Provider Credentialing & Payer Enrollment for Prior Authorization Specialists with Availity
The Problem
Credentialing a new Utilization Management provider into 15 payers is a 120-day slog — and each delayed day means the provider bills under someone else's NPI or not at all.
What We Build in Availity
AI assembles the CAQH profile, submits payer applications, tracks each status, and escalates stalls — time-to-enrolled drops from 120 days to 60. Purpose-built for teams running Availity — uses the native API or agent integration so nothing leaves the system of record.
Availity Integration Approach
Audit your Availity configuration
We map the specific Availity objects, custom fields, and workflows the automation needs to touch for your utilization management practice.
Build on the Availity API or agent
Integration happens inside Availity — no data leaves the system, no parallel tool for your team to learn, no license changes.
Human-in-the-loop handoff
Every automation routes exceptions back to a human in Availity with enough context to act — AI handles the 80%, your team owns the judgment calls.
See this running in your Availity instance
30-minute call. We'll look at your actual Availity setup and show exactly how this workflow fits.