Salesforce + Availity

Enhance Healthcare Operations with Smooth Payer-Provider Data Exchange

70%

Less time in portals

2x

Faster prior auths

0

Lost auth requests

Why Availity matters in your stack

Availity is the largest real-time clearinghouse in the U.S., and your billing and admissions teams are probably already inside it every day — running eligibility checks, submitting prior auths, and chasing claim status. The problem is that none of that activity lands in Salesforce, so leadership has no visibility and reps have no context.

Our Salesforce + Availity integration brings 270/271 eligibility, 276/277 claim status, and 278 prior authorization workflows into the Salesforce UI. One click on a patient record fires the transaction, parses the response, and updates the relevant fields and tasks.

Everything is logged, audit-trailed, and routed via case automation when human intervention is needed.

Challenges We Solve

Tab-Switching Tax

Reps wasting hours daily moving between Availity and Salesforce, copying numbers between systems.

Stale Eligibility

Eligibility checked once at admission, never refreshed — leading to surprise denials.

Prior Auth Black Hole

Auth requests submitted, then forgotten, until the claim comes back denied for missing PA.

No Single Pane

Leadership has no unified view of payer activity, denials, and pending authorizations.

Real-World Use Cases

270/271 Eligibility from Salesforce

Real-time benefits checks triggered from any patient record with parsed results inline.

276/277 Claim Status

Automated polling of claim status with case creation when payer flags an issue.

278 Prior Auth Tracking

Submit, track, and escalate authorization requests from inside Salesforce.

Payer Activity Dashboard

Executive visibility into eligibility volumes, denial rates, and authorization aging.

Key Features

270/271 real-time eligibility and benefits checks

276/277 automated claim status polling

278 prior authorization submission and tracking

Centralized payer communication logs

Automated alerts for eligibility changes

Executive dashboards for payer performance

How We Implement CallRail

1 Availity API Enablement

Coordinate with Availity to enable B2B API access for your trading partner ID.

2 Transaction Mapping

Map 270/271, 276/277, and 278 fields to the Salesforce schema.

3 Workflow Automation

Build the case routing, alerts, and re-check schedules around eligibility and auth.

4 Dashboard & Reporting

Build the payer-performance dashboards revenue cycle leadership needs.

5 Train & Hand Off

Roll out to billing, admissions, and UR teams with documentation and recorded training.

Availity Integration FAQs

Does this require an Availity Essentials Pro subscription?

B2B API access is required; most behavioral health groups already have it through their clearinghouse plan.

Are 837 claim submissions in scope?

We can include 837 generation, but most clients keep that in their billing system and only sync status.

Is patient data ever stored outside HIPAA-compliant infrastructure?

No. All transactions remain inside BAA-covered, encrypted environments.

HIPAA Compliant by Design

Every Availity integration we build runs inside BAA-covered, encrypted infrastructure with full PHI access logging, role-based controls, and audit-ready retention policies.

Why This Integration?

1 Reduce time spent on payer portals

2 Centralize all payer interactions in one place

3 Speed up prior authorization workflows

4 Improve revenue cycle efficiency

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Ready to Integrate Availity?

Let’s discuss how Salesforce + Availity can transform your operations. Start with a free consultation.