Introducing new functionality for non-medical providers

As part of our ongoing efforts to optimize and enhance the Claims Status application in Availity Essentials, we recently launched the ability for non-medical/atypical care providers — such as providers of non-emergency transportation, case management, or environmental modifications — to use the Dispute functionality in the enhanced Claims Status app. This new functionality allows atypical care providers to be more efficient and accurate in their dispute submission process.

Below are a few simple and important steps and reminders to follow for the best experience and results.

First step

Register with Availity Essentials

Non-medical/atypical care providers can submit a dispute using Availity Essentials. Care providers need to first register an organization with Availity Essentials, ensuring an administrator is chosen and their provider information — including tax ID — is added to Manage My Organization.

Once the organization is set up as Non-Medical/Atypical on Availity Essentials, it can use various functions, such as submitting disputes. Atypical care providers do not use an NPI to bill claims; therefore, it's important that the setup is completed.

Second step

Go to the Claims Status app:

• Navigate from the home page to Claims & Payments > Claim Status > select your organization and payer > Claim Status Inquiry page will open.
• When Manage My Organization has been completed, you can select the care provider from the drop-down menu and the tax ID field will display.
• Complete an inquiry by entering the required fields and selecting Submit for requested claims to display.

Third step

Select Dispute

To complete a dispute:

• Locate the claim and, if there is an option to appeal, select Dispute to initiate.
• Select Go to details to be navigated to the Appeals Application.
• Locate your initiated dispute and select the action menu to complete the dispute request.
• Choose the request reason, upload supporting documents, and submit the request.

Once completed, your progress will appear in the Notifications Center on the Availity Essentials home page when Web is selected in the contact field.

Explore training and resources

We are here to support you along the way through on-demand training and resources.

Availity Essentials offers keyword search assistance with the option to attend live or recorded demos:

• On the Availity Essentials home page, select Help & Training, then select Get Trained to register for upcoming live and recorded training demos for all Availity Essentials capabilities.
• Use the search bar to locate specific appeals training.
• The Availity Learning Center user guide will assist with how to locate training.

For questions, contact Availity Client Service:

• Online: Help & Training > Availity Support > Contact Support > Create a case or Chat with Support
• By phone: Call 800-AVAILITY (282-4548) Monday through Friday from 8 a.m. to 8 p.m. Eastern time