Availity, LLC

Founded in 2001 as a joint venture between Florida Blue and Humana, and based in Florida, US, Availity, LLC provides an information network in healthcare, connecting providers, health plans, and their technology partners, as well as offers providers, hospitals, and healthcare systems with revenue cycle and patient financial management solutions. The company, chaired by Russ Thomas as CEO, operates across 14 states in the US and serves a customer base of over 900,000 providers and processing over 10 million transactions daily. In July 2017, a consortium led by Francisco Partners, along with Anthem, Inc. , Blue Cross & Blue Shield Association, and Humana Inc, invested a 33.

33% minority stake in Availity, LLC, and in July 2021, Novo Holdings acquired a minority stake in the firm from Francisco Partners. Availity, LLC’s solutions include Healthplan solutions such as a provider engagement portal that offers a multi-payer alternative to improve communication between the health plan and provider network; an Intelligent Gateway offering editing services, Availity insights, coverage identification solutions, and migration and contracting drop-to-paper services, and financial clearinghouse services; and Clinical Gateway that offers patient care summary, monitoring ADT (admission, discharge, and transfer), lab exchange, and medical record exchange. Additionally, the firm offers vendor solutions to simplify healthcare transactions such as platform and clearinghouse solutions with Availity APIs, SOAP Web Services, Secure FTP, and support systems. Availity, LLC also offers provider solutions such as revenue cycle management, a provider portal with real-time access to payers, direct data entry from eligibility to authorizations to filing claims and getting remittances, and EDI clearinghouse solutions.

  Availity, LLC generates revenue when the insurance companies/payers pay for the transactions submitted by Availity on behalf of the providers. Availity chooses not to charge the providers for claim submissions, eligibility, and benefits, claim status, authorization, referrals, and remittance for commercial payers, however, additional optional chargeable services may be chosen by the providers.