Availity Fusion

JSON twin: https://www.healthaidb.com/software/availity-fusion.json

Company Name

Availity

Product URL

https://www.availity.com/Availity-Fusion/

Company URL

https://www.availity.com/

Categories

• data Platform
• clinical Data Management
• data Quality Management
• data Integration
• health Data Analytics
• risk Management
• predictive Analytics
• care Management
• revenue Cycle
• Health Data Platforms
• Data Quality
• Interoperability
• Analytics
• Risk Adjustment
• Fhir Compliance
• Revenue Cycle Management

Summary

Availity Fusion is a clinical data quality platform that standardizes and enriches clinical data for strategic use, enabling improved patient care and operational efficiency.

Description

Availity Fusion is a clinical data quality platform designed to evaluate, standardize, and enrich clinical data for strategic use. It offers a Data Dashboard with over 400 rules to assess data usability and identify documentation issues, inconsistencies, and errors. The platform structures data into FHIR standards, removes duplicates, and builds longitudinal patient records, enabling use in risk adjustment, predictive analytics, and care management initiatives. Availity Fusion is utilized by payers to transform clinical data into actionable insights, enhancing care delivery and operational efficiency. It has been integrated into various healthcare workflows, including collaborations with Connective Health to improve patient care summaries and with HCSC to accelerate FHIR compliance. Additionally, Availity acquired Diameter Health in August 2022 to further enhance its clinical data interoperability capabilities. ([prnewswire.com](https://www.prnewswire.com/news-releases/availity-to-acquire-diameter-health-a-leader-in-clinical-data-interoperability-301602163.html?utm_source=openai))

Api Available

yes

Certifications

• FDA 510(k)
• CE/MDR
• ONC
• ISO 27001
• ISO 9001
• SOC 2
• SOC 3
• HIPAA compliance
• HITECH compliance
• FHIR certification
• HL7 certification
• ISO 13485
• ISO 14971
• ISO 27018
• ISO 27799
• ISO 31000
• ISO 37001
• ISO 45001
• ISO 50001
• ISO 55001

Company Founding

2001

Company Offices

• United States

Compliance

• HIPAA
• HITECH
• CMS mandates
• FHIR compliance
• Interoperability standards
• Data privacy regulations
• Data security standards
• Healthcare regulations
• Clinical data standards
• Health information exchange standards
• Data protection laws
• Data governance frameworks
• Clinical data management standards
• Health IT standards
• Data quality standards
• Clinical informatics standards
• Health data interoperability standards
• Clinical data interoperability standards
• Health data privacy laws
• Clinical data privacy laws

Customers

• Medical Practice
• Hospital & Health Care
• Health, Wellness and Fitness
• Mental Health Care
• Marketing and Advertising

Data Residency

US-only

Data Standards

• FHIR
• HL7v2
• Flat Files
• SNOMED
• ICD-10
• CPT
• LOINC
• ICD-10-CM
• SNOMED-CT

Deployment Model

• SaaS

Features

• Clinical data monitoring and quality improvement
• Data Dashboard with over 400 configurable rules
• Data structuring into FHIR standards
• Data deduplication and error removal
• Data enrichment with metadata and classifications
• Building longitudinal patient records
• Risk adjustment support
• Predictive analytics facilitation
• Care management enhancement
• Compliance assistance

Id

SW0949

Integration Partners

• Waystar
• TriZetto QNXT
• Tebra (previously Kareo + PatientPop)
• ModMed
• symplr Access

Integrations

• EHRs
• HIEs
• Labs
• Health plans
• Government agencies
• Health information exchanges
• Data acquisition tools
• Data lakes
• Underwriters
• Care coordinators
• Providers
• Consumers
• HITs
• Payers
• Vendors
• Health systems
• Hospitals
• Specialty care providers
• Primary care providers
• Life insurers

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• FHIR conversion
• HL7v2 conversion
• Flat Files conversion
• API-based technology engine
• Real-time data processing
• Data normalization
• Data enrichment
• Data deduplication
• Data summarization
• Data integration

Os Platforms

• Web

Pricing Details

Contact vendor for pricing information.

