What is Availity?

Availity is a secure online portal used by healthcare providers to interact with insurance payers. It’s commonly used for:

  • Eligibility & benefits checks
  • Claims submission & status
  • Prior authorizations
  • Referrals
  • Remittance advice (ERA/EOB)
  • Secure messaging with payers

Logging In

  1. Go to availity.com
  2. Click Log In
  3. Enter your username and password
  4. Complete multi-factor authentication (if prompted)

Tip: Bookmark Availity for quick access.

Home Dashboard Overview

After logging in, you’ll see:

  • Menu (top left): All tools and applications
  • Payer Spaces: Insurance-specific tools
  • Favorites: Frequently used features
  • Announcements: Payer updates or system notices

Eligibility & Benefits (Most Common Task)

Used to verify patient insurance coverage.

Steps:

  1. Menu → Eligibility and Benefits
  2. Select Payer
  3. Enter patient information:
    • Member ID
    • Name
    • DOB
  4. Choose Service Type (medical, dental, vision, etc.)
  5. Submit request

What to Review:

  • Active coverage dates
  • Copays, deductibles, coinsurance
  • Plan limitations or exclusions

Claims Status

Check if a claim was received, processed, or denied.

Steps:

  1. Menu → Claims & Payments
  2. Click Claim Status
  3. Enter:
    • Patient info
    • Date of service
    • Claim number (if available)
  4. Submit

Statuses You May See:

  • Received
  • In Process
  • Paid
  • Denied
  • Pending Additional Info

Claim Submission

Submit professional or institutional claims electronically.

Steps:

  1. Menu → Claims & Payments
  2. Select Submit Claim
  3. Choose claim type:
    • Professional (CMS-1500)
    • Institutional (UB-04)
  4. Enter provider, patient, and service details
  5. Review for errors
  6. Submit

Always double-check diagnosis and procedure codes.

Prior Authorizations

Request approval for services that require authorization.

Steps:

  1. Menu → Authorizations
  2. Select Authorization Request
  3. Choose payer
  4. Enter patient and service information
  5. Attach required documentation
  6. Submit

Track Status:

  • Pending
  • Approved
  • Denied
  • Additional Info Required

Referrals

Used when a referral is required by the insurance plan.

Steps:

  1. Menu → Authorizations & Referrals
  2. Click Referral
  3. Enter referring and servicing provider details
  4. Submit referral

Remittance Advice (ERA/EOB)

View payment explanations.

Steps:

  1. Menu → Claims & Payments
  2. Select Remittance Viewer
  3. Search by date or payer

Secure Messaging

Communicate directly with payers.

Steps:

  1. Menu → My Inbox
  2. Click New Message
  3. Select payer
  4. Write message and attach documents if needed

Common Tips & Best Practices

  • Always confirm payer selection (many plans have similar names)
  • Save frequently used tools to Favorites
  • Check payer spaces for payer-specific rules
  • Log out after use to protect PHI
  • Clear browser cache if Availity runs slow

Troubleshooting

  • Can’t find a payer? → Check Payer Spaces
  • Access denied? → Admin may need to grant permissions
  • System error? → Try another browser or clear cache

Availity is a secure online portal used by healthcare providers to interact with insurance payers. It’s commonly used for:

  • Eligibility & benefits checks
  • Claims submission & status
  • Prior authorizations
  • Referrals
  • Remittance advice (ERA/EOB)
  • Secure messaging with payers