Eligibility checks with Availity
Check a client’s coverage in real time (270/271) through Availity’s API, from the client’s record, using your practice’s own Availity credentials. Nothing from the check is stored.
ABA billing software with Availity built in
Check coverage, track authorization units, submit claims and post payments without leaving the client’s record. Nūr Evoke connects to Availity for eligibility and claim submission, and checks every claim before it leaves, so fewer claims are denied for avoidable reasons.
Claim · Client A.Payer 1 · Dates of service Oct 14–15 Claim check passed
Prepared
Validated
3 Submitted via Availity
4 835 posted
DateCPTServiceUnitsAmount
Oct 1497153Direct therapy (RBT)12$240.00
Oct 1497155Protocol modification4$104.00
Oct 1597153Direct therapy (RBT)8$160.00
Total24$504.00
Download CMS-1500 Submit to Availity
From eligibility to payment
Billing follows the clinical record instead of being rebuilt from it.
Authorizations and units
Track approved units per billing code and payer with from and through dates. Scheduling past the authorized units is stopped before it happens.
Claims built from visits
Prepare claims from completed visits. Visits with a time change waiting for approval are held out until they are approved.
A check before every claim
A claim can’t be sent until it has a payer, member ID, NPI and diagnosis. A validation pass flags other things payers reject, such as a missing billing code or place of service.
Submit claims through Availity
Send the 837P to Availity over a secure SFTP connection you set up once, with a test mode and a production mode so you can try it safely first.
CMS-1500 and 837P downloads
Download the CMS-1500 PDF or the 837P file for any claim, for payers or clearinghouses that want them another way.
Payments come back in
Read 835 remittances back in and post payments by claim line, matched to the claim, so you can see what was paid, adjusted or denied without typing it again.
Secondary insurance and denials
Bill the secondary payer after the primary pays, mark a claim denied and reopen it for correction.
Revenue, payroll hours and family billing
Pay rates are saved with each visit, so hours and payouts per clinician match what was scheduled and signed. See revenue by period and handle the part families owe, from the same records.
How a visit becomes a paid claim
- 1
Check coverage and record the authorization
Run an Availity eligibility check, then enter approved units by billing code and payer with the dates they cover.
- 2
Schedule and deliver
Units are reserved as visits are scheduled, and the session note is completed and signed.
- 3
Prepare and check
Create the claim from the visits and run the validation check.
- 4
Submit through Availity
Send the 837P to Availity, or download the CMS-1500 or 837P instead.
- 5
Post the payment
Read the 835 remittance in, bill secondary if needed, and follow up on denials.
Frequently asked questions
Does Nūr Evoke work with Availity?
Yes. It checks eligibility through Availity’s API, submits 837P claims to Availity over SFTP, and reads 835 remittances back in. You connect your practice’s own Availity details once in settings.
Do I need my own Availity account?
Yes. Eligibility checks and claim submission use your practice’s Availity credentials and SFTP details, which you save in Nūr Evoke. A test mode lets you try the connection before going live.
Can it stop us from scheduling past an authorization?
Yes. Units are tracked per billing code and payer, and scheduling past what was approved is blocked, so you don’t deliver hours you can’t bill.
Can it bill secondary insurance?
Yes. Once the primary payer’s payment is posted, you can bill the secondary payer from the same claim.
Does it handle payroll too?
It saves the pay rate with each visit and shows hours and payouts per clinician. Payroll itself stays in your payroll provider.
More from Nūr Evoke
See it with your own practice in mind
Request a demo and we will walk you through it.