Latest news with #Availity
Business Wire
4 days ago
- Business
- Business Wire
Availity and Vim Partner to Streamline Care Gap Notification and Closure Process
JACKSONVILLE, Fla.--(BUSINESS WIRE)--Availity®, the nation's leading real-time health information network, and Vim, a leader in care orchestration for value-based care, have partnered to help payers streamline risk and quality care gap closure and reduce provider abrasion. The partnership leverages a multi-channel approach that surfaces action-oriented risk and quality gaps in providers' electronic health record (EHR) workflow, allowing them to submit the required information quickly and securely, while at the point-of-care. The partnership leverages a multi-channel approach that surfaces action-oriented risk and quality gaps in providers' electronic health record (EHR) workflow, allowing them to submit the required information quickly and securely, while at the point-of-care. Share Achieving this level of efficiency with care gap closure is critical for payers, especially as they look to improve HEDIS® performance and Stars ratings. Many payers still rely on manual, paper-based processes to notify and address care gaps that place a heavy administrative burden on providers, resulting in low adoption and engagement. Leveraging digital payer-provider collaboration and bidirectional EHR integration For more than 20 years, Availity has been a leader in developing digital tools designed to reduce administrative waste and improve payer-provider engagement. Availity was the recipient of the KLAS Points of Light 2025 for its innovative digital tools within Availity's multi-payer provider portal, which streamline quality and risk care gap reporting and closure. 'With Availity and Vim's partnership, the power of this streamlined care gap closure process extends beyond the Availity portal to the EHR, allowing payers to capture the attention of providers closer to the point of care,' said Ashley Basile, Availity Clinical Chief Product Officer. 'Vim seamlessly integrates care gap insights directly into EHR workflows, enabling healthcare providers to work more efficiently, while also enhancing patient outcomes and payer operations. Now Availity can be a one-stop shop for health plans looking maximize care gap closure via multiple provider destinations and workflow tools.' A single source of truth for payers In addition to reducing the administrative burden on providers, the partnership helps payers improve data integrity and reporting by capturing real-time care gap updates through both Vim Connect and Availity's Essentials portal while continuously synchronizing care gap data. 'At Vim, we believe that the future of value-based care depends on meeting providers where they are: inside their workflow, not outside of it. Our expanded partnership with Availity turns that belief into action. By embedding real-time, bidirectional data exchange directly into EHRs, we're removing the friction that slows down care and creating scalable infrastructure for payers and providers to align. This is what seamless, connected healthcare looks like,' said Josh Stern, Chief Business Officer of Vim. About Availity Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange. As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually—powering real-time collaboration in a dynamic, value-based care environment. About Vim Vim is a provider engagement platform for healthcare. Its flexible and scalable platform and unique and interactive integration layer unlock access to provider EHR workflows, allowing for the delivery of data, patient insights, and applications at the point of patient care. Vim's partners can leverage Vim's core applications or deploy their custom applications on top of Vim Connect – Vim's in-EHR connectivity layer – accelerating time to market at reduced cost and improved flexibility. Digital health builders of all sizes, including national health plans, leading ACOs and MSOs, and tech companies, use Vim's platform to connect with more than 50,000 providers. For more information, visit
Yahoo
21-05-2025
- Health
- Yahoo
Availity® Co-Honored with 2025 KLAS Points of Light Awards for Care Gap Closure and Payer-to-Payer Data Exchange
JACKSONVILLE, Fla., May 21, 2025--(BUSINESS WIRE)--Availity, the nation's largest real-time health information network, has been twice named a 2025 Points of Light Award recipient by KLAS Research. These recognitions celebrate two case studies with leading national health plans. One award recognizes Availity's efforts to improve clinical data exchange and provider engagement through innovative digital tools within Availity's multi-payer provider portal, designed to streamline quality and risk care gap reporting and closure. Together, the organizations replaced time-consuming, paper-based processes with integrated, electronic solutions that notify providers of quality and risk documentation gaps and allow them to submit the required information quickly and securely within their existing workflows to document patient care gap closure and support value-based care initiatives. The other award recognizes Availity's work with three national payer organizations to enhance payer-to-payer data exchange by developing a centralized connectivity hub, to accelerate interoperability mandate compliance and facilitate more seamless, interoperable exchange of member health plan data as they transition across plans, ultimately resulting in reducing care gaps, administrative inefficiencies, and data fragmentation during member transitions between health plans. This innovative solution enables multiple payer organizations to reduce the need for establishing multiple end-point connections with health plans, improves continuity of care, and supports compliance with upcoming CMS interoperability mandates. "Availity is proud to be recognized by KLAS, which embodies our shared commitment to reducing administrative burden in