List of Availity Essentials Customers
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United States
Since 2010, our global team of researchers has been studying Availity Essentials customers around the world, aggregating massive amounts of data points that form the basis of our forecast assumptions and perhaps the rise and fall of certain vendors and their products on a quarterly basis.
Each quarter our research team identifies companies that have purchased Availity Essentials for Patient Management, Insurance Claims Management from public (Press Releases, Customer References, Testimonials, Case Studies and Success Stories) and proprietary sources, including the customer size, industry, location, implementation status, partner involvement, LOB Key Stakeholders and related IT decision-makers contact details.
Companies using Availity Essentials for Patient Management, Insurance Claims Management include: Highmark Blue Shield, a United States based Insurance organisation with 44000 employees and revenues of $29.40 billion, Anthem Blue Cross and BlueShield, a United States based Insurance organisation with 11000 employees and revenues of $6.00 billion, Premera Blue Cross, a United States based Insurance organisation with 3200 employees and revenues of $3.40 billion, Arkansas Blue Cross and Blue Shield, a United States based Insurance organisation with 3375 employees and revenues of $1.10 billion, Blue Cross & Blue Shield of Wyoming, a United States based Insurance organisation with 220 employees and revenues of $100.0 million and many others.
Contact us if you need a completed and verified list of companies using Availity Essentials, including the breakdown by industry (21 Verticals), Geography (Region, Country, State, City), Company Size (Revenue, Employees, Asset) and related IT Decision Makers, Key Stakeholders, business and technology executives responsible for the software purchases.
The Availity Essentials customer wins are being incorporated in our Enterprise Applications Buyer Insight and Technographics Customer Database which has over 100 data fields that detail company usage of software systems and their digital transformation initiatives. Apps Run The World wants to become your No. 1 technographic data source!
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| Logo | Customer | Industry | Empl. | Revenue | Country | Vendor | Application | Category | When | SI | Insight |
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Anthem Blue Cross and BlueShield | Insurance | 11000 | $6.0B | United States | Availity | Availity Essentials | Patient Management,Insurance Claims Management | 2017 | n/a |
In 2017 Anthem Blue Cross and BlueShield implemented Availity Essentials as a provider-facing claims and patient management channel, deploying Availity Essentials on the Anthem provider website to handle online claims submission and related provider interactions. The implementation targets Patient Management,Insurance Claims Management functions, positioning the application as the primary web portal for external provider access to claims workflows.
The Availity Essentials configuration emphasizes core insurance claims management capabilities, including electronic claims submission, real-time eligibility and benefits verification, claim status inquiry, patient demographic management and support for attachments and electronic remittance acknowledgments. Configuration work focused on aligning form and transaction mappings, provider authentication flows and workflow automation typical to a payer-facing claims intake solution.
Operationally the deployment is embedded in Anthem’s provider portal and is used by provider billing offices, provider relations teams and internal claims operations to receive and manage inbound transactions. Governance for the Availity Essentials deployment centers on centralized provider access controls, account provisioning through the portal and standardized claims intake workflows to ensure consistent handling of incoming provider submissions.
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Arkansas Blue Cross and Blue Shield | Insurance | 3375 | $1.1B | United States | Availity | Availity Essentials | Patient Management,Insurance Claims Management | 2022 | n/a |
In 2022, Arkansas Blue Cross and Blue Shield began moving its provider portal to Availity Essentials in a phased transition. Availity Essentials is now Arkansas Blue Cross and Blue Shield’s provider portal for Patient Management,Insurance Claims Management functions, providing eligibility and benefits, claims and claims corrections, claims status, remittance viewer and related provider services. The deployment positions Availity Essentials as the central provider-facing application for eligibility verification, claims lifecycle interactions, and remittance visibility.
Configuration work focused on enabling functional modules for eligibility and benefits inquiry, claims submission and claims corrections, claims status tracking, and remittance viewing, alongside provider self service account management and workflow orchestration. These capabilities reflect standard Patient Management,Insurance Claims Management workflows and support provider initiated corrections and status driven case handling within the Availity Essentials platform.
Rollout is being executed as a phased transition with Availity and Arkansas Blue Cross coordinating education, provider engagement, and training activities and maintaining a single information hub for updates and adoption guidance. Public communications highlight an enhanced user experience for providers as the stated benefit, and Availity’s Arkansas Blue Cross page will serve as the primary source for ongoing updates and training opportunities.
