we have.

Pros

I appreciate the user friendliness of Availity, and the convenience of having so many insurances available on one website to check eligibility, claim status, records requests, etc. Some very useful insurance-specific functions have been added in the last few years that are incredibly helpful as well (ie BCBS ERM, BCBS "Reporting on Demand").

Cons

Some of the insurance-specific functions can be tricky to find, but our insurance provider reps have directed us to many helpful things in the last few years.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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A necessity for medical offices

Reviewed 2 years ago

Our medical practice depends heavily on Availity's website on a daily basis. It allows us to look up patients' insurance benefits through most insurance companies without having to call in, Electronic Remittance Advices are easy to look up, and we are able to keep insurance companies up-to-date with our practice and doctor information through their services. And best of all, it's free! We have used Availity for years, and plan to continue for many years to come.

Pros

This website allows a variety of necessary functions for any medical practice. It is easy to use, and very convenient.

Cons

Their customer service leaves much to be desired. And the CareCalc/Cost Estimator functions often go down.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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Availity

Reviewed a year ago

We love the ease of having all the Anthem claims information and eligibility in one place. It has helped save time for the users in the office while checking people in and out.

Pros

I like the ease of having eligibility and claim explanation of benefits all in one place. It is easy to use and to find things. It is a staple in our office. Easy to look up all the Anthem claims and EOB's for discussion on the phone with patients.

Cons

I do not like it when the system is down and we can not use it. It doesn't happen very often, but it does from time to time.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend8/10

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Availity

Reviewed 2 years ago
Pros

We use Avality most for Insurance verification and to pull remits for certain payors. its very easy to use when verifying insurance its give you up to date correct information

Cons

I often get emails saying I need to attach medical documents to claims when we don't submit claims through availity, its also difficult sometime to pull up remit information with a check # because of although the check I have in front of me might say BC/BS Minnesota I may have to use a different payor name on the list in availity

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend9/10

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Great online resource to review health insurance benefits!

Reviewed 2 years ago

Overall, this has been a very useful program and in my opinion, the best place to check Medicare insurance benefits. There are many insurances accessible in this website, which is great also. The very first time I used it, I was able to navigate through the program and do exactly what I needed to without explanation or confusion. Definitely worth using if you need to access health insurance information, and beats a phone call for benefit checks any day!

Pros

I can check health insurance benefits online, update provider profiles, access many different insurances companies and it's all very user friendly and easy to understand.

Cons

Some of the health insurance companies only have limited information on the website, so it can feel frustrating when you can't access everything you'd like to.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend9/10

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Great product

Reviewed a year ago

Availity has good customer support. They come to your office if needed to provide onsite training.

Pros

This product is easy to use and has streamlined our process by allowing one resource for multiple insurance carriers. We are able to do claims status, eligibility, benefits, prior auths and many other duties.

Cons

I am not a huge fan of the screen changing for different insurance carriers. I would prefer the same format for all insurance carriers.

Overall Rating
  • Value for money
  • Ease of use
  • Features
  • Customer support
  • Likelihood to recommend10/10

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Easy to Use! Fast Results!

Reviewed 3 years ago

Up to date Insurance eligibility answers.

Pros

We use this software to check insurance eligibility for our patients. Its quick! Has multiple search options to find your patient and the results are easy to understand.

Cons

If there is something that can be considered a con: It would be the verification of information on a quarterly basis. We are a home health agency and not an MD office so navigating through the verification questions are cumbersome.