What You Should Know:– Availity, a real-time health information network launches Predictive Editing, a revolutionary feature within its Availity Essentials Pro™ platform.– The AI-powered tool developed in partnership with Anomaly Insights empowers healthcare providers to significantly reduce claim denials, leading to smoother revenue cycle management and improved financial performance.The Problem: Costly Claim DenialsDenied claims are a major pain point for healthcare providers, resulting in lost revenue and wasted administrative time. Identifying and correcting errors before submission can significantly improve claim acceptance rates.Predictive Editing: A Powerful SolutionAvaility’s Predictive Editing tackles this challenge head-on with its intelligent AI engine:Proactive Denial Detection: The AI analyzes vast amounts of claims data, identifying patterns that indicate potential denials before claims are submitted.The AI analyzes vast amounts of claims data, identifying patterns that indicate potential denials before claims are submitted. Impressive Accuracy: A recent study involving over 100 million claims showcased the tool’s effectiveness, flagging over $828 million in potential denials with a remarkable 97% precision.A recent study involving over 100 million claims showcased the tool’s effectiveness, flagging over $828 million in potential denials with a remarkable 97% precision. Machine Learning Expertise: Developed in partnership with Anomaly Insights, a leader in healthcare AI/ML solutions, Predictive Editing continuously learns and adapts to evolving payer rules and claim adjudication patterns.Key Advantages of Predictive EditingAutomates Upfront Edits: Eliminates the need for time-consuming manual review of denied claims.Eliminates the need for time-consuming manual review of denied claims. Handles Complexities: Goes beyond traditional edit engines, addressing intricate payer-specific scenarios.Goes beyond traditional edit engines, addressing intricate payer-specific scenarios. Complementary Integration: Works seamlessly with existing editing tools, enhancing their effectiveness and reducing manual rule maintenance burdens.“Availity’s Predictive Editing tool works in real-time within the workflow and it can review each claim and permutation of the claim as its being created, generating predictions with virtually no latency and returning guidance via API,” said Linda Perryclear, Senior Director of Product Management for Availity Essentials Pro

JACKSONVILLE, Fla.--(BUSINESS WIRE)--Availity, the nation’s largest real-time health information network, announced the launch of Predictive Editing, the latest feature of the company’s robust end-to-end revenue cycle management platform, Availity Essentials Pro™. Predictive Editing’s engine, powered by artificial intelligence (AI), helps prevent claims denials by analyzing extensive claims data to identify potential denials prior to submission at the front-end of the provider’s submission workflow, allowing for timely corrections and smoother adjudication. In a recent proof-of-concept study of more than 100 million claims from two large health systems, the Predictive Editing tool demonstrated impressive results, flagging more than $828 million denials with 97% precision

As part of the investment, Jason Black from RRE Ventures will join the Anomaly Board of Directors.