Availity

Availity operates the nation's largest dual-sided, real-time healthcare network, connecting over 3 million providers with payers and health information technology vendors. The platform processes over $4 trillion in billed claims annually and provides direct connectivity to 95% of payers nationwide, along with 17,000 connected B2B partners.

The company specializes in reducing administrative friction between healthcare providers and payers through workflow automation, real-time eligibility verification, prior authorization management, claims processing, and revenue cycle optimization. Their technology platform integrates administrative and clinical data to support end-to-end healthcare transactions, from eligibility checks through claims submission and remittance. The platform emphasizes FHIR API connectivity and EHR integration to embed functionality directly into clinical workflows.

Availity serves as a neutral intermediary facilitating collaboration between providers, payers, and health IT vendors. The company has demonstrated measurable results including reduced denial rates, improved clean claim percentages, and accelerated prior authorization processes for major health systems and national payers.

Choose Availity when comprehensive payer connectivity and high-volume transaction processing are critical business requirements. The platform excels for organizations seeking to reduce claims denials, accelerate prior authorizations, and improve revenue cycle efficiency through real-time data access and workflow automation.

Expect a platform-based engagement model rather than custom development. Availity provides standardized connectivity solutions that leverage existing network infrastructure, enabling relatively rapid implementation compared to building direct payer connections. The dual-sided approach means improvements benefit both provider operations and payer efficiency.

Availity is exclusively focused on healthcare, specifically addressing the administrative complexity between healthcare providers and payers. The platform supports HIPAA-compliant transactions including eligibility verification, prior authorization, claims submission and status, and remittance processing. The company specializes in both administrative data exchange and clinical data integration for value-based care initiatives, quality reporting (HEDIS), and risk adjustment programs.

Their solutions directly address healthcare-specific challenges including clean claims rates, denial management, prior authorization delays, and payment accuracy. The platform's FHIR API capabilities support interoperability requirements under federal regulations.

Organizations operating at significant scale with high transaction volumes across multiple payers. Health systems with complex revenue cycle operations, medical billing companies serving multiple provider clients, health plans seeking to improve provider engagement, and healthcare IT vendors requiring robust payer connectivity infrastructure to support their applications.