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New Functionality in Availity Essentials

Date: 09/11/26

A Message for All Providers. Please share with your  team.

In an effort to continuously improve, Availity Essentials is making the following enhancements.

Eligibility and Benefits As-of-Date Extended to 30 Days: Providers in this region can now use the Availity Essentials Eligibility & Benefits form and As of Date search tool to check Medicare and Medicaid eligibility information for patients up to 30 days in advance.

Increased File Sized for Attachments: Providers who use Availity Essentials to submit HIPAA transactions claim appeals to Sunflower Health Plan can now include attachments up to 64 MB per attachment, with a maximum of 10 attachments.

Streamline Authorization Follow-Ups by Viewing and Responding to RFAI Online: Managing authorization follow-ups just got easier with request for additional information (RFAI). You can securely receive and respond to requests from Sunflower Health Plan — right within Availity Essentials.

View and respond to RFAIs

Use the Authorization/Referral Dashboard to review and respond to requests for additional information.

  • On the Dashboard Summary page, look for Pending Action – Contact Payer in the Status/Last Updated column.
  • Open the authorization and review the Review Reason 1 field for the payer message. Then scroll down the page to the RFAI section to review request details.
  • Upload your response. 
    • You can upload up to 10 attachments or a total of 64 MB. 

Tip: If you submitted an authorization outside of Availity Essentials (for example, through another portal or by fax), use the Authorization/Referral Inquiry tool to access the authorization, then pin it to your dashboard to track its status. 

Note: RFAI requests sent before the authorization is pinned to your dashboard won’t appear. You’ll continue to receive notifications through other channels.

Training and support resources

Access training and support resources in Availity Essentials:

  • Three-minute demo: 
    • From the Availity Essentials homepage, select Help & Training > Get Trained.
    • Search “CNC” in the Learning Center catalog.
    • Select Auth Request for Additional Information.
  • Illustrated step-by-step instructions:
    • In Availity’s Provider Help Center, go to Help & Training > Find Help.
    • Search “process requests for additional information authorizations.” 

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative or call us at the numbers below:

 

 

 

Ambetter from Sunflower Health Plan is underwritten by Celtic Insurance Company, which is a Qualified Health Plan issuer in the Kansas Health Insurance Marketplace.  ©2026 Celtic Insurance Company. All rights reserved.