Availity simplifies quality and risk adjustment workflows between health plans and providers

Availity, a real-time health information network, announced that it launched an innovative risk adjustment workflow solution for digital payer and provider collaboration. Revenue Program Management 1.0 (RPM) attacks the inefficiencies and frustration currently associated with gathering and managing quality and risk related information about patients.

As health plans work to improve the timeliness and accuracy of healthcare condition information for accurate coding, quality data for physician alignment and member care coordination, multiple representatives on their behalf often visit a single provider’s office seeking the same medical information. This causes poor data acquisition at a high cost for health plans and frustrates providers.

“With RPM 1.0 we’re digitizing the data collection process by engaging providers in their current workflows, where they already utilize the Availity network,” said Trent Gavazzi, Senior Vice President and Chief Technology Officer of Availity. “Our RPM solution dramatically transforms the way medical information is collected, bringing value to health plans, providers, and patients. We envision a future where retrospective chart chasing goes away, as we digitize these processes into the plan and provider workflows.”

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analytics, Availity, coding, Florida Blue, Revenue Program Management, workflow


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