Learn about Availity Essentials
Availity Essentials simplifies provider transactions such as electronic data exchange, prior authorization requests, claim status, and member inquiries.
Availity Essentials tools and features
Providers for Wellpoint have access to Availity Essentials, a secure, multi-health plan website offering quick access to clinical tools, member data, and health plan information.
Benefits and eligibility
- Get real-time member eligibility and benefits, including co-insurance, copayment, and deductible information
- Submit or check status of authorizations
Other resources
Several other tools and resources are available in the Payer Spaces section of Availity:
- Alerts Hub: primary care physicians (PCPs) can access a list of patients with recent clinical events
- Clear Claim Connection: research procedure code edits and receive edit rationale
- Custom Learning Center: find job aids, reference guides, and educational videos
- Remittance Inquiry: access, print, or save a remittance advice from the past [24] months
- Patient360: access a member’s health and treatment history, including care reminders and gaps in care
- Provider Online Reporting: generate custom reports, including member rosters
- Precertification Lookup Tool: check if preauthorization is required
Interactive Care Reviewer (ICR) requests
Effective July 1, 2024, all authorization requests for Wellpoint must be submitted through Interactive Care Reviewer (ICR) found within the Availity Essentials platform. ICR is available 24 hours a day, 7 days a week to accept prior authorization requests.
To request or check the status of a prior authorization request or decision for a particular plan member, access our ICR tool via Availity Essentials. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate.
Availity access
The Availity Essentials website offers healthcare professionals free access to real-time information and instant responses in a consistent format, regardless of the payer.
With Availity Essentials, you can:
Request authorizations
Submit claims
Confirm eligibility
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.
Availity Essentials account maintenance
To update organizational information, log in to Availity Essentials as an administrator and select the Maintain Organization option. To change administrators, please call Availity Essentials Client Services.
Interested in becoming a provider in the Wellpoint network?
We look forward to working with you to provide quality service for our members.