Medicare AdvantageAdministrativeMedium impact
New Functionality in Availity Essentials
Ambetter·KS·Provider Bulletin
We identified it
Sep 12, 2026
Summary
Availity Essentials has launched three new features for providers in this region: (1) extended eligibility lookups up to 30 days in advance for Medicare and Medicaid, (2) increased attachment file sizes to 64 MB per file (max 10 files) for claim appeal submissions to Sunflower Health Plan, and (3) streamlined authorization follow-ups by viewing and responding to Requests for Additional Information (RFAI) directly within the portal. Billing teams must familiarize staff with these new tools to improve workflow efficiency and reduce manual authorization follow-up processes.
Action Required
Immediately: Billing and authorization staff should access Availity Essentials training resources to understand the three new features. (1) Update internal workflows to leverage the extended 30-day eligibility lookups for Medicare and Medicaid patients to improve pre-visit verification. (2) Inform billing staff submitting claim appeals to Sunflower Health Plan that attachment capacity has increased to 64 MB per file (10 files max), allowing more comprehensive documentation uploads. (3) Train authorization staff to use the Authorization/Referral Dashboard to track and respond to RFAIs from Sunflower Health Plan directly in Availity Essentials—search for 'Pending Action – Contact Payer' status and use the RFAI section to upload responses (up to 10 attachments or 64 MB total). Note: RFAIs sent before an authorization is pinned to the dashboard will not appear in Availity; those will continue arriving through other channels. Access three-minute demos and step-by-step instructions via Help & Training in Availity Essentials or the Provider Help Center. Contact Sunflower provider relations (numbers listed in bulletin) with questions. Failure to utilize these new features may result in delayed authorization responses and unnecessary manual follow-up processes.