Health System

Get revenue on track with improved eligibility management

If you’re part of a larger health system, it can be difficult keeping up with multiple locations, NPIs, and staff as you’re managing patient eligibility.

Take control with the powerful workflow dashboard in ABILITY | COMPLETE™, the all-payer eligibility management system. You’ll see information from Medicare, Medicaid, and over 400 commercial payers. You can assign and prioritize patients, payers and tasks, plus create free-form and payer-specific notes to more effectively manage multiple tasks. You can also set up and save your own custom filters and sorting options to ensure accounts receive proper follow-up and resolution. Batch features allow you to enter multiple patients and check multiple payers all in one step.

What can we do for you?

ISSUE: I oversee several locations and it‘s hard to keep track of everyone’s tasks…

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.

ISSUE: I wish I had more control over the data…

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!

ISSUE: How do we keep the intake process fast and easy AND 100% accurate?…

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. I 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 admissions staff, even after we’ve provided services.

ABILITY ANSWER: Using the powerful ABILITY | COMPLETE dashboard, staff can set up and save certain Service Type Codes to produce an eligibility response optimized for your line of business or businesses. Your staff receives only the most relevant information, eliminating the need to wade through a bunch of non-relevant eligibility data for each patient. They can 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!

ISSUE: When claims can get denied, it’s so difficult to prove previous verification…

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.

Core services

Don’t take our word for it. Hear what our customers have to say.

“The time saved by simply reviewing a summary and then clicking on the patient’s name to jump to the claim in question is immeasurable. The accuracy of corrections is 100%, and the worry-free approach is exceptional.”

Ross Health Care

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Questions? Comments? We’re here to help!

888.895.2649