Integrated Eligibility With Availity Essentials PRO Plan

Integrated Eligibility With Availity Essentials PRO Plan

We are working with Availity to bring you integrated eligibility verification. This feature lets you send a request to verify information before rendering services. Verification is done in real time for an individual patient. Please note this feature ONLY WORKS with the Availity Essentials PRO Plan Payor and Eligibility ID numbers - Availity Essentials Pro Plan.

To get started, you will first need to contact Availity directly to ensure that your group is set up for their RCM product. Availity can then send the information outlined below to ticket@icanotes.com so that our Integrations Team can get everything connected.

  • Client ID
  • Client Secret
  • Domain
  • AccountKey

 

In Settings + Directories:  


1.  Go to Group Level Settings & Directories tab > Sites/Letterheads tab > Facility Info tab.


2.  Choose a location in the left column.  


3.  Make sure that the following areas are filled out (see screenshot below):

  1. Site Name
  2. NPI for Facility

 

 

There are areas in Demographics that need to be filled out:


1.  On the Patient Information tab, make sure that the following areas are filled out:

  1. First and last name 
  2. Date of Birth
  3. Where Seen
 

 

2.  On the Insurance Information tab, make sure that the following areas are filled out:

  1. Payer's name (Insurance)
  2. Member ID/Policy #
  3. Group # (optional)
  4. Patient Relationship to Insured
  5. Insured Party (if different than the patient)
  6. Insurance Provider Name (should be autofilled)
  7. Payer ID
  8. Eligibility ID
  9. Insurance Type

 

 

 

How To Use:

 

1.  From the Insurance Information section, click into the Eligibility tab. 

 

 

2.  Click the  button to submit.  This will generate an ANSI message (270), convert it to XML which sends to the clearinghouse (Availity), then ICANotes receives an XML, translates the ANSI, and then parses the ANSI into read-only information which can be viewed on the Integrated Eligibility tab.  

 

3.  If you want to see all the benefits, click the  button.  You will see the entire benefit details by scrolling up and down in the popover button.  

 

 

Note:  If you receive an error, verify that all the information noted above is filled out and try again.

  

 

In situations where the clearinghouse returns an error message or is non-responsive, you can click on the error message itself to see a pop-out that will provide more contextual information about the error. The following is an example error message

 

  

  

Watch our video demonstrating the Availity Eligibility Verification process:



Video Link: https://youtu.be/upjZ5o7d5Hk

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