Availity
Collaborating for patient care requires constant connectivity and up-to-date information. Simplifying how you exchange that information with your payers is more important than ever. Availity makes it easy to work with payers, from the first check of a patient’s eligibility through final resolution of your reimbursement. You want fast, easy access to health plan information. With Availity Essentials, a free, health-plan-sponsored solution, providers can enjoy real-time information exchange with many of the payers they work with every day. Availity also offers providers a premium, all-payer solution called Availity Essentials Pro. Essentials Pro can help enhance revenue cycle performance, reduce claim denials, and capture patient payments. Availity remains your trusted source of payer information, so you can focus on patient care. Our electronic data interchange (EDI) clearinghouse and API products allow providers to integrate HIPAA transactions and other features into their PMS.
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Definitive Healthcare
Access the highest quality data and intelligence on hospitals, physicians, and other healthcare providers - updated daily. We help companies across the healthcare ecosystem grow their businesses and create new paths to commercial success. Here are just a few reasons why we’ve been a leader in healthcare commercial intelligence for 10 years and counting. Fueled by powerful data science and AI, we have intelligence for all your commercial needs. Healthcare commercial intelligence untangles the web of data on delivery systems, physicians, payor, patients, government organizations and more to identify the people, opportunities and organizations that are the best fit for your product. Building and selling a product for the healthcare market is complex. Answers to critical questions are often buried in disparate information systems, making centralized insights hard to come by. Healthcare commercial intelligence (HCI) is a new category of software that untangles the web of data on delivery.
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Consensus Harmony
Access numerous endpoints, securely and simply with one API connectivity and avoid developing one-offs to disparate healthcare systems. Bridge the gap between multiple systems, standards, and data sets, using a single point of access for developing interoperability. Consensus Harmony includes universal healthcare APIs, cloud fax APIs, electronic signature APIs, and connectivity to multiple participating EHR partners and other leading industry cloud marketplaces. Flexible interoperability options to programmatically integrate digital faxing, secure messaging, patient record requests, e-signatures, and more into key workflows like payments, prior authorizations, and referrals. Extend your capabilities and access new information networks by partnering and leveraging community providers already integrated. Don’t limit the network you communicate with, leave the modality of communication up to our technology.
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InvisaClaim
InvisaClaim AI Revenue Cycle Management that prevents denials and wins the ones that slip through.
The most advanced all-in-one platform for billing companies and RCM teams. Before claims go out, Pre-Submission Check and Pre-Check AI scrub them against NCCI edits, coding conflicts, and payer rules stopping denials at the source. When one slips through, upload or live-feed a denial letter or 835 ERA and AI extracts patient data, CARC/RARC, CPT/ICD-10, amounts, and deadlines then drafts a payer-specific appeal in 60 seconds across 30+ payers.
Modules: Pre-Submission Check, Denial Workbench, NSA/IDR (eligibility, QPA, GFE & IDR letters), Prior Auth, A/R aging, NPI verification, deadline alerts, full audit trail.
Connects to your clearinghouse and EHR: Change Healthcare/Optum, Waystar, Availity, Athenahealth (pipeline), plus a FHIR R4 layer for EPIC/Cerner.
HIPAA Compliant · SOC 2 · 256 Encryption
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