Eligibility verification
Coverage must be confirmed. Availity integration handles eligibility verification across payers, so coverage is checked before or at the point of service, reducing downstream denials.
Custom Software
Availity Integration Services
Availity integration is about connecting your systems to Availity for eligibility verification, claims, prior authorizations, and the payer-connectivity transactions that run through its network. Availity provides broad payer connectivity and a strong prior-authorization and eligibility footprint, so a clean integration puts those payer transactions directly into your revenue cycle. Taction Software builds Availity integrations as compliant, production-ready connections, under a signed BAA. This page covers Availity integration specifically, distinct from other clearinghouses and networks. We are a healthcare-focused engineering team, founded in 2013, and every build runs under a signed BAA.
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Why Availity integration needs specialist engineering
Availity integration matters because eligibility, claims, and especially prior authorizations only flow cleanly when the integration implements Availity’s transaction formats and payer-connectivity requirements correctly. Availity connects providers to many payers, and the connection must verify eligibility, submit claims, handle prior authorizations, and manage payer-specific responses, then reconcile them in your revenue cycle. Prior authorizations in particular are complex and payer-specific, so a weak integration stalls authorizations and slows care. The right integration verifies eligibility, submits claims, handles authorizations, and manages payer connectivity, all compliantly. A partner who knows Availity builds the connection to keep payer transactions flowing. Below are the six areas that define strong Availity integration.
Prior authorization
Authorizations are complex and payer-specific. Availity integration handles prior authorization transactions, so authorizations are requested and tracked through the network rather than by phone and fax.
Claims submission
Claims flow through the network. Integration submits claims via Availity in the required formats, so claims reach payers and are processed.
Payer connectivity
Availity connects to many payers. Integration manages payer connectivity so transactions reach the right payers correctly across Availity’s network.
Response and error handling
Payer responses must be handled. Availity integration processes responses and errors, surfacing issues so staff can act rather than losing transactions silently.
Compliant, reliable operation
The connection moves payer and PHI data. Integration is built for reliability and runs under a signed BAA, with the security payer transactions require.
How Taction builds Availity integration
Taction Software builds Availity integrations as compliant, production-ready connections, because eligibility, claims, and prior authorizations only flow cleanly when the integration meets Availity’s transaction and payer-connectivity requirements. We build eligibility verification, prior authorization, claims submission, payer connectivity, and response and error handling, all reliable under a signed BAA. Rather than a generic connector, we scope your revenue cycle and Availity’s requirements first, then build the integration to fit. Most engagements start with a Discovery Sprint that maps the integration, then move into a production-ready build. The result is an Availity connection that verifies eligibility, handles authorizations, and submits claims cleanly.
01
Eligibility verification
We build eligibility verification across payers, drawing on our AI insurance eligibility verification work.
02
Prior authorization
We build prior authorization transactions so authorizations are requested and tracked through the network rather than by phone and fax.
03
Claims submission
We build claims submission via Availity in the required formats, connecting to our AI claim denials prevention work.
04
Payer connectivity
We manage payer connectivity so transactions reach the right payers across the network.
05
Response handling
We process responses and errors, surfacing issues so staff can act rather than losing transactions silently.
06
Compliant operation
We build for reliability and run under a signed BAA, connecting to our HIPAA-compliant app development work.
Pricing for Availity integration engagements
Engagements follow the same fixed-price productized tiers we use across our healthcare integration work, so cost and scope are clear before the build starts.
- Discovery Sprint: $45K, 4 weeks, integration and revenue-cycle mapping
- Production-Ready build: $95K, working Availity integration for one transaction type
- Pilot-Ready Sprint: $145K, integration validated in production
- Enterprise deployment: $500K+, full Availity integration across the revenue cycle
Related work
Explore related Taction integration services:
FAQs
Frequently asked questions
Availity integration is connecting your systems to Availity for eligibility verification, claims, prior authorizations, and payer-connectivity transactions. It implements Availity’s transaction formats and payer-connectivity requirements, so eligibility, claims, and authorizations flow cleanly into your revenue cycle rather than relying on manual portal work, phone, and fax.
Both are clearinghouses handling revenue-cycle transactions, but they are distinct platforms with different connections and payer relationships, and Availity is often associated with strong payer connectivity and prior authorization. Many organizations use one or both. Availity integration addresses Availity’s specific transaction and payer-connectivity requirements; Change Healthcare integration addresses Change Healthcare’s.
Yes. Prior authorizations are complex, payer-specific, and often handled by phone and fax, so Availity integration handles authorization transactions through the network, so they are requested and tracked electronically. Streamlining authorizations is one of the higher-value parts of Availity integration, since manual authorization work is slow and delays care.
Yes. Availity connects to many payers, so integration handles eligibility verification across them, checking coverage before or at the point of service. Verifying eligibility upstream reduces downstream denials, and doing it across Availity’s payer network gives broad coverage confirmation from a single integration.
Yes. Payer transactions carry PHI, so the integration is built compliantly and runs under a signed BAA, with the security payer connectivity requires. Compliance is part of the integration architecture rather than added later.
Yes. Most organizations start with a Discovery Sprint and a production-ready build for one transaction type, such as eligibility or prior authorization, keeping early cost contained while proving the connection works, then expand across the revenue cycle once the first build is reliable in production.