Availity Billing Services
Complete medical billing run through Availity — claims, remits and denials moving through the clearinghouse your practice already uses: you keep your EHR and your workflows; we supply the billing team.
Availity operates one of the largest health information networks in the United States, connecting providers with most major health plans for eligibility checks, claim submission, claim status and electronic remittances. Many payers route some or all of their provider transactions through Availity — for certain transactions it is the only channel a payer offers. If your practice transacts through Availity, Elite Bill Care runs your billing through your existing Availity access: you keep your EHR and your workflows; we supply the billing team that works the network every day.
What we do with Availity
- Eligibility and benefits verification across Availity's multi-payer network before visits, including payers that offer no other electronic route (see eligibility verification).
- Claim submission for payers routed through Availity, with submissions confirmed rather than assumed (see electronic claim submission).
- ERA posting and reconciliation — 835 remits delivered through Availity posted and matched to deposits (see payment posting).
- Denials and AR follow-up — claim status checked in Availity, denials categorized, appealed and worked down (see accounts receivable management).
- Reporting — collections, aging and denial trends on a regular rhythm (see reporting and analytics).
Platform-specific workflow
Availity's value is breadth — one login reaches many payers — but each payer still adjudicates by its own rules, and some transactions, attachments and remits live in Availity even when the claim itself originated in your EHR. Our team works Availity daily: checking claim status where the payer actually answers, retrieving remits that never surfaced in your practice management system, and keeping each payer's Availity enrollment — especially ERA delivery — pointed at the right account so payments and their explanations arrive together. Eligibility responses are kept against the patient record, so when a claim is later questioned, the coverage verified before the visit can be produced.
Because payer routing through Availity varies — one plan may take everything through it, the next only eligibility — we map your payer mix channel by channel at onboarding, so nothing is sent down a route the payer does not read. That mapping also covers authorizations and attachments where a payer requires them through Availity: requests go out through the channel the payer actually reads, with reference numbers recorded against the claim. The result is that Availity becomes what it is meant to be — one front door to most of your payers — instead of one more portal nobody has time to check.
No migration, no disruption
There is no clearinghouse switch and no EHR change: we work as named users under your organization's existing Availity account, covered by our Business Associate Agreement, and billing continues through the channels your payers already use. See the full operation on our medical billing services page, or the other platforms on our software page.
Frequently asked questions
Do we need our own Availity account, or do you use yours?
Yours. Practices register their own organization account with Availity — the Essentials portal is the standard route — and add our team as named users under it. That keeps your payer enrollments, your transaction history and your data under your ownership, and our work inside the account is auditable by you at any time. Access can be adjusted or removed by you whenever you choose.
Some of our payers require Availity and others don't — how does that work?
Mixed routing is normal. Some plans route every provider transaction through Availity; others take claims a different way and use Availity only for eligibility or remits. At onboarding we map each of your payers to the channel it actually requires, then work each channel daily — nothing is forced through Availity that a payer expects elsewhere.
Can you clear the claim status and remit backlog in our Availity account?
Yes. Unchecked claim statuses and unretrieved remits are a common starting point. We work through the backlog in your Availity account, match outstanding remits to deposits, chase the claims payers never answered, and then keep status and remit checks on a daily rhythm so the backlog does not rebuild. Going forward, every remit is matched to a deposit and every open claim has a next step and an owner.