Latest service enhancements include claims editing, streamlined status requests and improved eligibility checks

The newest enhancements to ABILITY services are focused on improving speed and efficiency for end users. Most notably, through ACCESS, we now offer additional claims editing features, including:

  • Adding and deleting revenue code lines
  • Correcting a Health Insurance Claim Number (HICN)
  • Suppressing the view of specific RTP claims so they do not bog down user workflow
  • Filing Notice of Election/Notice of Termination & Revocation for hospice agencies

These key enhancements are easy to deploy through our simple API toolkits. Upcoming development efforts will continue to expand these editing tools to enable end users to make updates to Medicare DDE data without accessing DDE itself.

In addition to the claims editing enhancements, we have also streamlined the way we process batches of claim status requests to CMS, reducing the time it takes to view the most recent claim status for all of your submitted claims. This helps you give your end users the most current claims status information.

With the latest of our eligibility service offerings, we can produce an HTML-formatted rendering of the 271 response. The HTML output of the 271 will assist our customers who want to display a readable format of the eligibility response without having to parse X12 and develop this feature in-house. You can ask your ABILITY account manager to assist you with enabling this feature in your eligibility services.

Finally, ABILITY has been working with CMS to define a threshold for redundant eligibility checks. The latest enhancements to our Medicare eligibility services prevent submitting excessive redundant eligibility requests through HETS. End users now receive an alert letting them know they have exceeded the number of allowed requests for an NPI and patient combination, while insulating them from the consequences of potentially having their credentials suspended by CMS. This important guidance is embedded within all of our Medicare eligibility service offerings.