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Abridge has teamed its AI platform for clinical conversations with Availity’s digital platform that connects payers and providers to enable payer determination during a patient visit.
The collaboration ensures a shared clinical context at the point of conversation for prior authorization review and submission, the companies said. The information is being shared between providers and payers, as opposed to having parallel AI systems.
Real-time conversational intelligence identifies gaps during a visit. Technology in the clinician-patient conversation facilitates a more efficient process between clinicians and health plans in medical necessity review, the companies said.
The goal is to help both payers and providers reduce manual workflows, administrative delays and peer-to-peer consults.
Availity is used by 95% of payers and supports 3.5 million providers. Availity’s FHIR-native Intelligent Utilization Management platform helps payers and providers digitize and operationalize coverage requirements within administrative workflows. It enables secure connectivity of payer information.
Abridge, which serves more than 200 health systems, is projected to support over 80 million patient-clinician conversations in 2026. Its Contextual Reasoning Engine technology gives visibility into clinical information during the conversation to support documentation aligned with prior authorization requirements.
The development of real-time prior authorization is one component of revenue cycle collaboration using conversational intelligence, the companies said.
Collaborations include using simplified prior authorization to enable payer determination during the visit, highlighting documentation gaps, authorization integrity, and reducing administrative burden by supporting clinicians with prior authorization documentation and submission during a visit.
“At Availity, we’ve invested in building AI-powered, FHIR-native APIs designed to bring clinical policy logic directly into provider workflows,” said Russ Thomas, CEO of Availity. “By embedding our technology at the point of conversation, we’re enabling faster, more transparent utilization management decisions rooted in clinical context. We’re excited to collaborate with Abridge and to demonstrate what’s possible when payer intelligence meets real-time provider workflows.”
“Abridge and Availity are each bringing national scale, deep trust, and a track record of solving important challenges across the care and claims experience to this partnership,” said Dr. Shiv Rao, CEO and cofounder of Abridge. “We’re building real-time bridges between patients, providers, and payers, unlocking shared understanding, focused at the point of conversation.”
Email the writer: SMorse@himss.org