ExchangeAdministrativeMedium impact
25-822 Simplify Claims Processing With the Availity Editing Services Tool
Health Net·CA·Reimbursement
Effective date
Aug 16, 2025
We identified it
Jun 20, 2026
Summary
Starting August 16, 2025, healthcare providers can use the new Availity Editing Services (AES) tool for Ambetter HMO and PPO claims to receive real-time error detection and correction capabilities before claim submission. This proactive tool helps identify and fix claim issues immediately within the submission workflow to reduce rejections and speed up payment processing.
Action Required
Before August 16, 2025: Billing team should register for Availity Essentials account if not already registered and prepare to utilize the AES tool for Ambetter claims. Organization's designated Availity administrator must complete registration and set up user accounts. Staff should attend available no-cost webinars on EDI file management and reporting preferences to maximize tool effectiveness. Update workflow procedures to incorporate real-time edit review and correction process.