To view Availity's participating insurers - those free to bill via Availity Essentials, you can navigate to the Integrations section of Account Settings in Kalix and use the Clearinghouse Lookup.

Use the search field to find each insurer you bill by name (usually, including your state in the search terms gives a more exact match). Kalix will list the supporting clearinghouses and their participating status.

Another option for insurer look up is to search Availity's Payer List via their website. Again, search for your insurers by name.

Make sure you select the Submission Type: Batch SFTP and the Transmission Type: Professional Claims (837P). If Availity lists an insurer as "Available" under the Batch column, it is free to submit claims to that insurer via the Kalix-Availity integration (with a free Availity Essentials account).

If an insurer is "non-participating" in Kalix. They are still available to bill, but you require a paid plan.

Payers requiring a paid account are listed as "Get EDI Plan" on Availity's Essentials Payer list.

Please see the below section for details on the correct paid Availity account to use.

Note: the EDI Plan is not the same as Availity Essentials Plus - which is for Availity portal submission only).

In order to submit insurance claims to Availity via the Kalix integration, you are required to create a free Availity Essentials account for your practice.

Please use the button below to commence this process:

Very Important: You also need to create an FTP (or SFTP) Mailbox (or Account) from within your Availity account settings.

To do this, navigate to Claims & Payments (in Availity) -> FTP and EDI Connection Services -> Manage Your FTP Mailbox.

With these FTP Mailbox details, input them into the Kalix via the Insurance Clearinghouse section of the Integrations page of Account Settings.

Note: The SFPT username and password are not the same as your regular Availity login details.

For detailed instructions about setting up Availity & integrating it with Kalix, please click on the button below:

An alternative to a paid Availity account is submitting insurance claims via multiple clearinghouses.

Many practices use the combination of two clearinghouses, e.g., Availity and Office Ally. By doing this, you might potentially complete all your insurance billing for FREE!

Office Ally is free to use if greater than 50% of your claims per month are from "Participating insurers."

For information about setting up Office Ally, please click here.

While Availity offers their Essentials plan which is completely free to use. Availity Essentials supports many of the largest health insurers, including Anthem and BCBS plans.

Kalix supports submitting different insurance bills within the same batch via a range of clearinghouses.

When setting up a client's insurance details, you can assign which clearinghouse you will submit their insurance claims to.

We highly recommend setting up your Insurer Page in Kalix if you choose to utilize two clearinghouses at the same time.

To navigate to your Insurer page, hover your cursor over Billing on the top header, followed by Insurers.

Your Insurer page (even if you have never visited it before) will contain a list of all the insurers you have billed.

If you haven't created any insurance bills, yet, click on the Plus button to add a new option. Search for and select each insurer you plan to bill for. Kalix should list each clearinghouse's participating status.

If you are already using Kalix's insurance billing for all insurers you bill, click on each insurer's row to edit. Their details will open up in a new window.

Delete insurers that are entered incorrectly or not used. To do this, click on an entry to edit. Then select the Delete button at the bottom left of the pop-up window.

Turn on to limit the selection of insurance companies to only what is listed on this page.

Important Note: When setting up your client's insurance details (in the insurance section of the client's details page), you must assign Availity as their clearinghouse (if you are billing through multiple clearinghouses).

When you are searching for an insurer, Kalix displays the associated clearinghouse and whether they are participating. (see example below).

Alternatively, you can select Availity in the Clearinghouse field.

Please note: the payer ID for insurers can vary between clearinghouses. If changing clearinghouses, you should double-check check the payer ID remains the same.

All insurance bills with the status - Ready to Batch (as shown below) selected on the Billing payments screen will be added to the batch with the exception of bills with critical errors.

Kalix automatically assigns this status to all new insurance bills yet to be added to a batch.

At the top of the New Batch page, Kalix will display an error message if there are any bills that have critical errors.

Click on the View button to see the individual bills.

Bills with critical errors will not be included in the batch. The errors must be resolved before they can be exported.

This section's instructions are applicable when manually uploading claims to Availity via their portal.

Kalix now directly integrates with Availity's clearinghouse solution via Secure FTP (or SFTP) for batch claim processing.

We recommend using Kalix's direct integration with Availity. By using the Kalix-Availity integration, you can submit claims directly to Availity from within Kalix with a click of a button (or the need to log into Availity.

You can also directly receive back into Kalix claim status updates, remittance advice, payment information, adjustments, and patient responsibility amounts without ever leaving Kalix.

This section's instructions are applicable when manually uploading claims to Availity via their portal.

Kalix now directly integrates with Availity's clearinghouse solution via Secure FTP (or SFTP) for batch claim processing.

We recommend using Kalix's direct integration with Availity. By using the Kalix-Availity integration, you can submit claims directly to Availity from within Kalix with a click of a button (or the need to log into Availity.

You can also directly receive back into Kalix claim status updates, remittance advice, payment information, adjustments, and patient responsibility amounts without ever leaving Kalix.

This section's instructions are applicable when manually uploading claims to Availity via their portal.

Kalix now directly integrates with Availity's clearinghouse solution via Secure FTP (or SFTP) for batch claim processing.

We recommend using Kalix's direct integration with Availity. By using the Kalix-Availity integration, you can submit claims directly to Availity from within Kalix with a click of a button (or the need to log into Availity.

You can also directly receive back into Kalix claim status updates, remittance advice, payment information, adjustments, and patient responsibility amounts without ever leaving Kalix.