healthcare, enhancing the provider experience, and advancing healthcare interoperability," said Ashley Basile, Clinical Chief Product Officer, Availity. "Through our digital care gap tools, we are empowering providers with a unified, multi-payer digital workflow to improve quality reporting and care outcomes. At the same time, our payer-to-payer data exchange initiative is helping health plans support better continuity of care for members as they transition between plans and support CMS mandate compliance." Availity Digital Care Gap Tools Key results from the digital care gap reporting collaboration include 34,000+ quality measures submitted electronically through Availity's multi-payer portal as of October 2024 (an average of two care gaps closed per form submitted during the measurement period). In addition: 70% of network providers now have access to Availity's digital care gap tools, up from just 25% In addition to improved HEDIS and Stars performance, considerable financial savings were generated through: Reduction in need for manual retrieval of medical records to support submissions; estimated $15 - $25 saved per medical record no longer required Reduction in estimated $10,000 in print, mail, and handling costs per quarterly mailing no longer required ($40,000 annually for each quarterly mailer) Payer-to-Payer Data Exchange Key results from the payer-to-payer collaboration include: Successful implementation of a centralized hub-and-spoke model for secure payer-to-payer data exchange Reduced onboarding time and administrative complexity for participating payer organizations Capture of long-term cost savings and improved data accuracy via a platform that delivers multi-payer connectivity efficiencies and economies of scale Strengthened compliance readiness for CMS interoperability mandates effective January 2027 Enhanced continuity of care during member transitions between health plans through faster, standardized data sharing The KLAS Points of Light annual awards celebrate success stories achieved by payers, healthcare organizations, and healthcare IT companies whose partnerships focus on reducing costs and inefficiencies while striving to improve the patient experience. The awards will be presented at the KLAS K2 Collaborative Summit, May 20–22 in Salt Lake City. About Availity Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange among health plans, providers, and technology partners. As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Learn more at View source version on Contacts Media Contact: fuocoavaility@ Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
21-05-2025
- Health
- Yahoo
Availity® Co-Honored with 2025 KLAS Points of Light Awards for Care Gap Closure and Payer-to-Payer Data Exchange
JACKSONVILLE, Fla., May 21, 2025--(BUSINESS WIRE)--Availity, the nation's largest real-time health information network, has been twice named a 2025 Points of Light Award recipient by KLAS Research. These recognitions celebrate two case studies with leading national health plans. One award recognizes Availity's efforts to improve clinical data exchange and provider engagement through innovative digital tools within Availity's multi-payer provider portal, designed to streamline quality and risk care gap reporting and closure. Together, the organizations replaced time-consuming, paper-based processes with integrated, electronic solutions that notify providers of quality and risk documentation gaps and allow them to submit the required information quickly and securely within their existing workflows to document patient care gap closure and support value-based care initiatives. The other award recognizes Availity's work with three national payer organizations to enhance payer-to-payer data exchange by developing a centralized connectivity hub, to accelerate interoperability mandate compliance and facilitate more seamless, interoperable exchange of member health plan data as they transition across plans, ultimately resulting in reducing care gaps, administrative inefficiencies, and data fragmentation during member transitions between health plans. This innovative solution enables multiple payer organizations to reduce the need for establishing multiple end-point connections with health plans, improves continuity of care, and supports compliance with upcoming CMS interoperability mandates. "Availity is proud to be recognized by KLAS, which embodies our shared commitment to reducing administrative burden in healthcare, enhancing the provider experience, and advancing healthcare interoperability," said Ashley Basile, Clinical Chief Product Officer, Availity. "Through our digital care gap tools, we are empowering providers with a unified, multi-payer digital workflow to improve quality reporting and care outcomes. At the same time, our payer-to-payer data exchange initiative is helping health plans support better continuity of care for members as they transition between plans and support CMS mandate compliance." Availity Digital Care Gap Tools Key results from the digital care gap reporting collaboration include 34,000+ quality measures submitted electronically through Availity's multi-payer portal as of October 2024 (an average of two care gaps closed per form submitted during the measurement period). In addition: 70% of network providers now have access to Availity's digital care gap tools, up from just 25% In addition to improved HEDIS and Stars performance, considerable financial savings were generated through: Reduction in need for manual retrieval of medical records to support submissions; estimated $15 - $25 saved per medical record no longer required Reduction in estimated $10,000 in print, mail, and handling costs per quarterly mailing no longer required ($40,000 annually for each quarterly mailer) Payer-to-Payer Data Exchange Key results from the payer-to-payer collaboration include: Successful implementation of a centralized hub-and-spoke model for