Learn about Availity

Providers for Wellpoint Iowa, Inc. have access to Availity , a secure, multi-health plan portal 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.

Availity tools and features

Benefits and eligibility

• Get real-time member eligibility and benefits, including co-insurance, copayment and deductible information
• Submit or check status of authorizations

Prior authorization

Availity’s Interactive Care Reviewer (ICR) is a utilization management tool that allows you to: 

• Submit prior authorization requests  
• Review previous submission and receive status updates 
• Attach clinical documentation for utilization management (UM) review
• Automatically authorize more than 40 common procedures
• Report a member’s pregnancy

Claims and payment

• View claim status, detailed payment information, and status of disputes or appeals
• Submit electronic medical records and itemized bills to support a pending or denied claim

Other resources

Several other tools and resources are available in the Payer Spaces section of Availity:

• Clear Claim Connection: Research procedure code edits and receive edit rationale
• Custom Learning Center: Find job aids, reference guides, and educational videos
• Education and Reference Center: Locate important policies, forms and educational resources
• Remittance Inquiry: View, 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

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.