Request for a new clearinghouse - Availity

[dqadri]

Piggybacking on the last message sent in the forum, I lost access to medical claim submission when Change Healthcare suffered their ransomware attack that crippled many health care institutions in 2/2024. Change Healthcare decided to not bring this particular product offering back online in a way that would work easily with Open Dental (so far). I have been looking for replacements that could potentially integrate in well with Open Dental.

I researched several other solutions and found that Availity has the capability to be a complete clearinghouse for dental and medical claims. For those not familiar with Availity, they support many HIPAA ASC X12N transactions including submitting 837P (Medical Professional claims) and 837D (Dental claims). They have a RESTful and a SOAP API, and can also accept X12 files for batch processing. Each payer within the Availity list of payers has different capabilities.

availity.com
developer.availity.com

I have started researching and familiarizing myself with their APIs. Hopefully I can cobble up a PoC quickly.