Availity has been nominated for the 2026 World AI Awards in the AI Denial Management category, recognising the healthcare technology company’s work in applying artificial intelligence to insurance claims, denial prediction and revenue cycle management.
For hospitals and healthcare providers, a rejected insurance claim means more than delayed payment. It can trigger additional paperwork, staff intervention and lengthy discussions with insurers. Availity is tackling that problem before claims even reach the payer.
The World AI Awards recognises organisations, individuals, products and technologies contributing to the development and real-world application of artificial intelligence across industries.
Based in Jacksonville, Florida, Availity operates a healthcare information network connecting providers, health plans and technology partners. The company reports processing more than 13 billion clinical, administrative and financial transactions annually.
Predicting claim denials before they happen
One of Availity’s most significant AI applications is Predictive Editing, introduced in April 2024 as part of its Availity Essentials Pro revenue cycle management platform.
The technology examines historical insurance claims and payment information to identify patterns associated with rejected claims. It then flags potentially problematic submissions before healthcare providers send them to insurers.
Unlike traditional claims editing systems that rely primarily on predefined rules, Predictive Editing uses machine learning to identify changing payment patterns and payer-specific requirements.
According to Availity, the technology was developed using a database containing more than 3 billion medical and pharmacy claims.
The system can also return predicted denial reasons, helping billing teams identify issues that may need correction before submission.
AI identifies $828 million in potential denials
Availity reported promising results from a proof-of-concept study involving more than 100 million claims from two large health systems.
According to the company, Predictive Editing flagged more than $828 million in claims associated with potential denials, achieving 97% precision in the study.
Those figures demonstrate the technology’s reported ability to identify denial risk. They do not mean that $828 million was recovered or that every flagged denial was ultimately prevented.
The distinction is important. Predicting a rejection gives healthcare organisations an opportunity to investigate and correct a claim, but successful reimbursement still depends on the underlying claim and the insurer’s requirements.
Moving healthcare revenue cycles beyond reactive management
Availity is pushing healthcare organisations toward a more proactive approach to insurance claims.
In June 2026, the company published guidance encouraging providers to address denial risks earlier through improved data quality, payer connectivity and predictive intelligence.
Its Availity Essentials Pro platform combines AI-powered predictive editing with claim correction workflows, allowing revenue cycle teams to review errors, identify recurring problems and manage multiple claims.
Availity’s 2026 Abrasion Index also identified denials as a major source of administrative friction between healthcare providers and insurers.
The company’s approach reflects a practical shift in healthcare AI: preventing avoidable administrative problems rather than simply automating the work required to resolve them.
Graham Cooke, President of the World AI Awards, said:
“Availity’s nomination in AI Denial Management highlights an important opportunity for artificial intelligence in healthcare: helping providers identify potential insurance claim problems before they become costly denials.
“From analysing billions of historical claims to predicting denial risks and improving revenue cycle workflows, Availity’s work shows how AI can support healthcare organisations in reducing administrative complexity and improving claims accuracy. We congratulate Availity on its 2026 World AI Awards nomination and look forward to following how these technologies continue to develop.”
Availity joins organisations, researchers, entrepreneurs and technology developers being recognised through the 2026 World AI Awards.
The programme celebrates contributions to artificial intelligence across industries, including healthcare, financial services, manufacturing and enterprise technology.
Availity’s nomination in AI Denial Management reflects the growing importance of AI in addressing operational challenges that directly affect healthcare organisations.
By identifying potentially problematic claims before submission, the company is demonstrating how predictive technology can help billing teams make better-informed decisions while reducing avoidable administrative work.
Learn more about Availity and its healthcare technology at https://www.availity.com/.
Discover the World AI Awards 2026, explore the nominees and learn more about the awards at https://www.worldawards.ai/.
