Payers

Outstanding support for your providers with less hassle for you

In this era of Medicare modernization, consumer-driven healthcare and rising healthcare costs, it’s more important than ever for payers to stay close to your provider community. Coordinated care and information flow are absolutely essential for managing the balance between health care and health costs. Yet, keeping in touch with so many providers isn’t always easy.

There is a reason each of the Top 25 Health Insurance Companies uses the ABILITY Network: they understand the need to have a secure and reliable connection between the payer-provider community. With our Provider Network Management services, ABILITY gives you a variety of solutions, from automated enrollment services to managing provider network communications. In addition, we’ll help your providers with the setup, secure connection, and continuous maintenance of the network as needed as well as maintain the support operations for these services. With the resources of the nation’s largest, most secure web and private network infrastructure, you can enjoy the benefits of closer ties to your provider community with less stress about the administrative details of providing it.

ABILITY supports clinical data transfer
Not only does ABILITY support administrative transactions, we also help payers move critical clinical information efficiently and seamlessly, allowing payers to communicate directly with providers, and providers to submit claims with ABILITY.

What can we do for you?

ISSUE: Providers need a more streamlined process for submitting transactions to payers through a trusted partner.

I’d like to provide a simple solution for providers to submit claims electronically.

ABILITY ANSWER:ABILITY supports the relationship between payers and providers by enabling providers to submit claims and transactions electronically at no cost to them. Not only does this expedite the reimbursement process, it streamlines provider billing with a fully integrated practice management solution.

ISSUE: Many providers still submit claims through paper.

I want to more fully transition to electronic claims, but I can’t because certain providers still submit paper claims.

ABILITY ANSWER:ABILITY helps reduce costly paper correspondence and the number of rejected claims by converting providers to EDI, and in turn, increasing provider adoption of ERAs and EFT. This helps support real-time eligibility verification services. Ask us how we utilize a co-branded portal, postcards to providers and caller outreach to reduce paper claims.

Core services for our Strategic Partners

  • ABILITY | INTEGRATE

    REST-based web services API for seamless EDI integration and workflow connectivity

  • ABILITY | ACCESS

    REST-based API and toolkit and web based portal for programmatic data retrieval

The Strategic Partner Program

Because we know your customers count on you to keep their businesses running smoothly, you can count on us. ABILITY provides Strategic Partners with a dedicated team of advanced technical support representatives who understand the unique needs of IT healthcare business. In addition, ABILITY has dedicated internal staff who work closely with Medicare to understand and proactively address industry changes. We quickly troubleshoot and resolve any Medicare EDI issues as they arise so you don’t have to.

To learn more about the ABILITY Strategic Partner Program, please contact us at 888.271.8222.

Additional resources

SP Product Sheet

Call us

Questions? Comments? We’re here to help!

888.895.2649