Stop delaying or losing revenue due to eligibility issues

Keeping on top of eligibility verification, including re-validation, is critical to your organization’s fiscal health. Too often facilities like yours can experience delayed or lost revenue because of the difficult, complicated process of checking eligibility status. Re-validation can be a nightmare, too, with patients changing insurance plans and no systematic historical record available.

Put those headaches in the past. 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?

ISSUE: Our system for verifying eligibility is slow and error-prone ...

Our system for verifying eligibility is not only a problem for us, but it’s affecting our patients’ bills, too. The process is time-consuming and complicated. And our patient satisfaction rates are going down because bills are late or need correcting.

ABILITY ANSWER: ABILITY | COMPLETE provides your staff a user-friendly interface with single sign-on that simplifies tasks and reduces workflow complexity. With the ability to batch requests and check multiple payers simultaneously for multiple patients, your staff immediately becomes more efficient. Re-validation is made easier, too, with sweeps that can check the eligibility of your entire patient census. Keep your patients happy – and your revenue on track – with bills that get it right the first time.

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ISSUE: It seems there’s no way to keep the intake process fast, 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 intake staff, even after we’ve provided services.

ABILITY ANSWER: Using ABILITY | COMPLETE, 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!

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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.

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Additional services for Skilled Nursing Facilities

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

888.895.2649