New Self‑Service Enhancements Now Available in Availity^® Essentials

Our self‑service provider portal has new enhancements to help streamline your administrative processes and improve efficiency.

We’ll Begin Reviewing Inpatient Short‑Stay Claims

Beginning Nov. 15, 2026, claims billed with inpatient short‑stay admissions will be reviewed for medical necessity.

Discuss Flu Shots and Other Vaccines With Members

With flu season approaching, we encourage you to talk with our members about vaccines that can reduce the risk of illnesses and potentially serious outcomes.

Consider 'Brown Bag Medicine Reviews'

You can help ensure patients are taking medications correctly by reviewing them with patients as part of their visit. See tips for a brown bag review.

Encourage Members To Discuss Urinary Incontinence Concerns

Although urinary incontinence is common among aging adults, it’s a topic our members may be reluctant to discuss with you. We have information to share with members to encourage conversations.

Take Note of Member Rights and Responsibilities

Member rights include the right to participate with providers in making decisions about their health care. Review a summary.

Review Medical Policies

Approved new or revised medical policies are published on our website. Medical policies serve as one of the sets of guidelines for coverage decisions. Some benefit plans may not provide coverage for certain services discussed in the medical policies. Members may call the number on their ID card for specific coverage information.