LOUISVILLE, Ky. -- Humana Inc. is taking full advantage of processing efficiencies from technology investments and changing market dynamics by naming Availity LLC its primary gateway for the submission of claims and encounters. Under this national arrangement, Humana is asking all of its major clearinghouses to send submissions destined for Humana through Availity.
The real-time capabilities of both companies provide more responsive service to healthcare providers. Clearinghouses that have already established contractual relationships with Availity for handling Humana claims are listed on http://www.availity.com . Humana also expects to reduce technical complexity and to increase service accountability by reducing the number of its clearinghouse relationships.
"This initiative is an extension of Humana's commitment to advance administrative simplicity and to continue delivering service excellence to our provider community," said Bruce J. Goodman, senior vice president and chief service and information officer of Humana. "It brings us and our stakeholders closer to realizing a real-time service norm for claim receipts that available technology and data standards offer."
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) electronic data standards that went into effect October 16, 2003 simplified electronic claims processing. Humana has integrated data and business events across its core processing systems using an enterprise application integration initiative (eHub).
"The eHub real-time technology solution we implemented not only succeeds in creating internal efficiencies," said Brian LeClaire, vice president and chief technology officer of Humana, "but provides faster receipt for claims and encounters when paired with the real-time capabilities of Availity as our primary gateway. Providers continue to control the decision of how they send claims, since this initiative is transparent for most submitters."
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