How much does Availity cost?
Availity is listed as free to start. Confirm current pricing with Availity before you buy.
Availity connects providers to hundreds of payers for eligibility verification, prior authorizations, claims submission, and remittance posting. Many ABA billers check eligibility in Availity before a learner's first session to confirm ABA coverage and units.
Availity is the nation's largest real-time health information network, facilitating secure information exchange between healthcare payers, providers, and health IT vendors. Founded in 2001 as a joint venture between Blue Cross and Blue Shield of Florida and Humana, Availity has grown into a critical healthcare infrastructure company serving the entire provider-payer ecosystem.
The platform connects more than one million providers with over 2,700 payers nationwide and processes more than 13 billion transactions annually. Availity's core service offerings include eligibility and benefits verification (X12 270/271), claim submission (X12 837), remittance posting (X12 835), claim status inquiries (X12 276/277), and prior authorization solutions. The company's Availity Essentials Pro product suite offers real-time eligibility integration directly into provider EHR workflows, enabling faster decision-making at point of care.
For ABA billing operations, Availity provides critical eligibility verification capabilities that allow behavioral health providers to confirm insurance coverage and authorized units before delivering services. The platform's multi-payer connectivity eliminates the need for providers to maintain separate relationships with hundreds of insurance companies.
Beyond core transaction processing, Availity has recently expanded its interoperability and clinical data capabilities through the acquisition of Diameter Health, integrating advanced data quality and upcycling technology into its clinical portfolio. The company is also developing enhanced prior authorization solutions in partnership with industry leaders to streamline administrative workflows.
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Availity is the company that makes it possible to submit claims and verify insurance, which means providers are stuck with them, and they clearly know it. Nothing about this company suggests they care. The process is bloated and needlessly complicated, the online chat is genuinely awful, and customer support is a dead end. I sent a certified letter precisely because I assumed they’d lose anything that wasn’t tracked. They lost it anyway, and no one could tell me where it went. When I called, I got a representative named Kamesha who was rude, dismissive, and acted like helping me was an imposition. No sympathy, no urgency, no interest in solving anything. She is a perfect example of why dealing with this company is miserable. If you have any alternative, use it. Availity is a big part of why the insurance billing process is as broken as it is, and the experience of actually trying to get help from them only makes it worse.
The process of submitting claims to insurances should be something straight forward. In reality, It became so convoluted nowadays, that third parties (such as availity) help to make the system EVEN MORE CONVOLUTED. Despite providing horrible service, those third parties (availity and others) survive in this inefficient system because you virtually can't submit claims without them. Crazy corporations' world!
In my opinion, this is an awful company and would warn anyone not to engage this company. They began billing us without notice, 3 years after we cancelled their services and sold our operations. We have spent tens of hours attempting to resolve their unauthorized billing and they continuously put up new roadblocks and make ridiculous requests. I wish we had read the horrible reviews before engaging with this company. Run in the other direction and DO NOT work with Availity.
Availity as a whole needs to do far better than the services that is currently provided to dental professionals and services. It's a shame that there are so many things missing from your platform. Come sit with your client/end user base and see how shoddy your program actually is. Will you still be patting yourself on the back for the claim appeal functionality?
Great place to work!!! Fun team building and wonderful colleagues!
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| Qualified reviews | 0 / 60 | No published reviews yet |
|---|---|---|
| Decision facts | 35 / 35 | 8 of 8 disclosed |
| Primary-category fit | 5 / 5 | Clearinghouse & Claims is its main category |
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Availity is listed as free to start. Confirm current pricing with Availity before you buy.
Yes. Availity is listed as a cloud-hosted product.
Availity lists integrations with Amazon Web Services (AWS), Blue Cross Blue Shield (BCBS), Electronic Health Record (EHR) Systems, Practice Management Systems, Hospital Information Systems (HIS), FHIR API Integrations and 1 more.