Hospitals large and small are continually challenged to make sure patient admissions and revenue both keep flowing. Keeping track of patient eligibility and fixing and re-submitting claims are time-consuming, complicated processes. All of this can mean delayed or lost revenue for your organization.
ABILITY services accelerate and simplify complex reimbursement processes and can also save you thousands of dollars. Take a look at how ABILITY can help you get your hospital’s eligibility and billing under control.
What can we do for you?
ISSUE: I spend huge amounts of time tracking down all relevant eligibility…
I spend huge amounts of time tracking down all the relevant eligibility info on a patient. Every single time, I have to access several sections of DDE to get a comprehensive picture. I have to go into all these portals and use a different login process for each payer. I keep a folder handy with all the different payers’ requirements.
ABILITY ANSWER: The ABILITY | COMPLETE service 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!
ISSUE: Looking up multiple patients and multiple payers takes forever…
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! 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.
ISSUE: When claims 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.
ISSUE: Our billing staff has to manually search for and identify Medicare claims problems…
It also takes a lot of effort to correct claims the process is a nightmare! All of that can cause delays in getting reimbursement, because claims needing to be fixed are missed or aren’t identified right away.
ABILITY ANSWER: With ABILITY | EASE Medicare billing staff gets automated alerts, reports, and inquiries for ALL claims submitted to Medicare, sent right to their desktops. They’ll see whether the claims are paid, suspended, RTP’d, rejected, denied, or need modifications. Pop-ups on the reports explain the problem in detail so the corrective action is clearly identified no need to refer to external resources.
The biller then uses a simple “click to fix” option from a “Windows-style” interface to correct and resubmit claims all without having to access the multiple, complex “green screens” of the DDE/FISS system.
ISSUE: I’d love to get a better handle on cash flow from Medicare…
I’d love to get a better handle on reimbursement cash flow projection for our Medicare claims, but it seems almost impossible with our current setup.
ABILITY ANSWER: With ABILITY | EASE, you have access to comprehensive Medicare claim reimbursement information daily, with reports that provide a view of all claims paid as well as reimbursements expected (for up to 14 days in the future) and claims in process. You can eliminate the limited visibility regarding Medicare reimbursement and the risk of not knowing your cash flow position.