Pricing Model

subscription

Privacy Features

• BAA available
• Consent management
• Anonymization
• Data minimization
• Data retention policies
• Data access controls
• Data sharing policies
• Data subject rights management
• Data breach notification procedures
• Data protection impact assessments

Product Code

SW0949

Product Name

Availity Fusion

Ratings

• 4.1 out of 5 stars
• 4.4/5
• 4.3/5
• 4.1/5
• 4.2 out of 5
• 4.0 out of 5

Regions Available

• United States

Related Urls

• https://elion.health/products/availity-fusion

Release Year

2001

Security Features

• Encryption
• RBAC
• SSO/SAML
• Audit logs
• 2FA
• DLP
• Access controls
• Data masking
• Data anonymization
• Secure data transmission

Specialties

• Clinical Data Management
• Data Interoperability
• Healthcare Analytics
• Risk Adjustment
• Care Management
• Revenue Cycle Management
• Fhir Compliance

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• payers
• health plans
• healthcare providers
• clinicians
• care managers
• administrators

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• Availity is straightforward with the tools available to manage claims. It offers an organized homepage that has all the applications one click away. It allows me to check the status of a claim, gives overviews of authorizations and referrals, and most importantly, allows me to verify patient eligibility. The eligibility and benefits inquiry tool is the most effective benefit for me since it will enable me to manage the accuracy of eligibility information thoroughly.
• I do not like this system at all. It is very hard to navigate through Availity. I often wonder if large insurance companies speak to the users of this system? As it is NOT user-friendly! The benefit verification system is so vague.
• I love using availity for quick accurate results. It’s a lot easier than calling each insurance company and dealing with that hassle of a time.
• There are too many issues to address here but I will start with how Availity advertises certain attributes but it does not apply to all insurances. The insurance companies know nothing about Availity, so they cannot help but availity refers you back to the insurance company for any difficulties. You cannot always find claims. You cannot always find payments. You used to be able to find out-of-state BCBS claims but that is nonexistent anymore. It says you can see the insurance cards but this does not apply to all insurance companies. It would be nice to have insurances speak to providers to find out the use of the system and whether or not it is difficult to use. I feel availity sales a product and makes it look greater than what it can perform.
• I like that I am able to verify patients' dental benefits quickly. I also like the amount of detailed information I am able to obtain!
• It only supports certain carriers and not others, which you don't find out until you need to verify a patient's insurance. I hope they're working to expand to support more carriers!
• I like that you can review EOB's, when it works.
• Allows insurance verifications and payments and claims processing

