Availity and 1st Providers Choice: Providing Critical Support Following Ransomware Breach

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Availity Electronic Claims

Electronically Batch Claims in the ANSI X122 837 Insurance Claims Format

ANSI X122 837 is the most commonly used format for insurance claims. The Change Healthcare breach solution from 1st Providers Choice ensures these insurance claims are sent to the carriers and paid out as quickly as possible.

1st Providers Choice is a highly regarded billing and claims management software vendor that Availity has trusted for years. With over 40 years of experience, 1st Providers Choice offers solutions that make it easy for your practice to succeed with billing and claims management.

Simplify Claims Processing

By automating claims filing, specialists can submit claims from the 1st Providers Choice software and upload them to Availity before sending them to the insurance carriers. The claims undergo meticulous scrubbing for accuracy and completeness before being generated and sent. This approach ensures that a high percentage of claims are approved and paid the first time they are billed.

With our billing and claims management software, you will receive a complete report within 24 hours of submission, letting you know how you did with your claims. Instead of waiting 30 to 60 days and wondering why the claim remains unpaid, the system detects errors or missed fields and alerts you the next day.

Streamline Your Claims Processing Today!

Electronic Posting of Insurance Payments and EOBs in the ANSI X12 835 File Format

Insurance carriers recommend electronically posting insurance payments and Explanation of Benefits (EOBs) in the ANSI X12 835 file format, as it is the quickest way to receive payment. Availity can assist with the electronic processing of ANSI X12 835 files containing EOBs.

Carriers prefer to deposit payments directly into your bank account. Using 1st Providers Choice’s billing and claim management software, you can automatically receive the ANSI X12 835 files from Availity for auto-posting insurance payments and contractual write-offs.

For commercial insurance patients, you can get an accurate patient balance and generate a patient statement. The files are actual ANSI X12 835 files, enabling automatic posting of your insurance payments directly into our software. This method saves providers and billers nationwide significant time on billing, insurance payment posting, and claims management.

X12 EDI 837

What is an EDI 837 Healthcare Claim?

Claims specialists use the EDI 837 Healthcare Claim transaction set to submit medical claims, encounter information, and billing information from providers to payers directly or via intermediary billers and claims clearinghouses.

How is an EDI 837 Used?

The EDI 837 Healthcare Claim involves submitting healthcare claim billing information, encounter information, or both for healthcare services. This X12 Transaction Set follows a specific format and is designed to build the data contents of the EDI 837 Healthcare Claim transaction, which is used within an EDI environment.

Benefits of Submitting EDI 837 Claims

With our cutting-edge software, healthcare providers can:

  • Connect with insurers and seamlessly manage their backend operations
  • Improve billing accuracy and efficiency
  • Ensure providers receive prompt reimbursements

Key Data Elements in a Healthcare Claim

Below are some of the critical data elements found in a healthcare claim:

  • Patient information
  • Condition and reason for treatment
  • Services provided
  • Cost of treatment

Improve Your Billing Efficiency Now

Integrated Solutions from 1st Providers Choice and Availity

The healthcare industry has recently faced several cybersecurity attacks, causing Change Healthcare’s network to shut down. To help providers, 1st Providers Choice has partnered with Availity to provide integrated solutions that simplify claims processing across standard claim formats.

If you are interested, please call 480-782-1116 today.