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Blue Cross & Blue Shield of Wyoming | Insurance | 220 | $100M | United States | Availity | Availity Essentials | Patient Management,Insurance Claims Management | 2019 | n/a |
In 2019 Blue Cross & Blue Shield of Wyoming implemented Availity Essentials for Patient Management,Insurance Claims Management to centralize provider billing and claims processing. Availity Essentials was adopted as the primary platform for provider-facing billing and claims transactions and as the repository for billing resources published to providers on the BCBSWY portal.
Implemented functional modules and capabilities included EDI transaction file upload and ingestion for batch EDI workflows, claims adjustment processing with downloadable Professional Claim Adjustment Form and Institutional Claim Adjustment Form, remittance advice and claim remark code visibility, CMS-1500 form guidance and form management, and electronic claim correction instructions. The system also hosted policy and coverage guidance materials such as obesity coverage guidelines alongside operational billing resources.
The deployment was structured to integrate Availity Essentials directly with provider billing workflows and EDI transaction feeds, enabling providers to upload EDI batch files and submit electronic claim corrections through the platform. Operational coverage focused on billing and claims processing teams and provider relations, supporting both professional and institutional claim types and the end-to-end claims submission and correction lifecycle.
Governance emphasized standardized upload procedures and published instructions, using the Availity Essentials environment to enforce consistent transaction file handling, claims adjustment submission, and remittance code reconciliation. Provider-facing documentation and step by step instructions for uploading transaction files and completing CMS-1500 and adjustment forms were used to operationalize workflows and reduce submission errors.
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Bone and Joint Institute of Tennessee | Healthcare | 100 | $10M | United States | Availity | Availity Essentials | Patient Management,Insurance Claims Management | 2018 | n/a |
In 2018, Bone and Joint Institute of Tennessee deployed Availity Essentials to orchestrate patient scheduling and insurance workflows. Availity Essentials was used as a Patient Management,Insurance Claims Management platform across the Franklin, Tennessee practice from July 2018 to November 2020.
The implementation centralized scheduling for surgery, pre op and post op appointments, and managed surgical clearances and insurance authorizations, with clinical coordinators and front desk staff handling booking and authorization status tracking. Availity Essentials was configured to support submission and tracking of authorization requests to coordinate imaging, injections, and surgical procedures.
Authorization workflows included online and phone submission for MRIs, CTs, surgeries, and various pain management injections, routed according to each patients payer requirements through Availity Essentials and by interfacing with EviCore and AIM for payer specific authorization paths. The operations team performed eligibility verification, followed up on pending authorizations, and set up peer to peer provider calls when procedures were denied to pursue coverage.
Operational integration tied Availity Essentials into the practices EMR landscape, with documented interactions to Allscripts, Athena, and Meditech to reconcile scheduling, clinical documentation, and authorization status into patient records. Daily operational coverage encompassed scheduling, pre certification, imaging coordination, insurance verification, and patient call handling to answer procedure and coverage questions.
Governance emphasized safeguarding patient privacy and confidentiality in accordance with HIPAA, with process controls to log authorization requests, denials, and peer to peer activities for clinical coordinators to manage. Workflows prioritized timely follow up on authorizations so patients could be scheduled for care within payer required windows.
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Highmark Blue Shield | Insurance | 44000 | $29.4B | United States | Availity | Availity Essentials | Patient Management,Insurance Claims Management | 2020 | n/a |
In 2020, Highmark Blue Shield deployed Availity Essentials for Patient Management,Insurance Claims Management to centralize provider-facing transactions and administrative workflows. Availity Essentials was provisioned as the primary Availity Portal access point for provider users, aligning Highmark Blue Shield Availity Essentials Patient Management,Insurance Claims Management with claims processing, eligibility verification and authorization administration functions.
The implementation exposed core modules including eligibility and benefits inquiry, claims submission, claims status inquiry and claim dispute, authorizations and a precertification lookup tool. Additional configured capabilities included Clear Claims Connection, Patient 360, member panel listings, member reports and provider online reporting, enabling end to end provider interactions across clinical and administrative touch points.
The rollout leveraged Availity multi payer features and payer spaces applications to support cross payer workflows and to present payer specific tools within the Availity Portal. Access is delivered through provider portal authentication and account registration, and the operational scope centers on provider offices and provider-facing teams responsible for administering members health plans and handling claims lifecycles.
Governance and enablement were addressed through the Availity Provider Learning Hub, which provides a library of self paced courses and instructor led training sessions available 24 hours a day at no cost. Provider registration and on demand learning materials were used as the primary adoption mechanism, supporting provider staff training for eligibility checks, claims submission, claim status inquiries and authorization workflows.
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Insurance | 3200 | $3.4B | United States | Availity | Availity Essentials | Patient Management,Insurance Claims Management | 2021 | n/a |
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