Anyone successfully using Availity as their clearinghouse?

Is anyone out there using Availity with success in billing claims? Any insight that you can share is appreciated.

Sometimes, what are they sharing with you that they are not able to accept your claims?

Hi Sherwin,

Thank you for your response. After a high volume of claims were rejected, I was able to reach Availity and confirm that it was because the payor ID was left off of all the claims they received. I was told the payor ID needs to populate in the “LOOP2010BBNM109” location for submission.

Just wondering if anyone else had hit this same speed bump.


Your post here will be seen by many and replied to by a few.
Did you get the information entered into the right place in the system so that it shows in the claims?

Yes, as far as I can tell, everything is entered correctly on our end.


Did you review the claim log / scrubber to see if anything was missing from the claims in the system before sending it to Availity?
Did you put the payor ID for the insurance company under practice settings?

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We validated the claims and put the insurance companies/payor IDs in the practice settings.

Thanks! :slight_smile:

Hi Folks-
Don’t know if this is helpful, but we ran into the same problem with one of our customers running OpenEMR 7.0.0-dev. One of our developers looked into it and came up with this:

'…I did some testing and I was able to reproduce the error. It appears that when “Generate X12 Encounter” is selected, it leaves the ID off of the claim. Apparently, [the global setting] “Allow Encounter Claims” was set to a default as True so this option is available in the Billing Manager.

We should not be using the “Generate X12 Encounter”. Its purpose is for “Allow creation of claims containing diagnoses but not procedures or charges. Most clinics do not want this”.

I disabled this option and the option to generate X12 Encounters is no longer available. ’

Hope this is helpful to somebody!
Best- Harley