Administrative Digital SolutionsCommercialNovember 1, 2023

Digital RFAI process improvements

The Progress Dashboard is now available.

Care providers enrolled in the Medical Attachments applications on Availity.com are taking advantage of faster claims processing through Digital Request for Additional Information (Digital RFAI). They are receiving digital notifications when additional documents are needed to process our members’ claims.

We receive the documentation faster, so the claim is processed faster.

Digital RFAI care providers will want to use the Digital RFAI Progress Dashboard right away. Track the number of document submissions, processing turn-around times, payment turn-around times, types of documents requested, and more. Use filters to customize the report and reporting period.

Access the Digital RFAI Progress Dashboard from Availity.com through Payer Spaces. Use the link on the Digital RFAI Progress Dashboard disclaimer page to access the Quick Reference Guide.

Not a Digital RFAI care provider?

If you’re not already using the Digital RFAI process and want to take advantage of faster claims processing, participation is easy.

1.

Registration

The organization’s Availity administrator will register for Medical Attachments, which enables care provider organizations to receive notices from the payer and submit requested documents digitally.

All billing NPIs/TINs must be registered.

2.

User roles

The Availity administrator will be required to update or add new users with these specific role assignments through Availity:

  • Claims Status
  • Medical Attachments

Enable users to view the Availity Attachment Dashboard.

3.

Ready to go!

After the registration and user roles are completed on Availity, the Digital RFAI process is ready.

Requests will automatically appear on the Attachments Dashboard each morning (when documents are needed).

Learn more

Register for live training or view training on demand here.

Digital RFAI process improvements

Eliminating the Acknowledgement box to save steps and streamline processes

We’ve eliminated the Acknowledgement requirement when care providers access their Attachments Dashboard. You’ll notice that notifications on your Attachments Dashboard have a New status.

Saves you time: When you select the claim, you are no longer required to complete the Acknowledgement. You will be diverted directly to the notification information.

Adds transparency: If you upload your notification and select Save, you’ll have access to a Saved status that dates your upload.

Contact your provider relationship representative with any feedback. Your feedback is important to us and will help us create greater efficiencies for you and your practice.

Now accepting Medicaid and Medicare member claims

As a care provider taking advantage of Digital RFAI, you know it is the most efficient way to send the required documentation to process your Commercial member claims. Beginning in mid-November, you will also receive Digital RFAI notifications for your Medicaid and Medicare member claims.

The process will not change for Medicaid and Medicare member claims. You will still follow the same fast and easy process for our Medicaid and Medicare member claims as you do for your commercial member claims. The only change is that your Medicaid and Medicare member claims will not pend. Medicaid and Medicare member claims will deny when additional documentation is needed to process the claim.

Notifications will remain on your dashboard for up to 30 days as they do today. Submit the documentation at your convenience (most care providers submit documents within seven to 14 days).

Your notifications will continue to arrive on your dashboard each morning, making it convenient to plan your work; no need to check your dashboard throughout the day.

Learn more!

In collaboration with Availity, we’ve developed training for your organization’s administrators about how to update the Medical Attachment registration:

Date

Time

November 14, 2023

10:30 to 11:45 a.m. ET

November 15, 2023

3 to 4:25 p.m. ET

December 4, 2023,

2:30 to 3:45 p.m. ET

December 11, 2023

2:30 to 3:45 p.m. ET

January 23, 2024

2:30 to 3:45 p.m. ET

Availity administrators can use this link to register for live training or to view the training on demand.

For associates who are responsible for sending attachments, we’ve developed an enhanced training session that walks through the Attachments Dashboard and many of the unique features that make it most efficient:

Date

Time

November 14, 2023

3 to 4 p.m. ET

November 15, 2023

3 to 4 p.m. ET

December 4, 2023,

12 to 1 p.m. ET

December 11, 2023

10:30 to 11:30 a.m. ET

January 23, 2024

2:30 to 3:30 p.m. ET

Availity users with the Medical Attachments and Claims Status role assignment can use this link to register for live training, or to view the live training on-demand.

Contact Availity Customer Support at availity.com/Contact-Us or your provider relationship representative if you have any questions.

We are committed to finding solutions that help our care provider partners offer quality services to our members.

MULTI-BCBS-CM-041237-23-CPN41100

PUBLICATIONS: November 2023 Provider Newsletter