Learn about Availity

Availity simplifies provider transactions such as electronic data exchange, prior authorization requests, claim status, and member inquiries.

Availity tools and features

 

Providers for Wellpoint South Carolina, Inc. have access to Availity, a secure, multi-health plan website offering quick access to clinical tools, member data, and health plan information. Availity simplifies provider transactions such as electronic data exchange, prior authorization requests, claim status, and member inquiries.

Patient Registration

  • Get real-time patient eligibility and benefits, including current and historical coverage information, plus detailed co-insurance, copay and deductible information
  • Submit secure, online authorizations or check the status of existing ones with our Interactive Care Reviewer (ICR)

 

Precertification

 

ICR is the Wellpoint innovative utilization management (UM) feature accessed through Availity that allows you to:

  • Submit prior authorization requests, clinical information and receive status updates without having to pick up a phone or fax any information
  • Have instant access to all submission records from any location at any time of day
  • Create and submit UM prior authorization cases quickly by attaching clinical documents for review
  • Automatically authorize more than 40 common procedures

 

Claims and Payment

  • Find everything you need to take care of your patient’s needs, including claim submissions, detailed payment information, claim payment disputes and appeals
  • Submit your medical records electronically when requested to support a pending or denied claim, including an itemized bill and requested medical records
     

Payer Spaces Application

  • Research procedure code edits and receive edit rationale with Clear Claim Connection
  • Access job aids educational videos through the Custom Learning Center
  • Locate important policies and forms in the Education and Reference Center
  • Access images of Wellpoint paper remits from the past 24 months through Remittance Inquiry
  • Get a thorough snapshot of your patient’s health and treatment history that now includes gaps in care and care reminders with Total Member View
  • Access your proprietary reports such as member rosters in Provider Online Reporting

Availity access


The Availity website offers healthcare professionals free access to real-time information and instant responses in a consistent format, regardless of the payer.

 

With Availity, you can:

 

  Request authorizations

  Submit claims

  Confirm eligibility

Don't have an Availity account?

 

Register free now     

Learning opportunities

 

Find learning opportunities to assist with administering your patient’s health plan using Availity Essentials multi-payer features and payer spaces applications. Use the library of self-paced courses and instructor-led training sessions, available 24/7 at no cost. Be prepared with the knowledge to assist our members.

 

Launch Provider Learning Hub 

Submit a precertification request

 

1.Log in to the Availity Essentials Portal

2.Select Patient Registration from the top navigation

3.Then, select Auth/Referral Inquiry or Authorizations

Availity account maintenance

 

To update organizational information, log in to Availity as an administrator and select the Maintain Organization option. Once logged in, you will be able to change your organization's address, phone number, tax ID, and NPI. Any changes made will automatically apply to all Availity users.

 

To change administrators, please call Availity Client Services.

 

Availity Client Services

 

 1-800-282-4548

Interested in becoming a provider in the Wellpoint network?

 

We look forward to working with you to provide quality service for our members.

 

Join our network