Hospital – More than 150 beds

    Transform your all-payer eligibility management

    Take control of your admissions and eligibility workflow. ABILITY | COMPLETE™ gives you single sign-on access to eligibility verification from Medicare, Medicaid, and over 400 commercial payers. And, you’ll receive alerts automatically if there’s a coverage overlap. Batch features allow you to enter multiple patients and check multiple payers – all in one step.

    With ABILITY | COMPLETE, you not only bill the correct payer the first time, you can re-validate eligibility with confidence. Best of all, ABILITY | COMPLETE provides you with access to all eligibility transaction history – great documentation for your records and for any challenges to a patient’s verification status.

    What can we do for you?

    Tracking down all the relevant eligibility info on a patient takes huge amounts of time. Every single time, I have to access several sections of DDE to get a comprehensive picture. I keep a folder handy with all the different payers’ logins, passwords and info requirements. 

    ABILITY ANSWER: ABILITY | COMPLETE gives you a single, easy-to-use interface presented in a standard format regardless of payer or payer class. Sign in with one username and password to verify eligibility with Medicare, Medicaid, and over 400 commercial/private payers. You’ll get information on co-pays, termination dates, deductibles and coinsurance. Get rid of your sticky notes – and increase efficiency and accuracy!

    When I get a stack of referrals that need to be validated, I know it’s going to take forever to look up multiple patients and multiple payers. I’m always afraid I’m going to miss something when the process is so tedious and time-consuming to check every patient with every payer.

    ABILITY ANSWER: Eliminate those long sessions and repetitive tasks going in and out of DDE! Using the simple ABILITY | COMPLETE interface you enter each patient (back to back), and with the click of a button send out a batch verification request for a single payer. Or, check one patient’s status with multiple payers, simultaneously. . Or – check multiple patients, with multiple payers! Think about the time you’ll be saving.

    It seems there’s no way to keep the intake process fast and easy for our patients AND be 100% accurate at registration, given our current staffing levels. We don’t want to add staff, but the alternative seems to be having back office staff take time to double-check and correct the verification work of the intake staff, even after we’ve provided services.

    ABILITY ANSWER: Using ABILITY | COMPLETE, you can set up and save certain Service Type Codes to produce an eligibility response optimized for your line of business or businesses. You receive only the most relevant information, eliminating the need to wade through a bunch of non-relevant eligibility data for each patient. Set up customized notes for each payer’s eligibility response (for example, whether or not that payer requires pre-authorization, the phone number needed to call to verify, reminders, payer contact information, and more). You’ll improve efficiency at intake, reduce errors – and stop repetitive work. Get more productivity from the same number of staff!

    Eligibility verification is frustrating because status changes are so easy to miss. A patient might have Medicare, dual eligibility, or another insurance as primary. It’s hard to know what I’ve done wrong if I get dinged for “failed eligibility.” When I miss something, it can delay payments and really mess up the patient’s bill.

    ABILITY ANSWER: With ABILITY | COMPLETE, you can set up automated sweeps that check the eligibility of your entire patient census, giving you status alerts when coverage changes or switches to non-eligibility. You also receive alerts with visual cues for failed eligibility or other follow-up items that need attention. Bill the correct payer the first time!

    With all that’s on my plate, it’s hard to keep track of everyone’s tasks remotely. I wish I didn’t have to hold so many meetings to make sure we’re getting it all done.

    ABILITY ANSWER: The powerful dashboard of ABILITY | COMPLETE puts you in the driver’s seat!  Manage workflow from your desktop: you can prioritize and assign patients, payers, and daily task lists to specific staff, as well set up your own reminders and notes to staff, even if they’re located at multiple facilities. Keeping track of tasks is as easy as logging into your dashboard.

    Responses from payers don’t always provide all the info we need to verify eligibility. Our admissions people are so busy, inevitably I’m the one spending time figuring out who to call to get the whole picture, and then sitting on the phone waiting for the information.

    ABILITY ANSWER: The workflow dashboard for ABILITY | COMPLETE gives you the ability to add notes to a payer’s eligibility response (for example, whether or not that payer requires pre-authorization, the phone number you need to call to verify, reminders, payer contact information, etc.). You or your staff can receive customized reminders and payer specific requirements – and decrease time spent on the phone.

    Instead of everybody seeing everything, it would be great if staff users could filter down to just the info they need. I know people would be happier if they didn’t have to wade through everything to get the info they need.

    ABILITY ANSWER: ABILITY | COMPLETE gives you the control you want. Users can create personalized filters for the pieces of information they most often check. Users can also create follow-up indicators on patients for other departments or users. More ease and control for you!

    When claims get denied and we need to appeal, too many times we can’t prove a patient’s eligibility was previously verified. We often need to produce historical insurance verification when challenged by Medicaid, Medicare or a commercial payer – for patients we’ve already provided service for – and there’s no easy way to do it.

    ABILITY ANSWER: ABILITY | COMPLETE stores all validation transactions for historical proof of eligibility status. Staff can pull up all historical insurance verification transactions (time and date stamped) by simply running an electronic report from their desktop. You get fast, accurate documentation – proof that eligibility was verified, and confirmation of coverage – all in one easy-to-produce report.

    Call us

    Questions? Comments? Give us a call, we’re here to help!