secure payer-to-payer data exchange Reduced onboarding time and administrative complexity for participating payer organizations Capture of long-term cost savings and improved data accuracy via a platform that delivers multi-payer connectivity efficiencies and economies of scale Strengthened compliance readiness for CMS interoperability mandates effective January 2027 Enhanced continuity of care during member transitions between health plans through faster, standardized data sharing The KLAS Points of Light annual awards celebrate success stories achieved by payers, healthcare organizations, and healthcare IT companies whose partnerships focus on reducing costs and inefficiencies while striving to improve the patient experience. The awards will be presented at the KLAS K2 Collaborative Summit, May 20–22 in Salt Lake City. About Availity Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange among health plans, providers, and technology partners. As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Learn more at View source version on Contacts Media Contact: fuocoavaility@
Business Wire
06-05-2025
- Health
- Business Wire
Availity® Adds Another Large Blues Plan to Growing List of Customers Seeking to Streamline Authorizations
JACKSONVILLE, Fla.--(BUSINESS WIRE)--Availity, the nation's largest real-time health information network, successfully implemented its Intelligent Utilization Management, solution with a large regional Blue Cross Blue Shield health plan seeking to deliver near real-time authorization decisioning for its expansive network of providers and members. "By partnering with Availity, we've aligned technology, clinical judgment, and policy into one seamless solution—improving patient access and reducing administrative waste." The regional health plan is the largest commercial payer in its state. Its decision to modernize the prior authorization experience through Availity's Intelligent Utilization Management marks one of the most significant payer-led transformations in the region in years. The health plan implemented Availity Intelligent Utilization Management solution to fulfill several strategic imperatives: Availity expects the results to mirror the outcomes seen by other Availity clients. More than 1.1 million authorizations were submitted through Availity Intelligent Utilization Management between January 2024 and March 2025, spanning diagnostic imaging, cardiology and musculoskeletal cases. Seventy-six percent of those submissions were recommended for approval in near real time, with average response time of under 20 seconds. 'Prior authorization was never meant to delay care,' said a spokesperson from the regional health plan's leadership team. 'By partnering with Availity, we've aligned technology, clinical judgment, and policy into one seamless solution—improving patient access and reducing administrative waste.' Rapid Implementation, Strong Adoption, and Measurable Control The health plan implemented the full Intelligent Utilization Management platform across high-volume outpatient services, including musculoskeletal, cardiology, and imaging. Most recommendations can be returned in under 90 seconds. This speed and precision are possible because Availity's solution extracts clinical information directly from the medical record and uses a proprietary AI engine to analyze it against codified medical policy to determine medical necessity. To streamline the prior authorization processes, utilization management clinicians should be focused on the most complex cases that require their expertise. To do this, they need a better way to identify cases where medical necessity can be easily determined in near real-time with appropriate clinical documentation. The health plan's decision to partner with Availity was based on its desire to meet the demands of their provider network and members to deliver a faster and more transparent authorizations process. Most providers in the state already use Availity for payer engagement, due in part to state mandates. This existing infrastructure enabled a remarkably smooth deployment—completed on time and under budget in just 10 months, shorter than the average 12-18 months of an implementation of this size. Because Availity serves as a digital front door, providers have just one place to go to submit authorizations and access a comprehensive dashboard that delivers real-time visibility into all authorization statuses. The health plan sought to reclaim control over a utilization management process that had long been outsourced to delegated vendors. Availity Intelligent Utilization Management supported the integration of the health plan's preferred clinical content. This level of configurability—integrating the content of their choice with the platform of their choice—was a critical differentiator and a signal of Availity's flexibility. Future-Ready and Fully Aligned The health plan's deployment of Availity Intelligent Utilization Management positions it well ahead of the January 1, 2027, CMS Interoperability and Prior Authorization Final Rule deadline. With Fast Healthcare Interoperability Resources (FHIR)® APIs and bi-directional connectivity already in place through Availity, the plan is not just compliant—it's future-ready. 'Our clients want to do more than comply with the CMS final rule,' said Russ Thomas, CEO of Availity. 'They want a smarter, more sustainable UM program that supports providers, improves member experience, and ensures that medical necessity is determined quickly, consistently, and fairly.' About Availity Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial information. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange among health plans, providers, and technology partners. As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Our suite of dynamic products, built on a powerful, intelligent platform, enables real-time collaboration for success in a competitive, healthcare ecosystem.
