Software vendors

Easy Medicare and commercial payer access, within your own applications

ABILITY® Network is a leading healthcare information technology company trusted by over 120,000 providers and payers across the continuum of care, providing a broad suite of innovative workflow services to help manage the administrative and clinical complexities of healthcare. ABILITY is headquartered in Minneapolis with principal offices in Boston and Tampa.

For over 20 years, ABILITY has supported hundreds of healthcare IT vendors across the U.S., connecting the industry to Medicare and commercial payers. ABILITY provides easy EDI payer access, embedding mission-critical eligibility and claims management services directly into a software vendor’s own applications.

Link to http://abilitynetwork.com/about/ for more info about ABILITY.

What can we do for you?

ISSUE: Having to source Medicare data from multiple platforms is a pain…

I want to support as few connections as possible to decrease our support and infrastructure costs. I’d really like to provide a simple, one-stop solution to our customers.

ABILITY ANSWER: ABILITY pioneered secure, easy access to Medicare. A single ABILITY connectivity platform delivers simple access to Medicare. As the nation’s largest Network Service Vendor (NSV), we connect thousands of providers daily to core EDI services such as:

  • Medicare Claims File Transfer (837/835) to all MACS
  • HIPAA Eligibility Transaction System (HETS 270/271) transactions
  • Access to the Medicare Shared Systems (DDE/PPTN/CSI)

ISSUE: Medicare connectivity should be simple and efficient and secure…

Maintaining Medicare connectivity is a challenge for our organization. Keeping on top of MAC changes, addressing the CWF eligibility move to HETS, MAC consolidation  all these keep our technical resources scrambling. Why can’t it be simpler?

ABILITY ANSWER: Our platform sits atop secure Internet connectivity, with uncomplicated installation and no-fuss maintenance. PKI technology and enhanced API toolkits make integrating core and enhanced Medicare services into your applications simple and manageable. ABILITY insulates you from continual Medicare changes. With ABILITY, you can focus on your customers, not on the technology.

ISSUE: Just when I think my customers are covered, Medicare makes a change that complicates everything…

Everyone knows how fast the healthcare industry is changing. There are updates from CMS almost every day. It’s a hassle to have to understand and manage all the moves that Medicare makes, just to keep our customers up to speed.

ABILITY ANSWER: With ABILITY, you get a layer of “insulation” between you and Medicare. ABILITY intelligent connectivity solutions adapt to changes made by Medicare, requiring minimal impact to your internal data systems.

In addition to the technical side, ABILITY has dedicated internal staff with relationships with CMS, so we can understand and proactively address industry changes even before they occur. When there are issues, ABILITY staff can quickly troubleshoot and resolve any Medicare EDI issues as they arise.

ISSUE: Because we support multiple connections to Medicare, it’s hard to navigate through multiple channels to get answers when issues arise…

When something comes up, I never know exactly who to call or who will be helpful  it seems to change depending on the issue.

ABILITY ANSWER: Because we know your customers count on you to keep their businesses running smoothly, you can count on us. ABILITY provides our Strategic Partners with a dedicated team of advanced technical support representatives with decades of experience who understand the unique needs of revenue cycle management. No matter the issue, we’re the place to call.

ISSUE: Our customers want access to commercial payers too…

Many of our end users need connectivity to commercial payers in addition to Medicare, but it’s difficult to provide one consolidated, seamless service for them.

ABILITY ANSWER: ABILITY offers connectivity to most commercial payers for both claim submission and eligibility, in addition to Medicare and Medicaid.

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

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