Entries by ABILITY

New law eliminates access to FL Medicaid claims portal

New changes to the Agency for Health Care Administration (AHCA) in Florida could impact your practice’s claims submission and remit processes. CS/HB 1057, signed into law in June, eliminates parts of the AHCA’s requirements for Medicaid reporting. As part of those changes, Florida providers will no longer have access to CMS’ free Medicaid reporting portal.1 […]

How a family medicine practice protected revenue and served more patients with telehealth

How can practices protect revenue while serving more patients and improving outcomes? During the COVID-19 pandemic, Southwest Family Medicine was faced with a serious challenge: how to reach patients and provide outstanding care when in-person appointments weren’t an option. Thanks to the right telehealth technology, the practice was able to see more patients and maintain […]

Hospice providers now may submit claims to Medicare Advantage Organizations

More Medicare beneficiaries may enter hospice care with complementary Medicare Advantage (MA) plans as the Centers for Medicare & Medicaid Services (CMS) rolls out health plan innovations under the Medicare Advantage Value-Based Insurance Design (VBID) Model. The innovative plans are meant to reduce costs and improve care for Medicare beneficiaries. Once hospice providers have registered […]

Inovalon and Homecare Homebase Announce Multi-Year Exclusive Agreement

Next-Generation, Cloud-Based Platform Empowers More Than 25% of Home Health Providers Nationwide with Greater Patient Data Accuracy and Administrative Efficiency Across All Payers BOWIE, Md. – June 22, 2021 – Inovalon (Nasdaq: INOV), a leading provider of cloud-based platforms empowering data-driven healthcare, and Homecare HomebaseSM, LLC (HCHB), the leading agency management and EMR software platform […]

Overcoming the biggest challenges facing skilled nursing facilities today

Over the last few years, skilled nursing facilities have been put through the wringer as they’ve grappled with a new Medicare payment model, higher acuity patients, declining reimbursements, increased regulatory scrutiny and most recently, the COVID-19 pandemic and staff turnover. Staying afloat in this ever-changing post-acute care industry can be an uphill battle; however, it […]

How telehealth helped a marriage and family therapy practice expand access to care

How do you provide patients access to care when you can’t meet them in person? Like all healthcare providers across the country, Dawn Theodore faced a once-in-a-lifetime challenge in the worldwide COVID-19 pandemic. But COVID wasn’t the only thing keeping patients from accessing care from the marriage and family therapist. “Even before the pandemic,” Theodore […]

Medicare simplifies home health claims, phasing out RAPs

The Centers for Medicare & Medicaid Services (CMS) announced that its phase-out of requests for anticipated payments (RAPs) will be complete in 20221, simplifying the process of billing home health care delivered to Medicare patients by Home Health & Hospice Medicare Administrative Contractors (MACs). Instead of the RAP, home health agencies (HHAs) will submit a […]

Understanding PDPM & the ABILITY CAREWATCH PDPM Calculator

How is PDPM calculated?   The ABILITY CAREWATCH PDPM calculator uses the payment for each component and is calculated by multiplying the case-mix index (CMI) that corresponds to the patient’s case-mix group (CMG) by the wage adjusted component base payment rate, then by the specific day in the variable per diem adjustment schedule when applicable. […]

Close the gaps between your claims data, insights and actions

Think about a claims- or billing-related issue that you face on a regular basis. Denials. Audits and appeals. Missing reimbursements. Now, what do you need to tackle any of those problems? You need to know they are happening, and you need the data and insights to resolve them — fast. If you’re using multiple claims […]