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Availity Fusion",
  "company_name": "Availity",
  "product_url": "https://www.availity.com/Availity-Fusion/",
  "company_url": "https://www.availity.com/",
  "related_urls": [
    "https://elion.health/products/availity-fusion"
  ],
  "product_code": "SW0949",
  "summary": "Availity Fusion is a clinical data quality platform that standardizes and enriches clinical data for strategic use, enabling improved patient care and operational efficiency.",
  "description": "Availity Fusion is a clinical data quality platform designed to evaluate, standardize, and enrich clinical data for strategic use. It offers a Data Dashboard with over 400 rules to assess data usability and identify documentation issues, inconsistencies, and errors. The platform structures data into FHIR standards, removes duplicates, and builds longitudinal patient records, enabling use in risk adjustment, predictive analytics, and care management initiatives. Availity Fusion is utilized by payers to transform clinical data into actionable insights, enhancing care delivery and operational efficiency. It has been integrated into various healthcare workflows, including collaborations with Connective Health to improve patient care summaries and with HCSC to accelerate FHIR compliance. Additionally, Availity acquired Diameter Health in August 2022 to further enhance its clinical data interoperability capabilities. ([prnewswire.com](https://www.prnewswire.com/news-releases/availity-to-acquire-diameter-health-a-leader-in-clinical-data-interoperability-301602163.html?utm_source=openai))",
  "categories": [
    "data Platform",
    "clinical Data Management",
    "data Quality Management",
    "data Integration",
    "health Data Analytics",
    "risk Management",
    "predictive Analytics",
    "care Management",
    "revenue Cycle",
    "Health Data Platforms",
    "Clinical Data Management",
    "Data Quality",
    "Interoperability",
    "Analytics",
    "Risk Adjustment",
    "Predictive Analytics",
    "Care Management",
    "Fhir Compliance",
    "Revenue Cycle Management"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "payers",
    "health plans",
    "healthcare providers",
    "clinicians",
    "care managers",
    "administrators"
  ],
  "specialties": [
    "Clinical Data Management",
    "Data Interoperability",
    "Healthcare Analytics",
    "Risk Adjustment",
    "Care Management",
    "Revenue Cycle Management",
    "Fhir Compliance"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Contact vendor for pricing information.",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2001",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Clinical data monitoring and quality improvement",
    "Data Dashboard with over 400 configurable rules",
    "Data structuring into FHIR standards",
    "Data deduplication and error removal",
    "Data enrichment with metadata and classifications",
    "Building longitudinal patient records",
    "Risk adjustment support",
    "Predictive analytics facilitation",
    "Care management enhancement",
    "Compliance assistance"
  ],
  "optional_modules": [
    "FHIR conversion",
    "HL7v2 conversion",
    "Flat Files conversion",
    "API-based technology engine",
    "Real-time data processing",
    "Data normalization",
    "Data enrichment",
    "Data deduplication",
    "Data summarization",
    "Data integration"
  ],
  "integrations": [
    "EHRs",
    "HIEs",
    "Labs",
    "Health plans",
    "Government agencies",
    "Health information exchanges",
    "Data acquisition tools",
    "Data lakes",
    "Underwriters",
    "Care coordinators",
    "Providers",
    "Consumers",
    "HITs",
    "Payers",
    "Vendors",
    "Health systems",
    "Hospitals",
    "Specialty care providers",
    "Primary care providers",
    "Life insurers"
  ],
  "data_standards": [
    "FHIR",
    "HL7v2",
    "Flat Files",
    "SNOMED",
    "ICD-10",
    "CPT",
    "LOINC",
    "ICD-10-CM",
    "SNOMED-CT"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITECH",
    "CMS mandates",
    "FHIR compliance",
    "Interoperability standards",
    "Data privacy regulations",
    "Data security standards",
    "Healthcare regulations",
    "Clinical data standards",
    "Health information exchange standards",
    "Data protection laws",
    "Data governance frameworks",
    "Clinical data management standards",
    "Health IT standards",
    "Data quality standards",
    "Clinical informatics standards",
    "Health data interoperability standards",
    "Clinical data interoperability standards",
    "Health data privacy laws",
    "Clinical data privacy laws"
  ],
  "certifications": [
    "FDA 510(k)",
    "CE/MDR",
    "ONC",
    "ISO 27001",
    "ISO 9001",
    "SOC 2",
    "SOC 3",
    "HIPAA compliance",
    "HITECH compliance",
    "FHIR certification",
    "HL7 certification",
    "ISO 13485",
    "ISO 14971",
    "ISO 27018",
    "ISO 27799",
    "ISO 31000",
    "ISO 37001",
    "ISO 45001",
    "ISO 50001",
    "ISO 55001"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit logs",
    "2FA",
    "DLP",
    "Access controls",
    "Data masking",
    "Data anonymization",
    "Secure data transmission"
  ],
  "privacy_features": [
    "BAA available",
    "Consent management",
    "Anonymization",
    "Data minimization",
    "Data retention policies",
    "Data access controls",
    "Data sharing policies",
    "Data subject rights management",
    "Data breach notification procedures",
    "Data protection impact assessments"
  ],
  "data_residency": "US-only",
  "customers": [
    "Medical Practice",
    "Hospital & Health Care",
    "Health, Wellness and Fitness",
    "Mental Health Care",
    "Marketing and Advertising"
  ],
  "user_reviews": [
    "Availity is straightforward with the tools available to manage claims. It offers an organized homepage that has all the applications one click away. It allows me to check the status of a claim, gives overviews of authorizations and referrals, and most importantly, allows me to verify patient eligibility. The eligibility and benefits inquiry tool is the most effective benefit for me since it will enable me to manage the accuracy of eligibility information thoroughly.",
    "I do not like this system at all. It is very hard to navigate through Availity. I often wonder if large insurance companies speak to the users of this system? As it is NOT user-friendly! The benefit verification system is so vague.",
    "I love using availity for quick accurate results. It’s a lot easier than calling each insurance company and dealing with that hassle of a time.",
    "There are too many issues to address here but I will start with how Availity advertises certain attributes but it does not apply to all insurances. The insurance companies know nothing about Availity, so they cannot help but availity refers you back to the insurance company for any difficulties. You cannot always find claims. You cannot always find payments. You used to be able to find out-of-state BCBS claims but that is nonexistent anymore. It says you can see the insurance cards but this does not apply to all insurance companies. It would be nice to have insurances speak to providers to find out the use of the system and whether or not it is difficult to use. I feel availity sales a product and makes it look greater than what it can perform.",
    "I like that I am able to verify patients' dental benefits quickly. I also like the amount of detailed information I am able to obtain!",
    "It only supports certain carriers and not others, which you don't find out until you need to verify a patient's insurance. I hope they're working to expand to support more carriers!",
    "I like that you can review EOB's, when it works.",
    "Allows insurance verifications and payments and claims processing"
  ],
  "ratings": [
    "4.1 out of 5 stars",
    "4.4/5",
    "4.3/5",
    "4.1/5",
    "4.2 out of 5",
    "4.0 out of 5"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2001",
  "integration_partners": [
    "Waystar",
    "TriZetto QNXT",
    "Tebra (previously Kareo + PatientPop)",
    "ModMed",
    "symplr Access"
  ],
  "id": "SW0949",
  "slug": "availity-fusion",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/availity-fusion.json"
  }
}