Yahoo
07-04-2025
- Business
- Yahoo
WNS-HealthHelp and Availity Join Forces to Transform Payer-Provider Collaboration
JACKSONVILLE, FL, & NEW YORK & LONDON & MUMBAI, India, April 07, 2025--(BUSINESS WIRE)--WNS-HealthHelp, a trusted healthcare technology platform for health plans, and a part of WNS, a digital-led business transformation and services company, today announced its strategic collaboration with Availity, North America's largest real-time health information network. The collaboration unites two industry leaders to streamline Utilization Management (UM), expedite approvals, ease provider administrative burdens and enhance patient care. WNS-HealthHelp's advanced AI-driven clinical engine, business transformation capabilities and fully delegated specialty programs, in combination with Availity's extensive healthcare network, which connects over 95% of payers and more than 3 million providers nation-wide, will elevate outcomes across the healthcare ecosystem. WNS-HealthHelp's technology platform and proprietary specialty outpatient clinical guidelines will be fully integrated into Availity's Intelligent Utilization Management solution, which transforms the prior authorization process by delivering near real-time decision recommendations based on codified medical policy and clinical documentation. Additionally, WNS-HealthHelp's fully delegated UM programs and expert clinical resources across multiple specialties will be made available to Availity clients. "We are excited to collaborate with Availity to deliver our proprietary specialty outpatient clinical guidelines, our industry-leading clinical expertise and UM program options to empower payers in a competitive landscape. WNS-HealthHelp embodies the perfect fusion of high-touch clinical expertise and high-tech automation in healthcare management. Together with Availity, we will extend our AI-led clinical solutions to a wider audience, focusing on enhancing member outcomes and reducing healthcare costs," said Keshav R. Murugesh, Group CEO, WNS. "We are thrilled to collaborate with WNS-HealthHelp to bring their platform led best-in-class clinical guidelines and clinical specialists to our network," said Russ Thomas, CEO, Availity. "This collaboration aligns with our mission to simplify healthcare administration and improve the provider and patient experience. By integrating WNS-HealthHelp platform into our intelligent UM solution, we are taking a significant step toward reducing friction in the prior authorization process and enabling better care coordination," he added. About Availity Availity empowers payers and providers to deliver transformative patient experiences by enabling the seamless exchange of clinical, administrative, and financial information. As the nation's largest real-time health information network, Availity develops intelligent, automated, and interoperable solutions that foster collaboration and shared value across the healthcare ecosystem. With connections to over 95% of payers, more than 3 million providers, and over 2,000 trading partners, Availity provides mission-critical connectivity to drive the future of healthcare innovation. For more information, including an online demonstration, please visit please visit or call (282.4548). Follow us on LinkedIn and X. About WNS- HealthHelp HealthHelp, a unit within WNS, is a trusted healthcare technology platform for health plans' clinical programs for over 25 years. Our unified suite of Advanced AI powered technology platform-based solutions simplifies medical complexity and workforce challenges, and enhances provider relations and member journeys (i.e., customer experiences). Our uniquely designed UM and clinical solutions were developed to fit into health plans' existing clinical programs to advance outcomes and success. We work in partnership to understand health plan commercial and Medicare clinical programs, and determine where our solutions can advance outcomes and lower cost. There is no one size fits all, and we know how to expediently deliver the best tailored solution for a specific health plan's needs. For more information, visit About WNS WNS (Holdings) Limited (NYSE: WNS) is a digital-led business transformation and services company. WNS combines deep domain expertise with talent, technology, and AI to co-create innovative solutions for over 600 clients across various industries. WNS delivers an entire spectrum of solutions including industry-specific offerings, customer experience services, finance and accounting, human resources, procurement, and research and analytics to re-imagine the digital future of businesses. As of December 31, 2024, WNS had 63,390 professionals across 66 delivery centers worldwide including facilities in Canada, China, Costa Rica, India, Malaysia, the Philippines, Poland, Romania, South Africa, Sri Lanka, Turkey, the United Kingdom, and the United States. For more information, visit or follow us on Facebook, Twitter, LinkedIn, and Instagram. Safe Harbor Provision This document includes information which may constitute forward-looking statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, the accuracy of which are necessarily subject to risks, uncertainties, and assumptions as to future events. Factors that could cause actual results to differ materially from those expressed or implied are discussed in our most recent Form 20-F and other filings with the Securities and Exchange Commission. WNS undertakes no obligation to update or revise any forward-looking statements, whether as a result of new information, future events, or otherwise. View source version on Contacts WNS CONTACT:Investors: David Mackey EVP – Finance & Head of Investor RelationsWNS (Holdings) Limited+1 (646) Media: Archana Raghuram EVP & Global Head – Marketing & CommunicationsWNS (Holdings) Limited+91 (22) 4095 pr@ AVAILITY CONTACT:Media: Matt Schlossberg Director of Public Relations,Availity+1 Sign in to access your portfolio
