Sanford Health Partners with Availity for Enhanced Revenue Cycle Management
Sanford Health has made a significant move by partnering with Availity to bolster its revenue cycle management. This collaboration promises to streamline claim and payment processing through the implementation of an integrated, all-payer clearinghouse solution.
Benefits of the New Partnership
The decision to collaborate with Availity comes in light of their efficient response during a recent cyber event. Availity Lifeline, a specialized service, played a crucial role in supporting organizations affected by a cyberattack that impacted the Change Healthcare clearinghouse. During this tumultuous time, Availity Lifeline provided free connectivity for essential transactions, ensuring operational continuity even amidst challenges.
Impact of the Cyberattack
When the cyberattack struck, Sanford Health rapidly severed connections to the affected clearinghouse. This critical action protected their systems but halted electronic claims submissions to health plans. Thanks to the swift deployment of Availity Lifeline, within days, Sanford Health resumed processing clean claims and receiving payments.
Volume of Transactions
Sanford Health was one of the pioneers in utilizing Availity Lifeline, which became operational within just 48 hours post-attack. Since then, the system has successfully processed over 186 million claims, amounting to an estimated total value of $315 billion.
Overview of Sanford Health
As the largest rural health system in the United States, Sanford Health caters to over 1.4 million patients and nearly 200,000 health plan members every year. The health system employs more than 42,000 individuals and operates 48 medical centers, 211 clinics, and 160 senior living centers, striving to provide high-quality care complemented by innovative solutions.
Commitment to Quality Care
With the submission of around 12 million claims annually and an annual operating revenue of $13 billion, Sanford Health stands at the forefront of healthcare delivery. Tony Morrison, the Vice President of Revenue Cycle at Sanford Health, affirmed the urgency they faced during the cyberattack but praised Repailing Lives for their timely support and effective management of the situation.
Core Features of Availity Essentials Pro
The Availity Essentials Pro platform is a key component of this partnership, supporting over 2 million providers in their revenue cycle operations. Its features tackle prevalent challenges in healthcare revenue cycle management with precision. This includes tools for managing pre-service denials, streamlining post-service claims processes, and facilitating vendor interactions.
Moreover, the platform heightens data accuracy by incorporating AI-driven predictive editing along with advanced remittance solutions. The real-time eligibility checks and patient engagement tools available through the platform empower providers to make informed decisions and enhance the quality of care.
Integration and Scalability
Availity Essentials Pro also integrates seamlessly with Epic electronic health record systems, a feature currently utilized by over 145 hospitals and health systems. This integration supports 112 million covered patients and enables the processing of approximately 12 billion transactions annually.
Future-Proofing Healthcare Operations
Russ Thomas, the CEO of Availity, emphasized their dedication to ensuring security, efficiency, and unwavering customer support. This commitment will play a critical role in supporting Sanford Health's mission to deliver outstanding healthcare. By integrating Availity's solutions, Sanford Health aims to minimize potential future risks associated with cyber incidents, ultimately safeguarding its financial health and service delivery.
About Availity
Availity is dedicated to transforming healthcare experiences by facilitating efficient exchanges of clinical and financial information. As a leader in providing robust health information networks, Availity builds automated solutions that enhance collaboration across the healthcare ecosystem, ensuring maximum efficiency and resilience.
About Sanford Health
Sanford Health is redefining the healthcare landscape across America, serving 1.4 million patients through its extensive network of hospitals, clinics, and senior living centers. This commitment positions Sanford as an influential force in rural healthcare, dedicated to improving the lives of patients across various spectrum of care.
Frequently Asked Questions
What is the purpose of the partnership between Sanford Health and Availity?
The partnership aims to enhance revenue cycle management by simplifying claim and payment processing through Availity's integrated solutions.
What specific challenges did Sanford Health face during the cyberattack?
During the cyberattack, Sanford Health had to disconnect from the affected clearinghouse, which temporarily halted electronic claims submissions to health plans.
What is the significance of Availity Lifeline?
Availity Lifeline provided crucial support during the cyberattack, enabling seamless connectivity for essential transactions without costs during increased operational stress.
How many claims has Availity Lifeline processed since its launch?
Since launching, Availity Lifeline has processed over 186 million claims valued at approximately $315 billion.
What commitment has Availity made to its partners?
Availity has committed to ensuring high security, operational efficiency, and quality customer support, essential for navigating complex healthcare challenges.
