News
AVAILITY ESSENTIALS TRANSITION UPDATE
Date: 09/09/24
Delaware First Health, Ambetter Health of Delaware, and Wellcare, are pleased to announce we have chosen Availity Essentials as our new secure provider portal. This transition will help ease your administrative burden so you can focus on what matters—providing high quality care to our members. Below are some important updates relating to our Availity Essentials’ transition.
Risk Condition Validation (RCV) and Clinical Quality Validation (CQV) Apps – Live Today
- Effective September 4, 2024, Delaware First Health started sending open risk and care gaps to providers via Availity Essentials Condition Validation (RCV) and Clinical Quality Validation (CQV) work queues, respectively.
- This means that our participating providers across our Medicaid, Marketplace, and Medicare/DSNP networks can use the RCV app to earn bonuses as part of the Continuity of Care (CoC) program and use CQV to close care gaps.
- The RCV and CQV apps are quick, easy alternatives to current submission methods. You decide what works best for you and your group.
Phase 1 Functionality – Estimated Go-Live October 21, 2024
- Starting October 21, 2024, you can log in to your existing Essentials account to verify member eligibility and benefits, submit claims, check claim status, submit authorizations, and access health plan payer resources via Availity Essentials. Our current secure portal will still be available for other functions you may use today.
- If you are new to Availity Essentials, getting your Essentials account is the first step toward working with us on Availity. See the next page for additional information on how to get started.
- Look for additional functionality in each health plan’s payer space on Essentials and use the heart icon to add apps to My Favorites in the top navigation bar.
- Access Manage My Organization – Providers to save provider information. You can then auto-populate that information repeatedly to eliminate repetitive data entry and reduce errors.
Getting Started: Designate an Availity Administrator for Your Provider Organization
Your provider organization’s designated Availity administrator is the person responsible for registering your organization in Essentials and managing user accounts. This person should have legal authority to sign agreements for your organization.
| HOW DOES THIS IMPACT ME? | WHAT IS MY NEXT BEST STEP? |
|---|---|
I am the administrator. I am the designated Availity administrator for my organization. | Visit Register and Get Started with Availity Essentials to enroll for training and access other helpful resources. |
I am not the administrator. I am NOT the designated Availity administrator for my organization. |
Your designated Availity administrator will determine who needs access to Availity Essentials on behalf of your organization and will add user accounts in Essentials. TIP: You can locate the administrator for your organization in the Essentials menu bar. Click [Your Name’s] Account | My Account | Organization(s) | Open My Administrators.
|
I am not sure. I am not sure who will be the designated Availity administrator for my organization. | Share this information with your manager to help determine who will be the designated Availity administrator for your organization. |
Resources
- Log into Availity to view the RCV demo and CQV demo
- Join one of our upcoming free webinars in October 2024 (details to follow), Availity Essentials Overview to learn additional tips for streamlining your workflow. We’ll show you how to verify eligibility and benefits, submit claims, check claim status, submit authorizations, and more.
- For additional assistance with your registration, please call Availity Client Services at 1-800-AVAILITY (282-4548) Monday through Friday, 8 a.m. – 8 p.m. ET.
- For general questions, please reach out to Provider Services at 1-877-236-1341 or contact your Provider Engagement Administrator.
We're excited to welcome you to Availity Essentials, helping you transform the way you impact patient care with our health plans.