Exciting enhancements to ABILITY services

October 20, 2015 ABILITY

ABILITY is constantly evaluating our services to better serve our Strategic Partners. Our product management team strives to provide our partners and their customers access to the features they need in order to support and grow their business. That’s why we’re excited to share several enhancements to existing ABILITY services that will better serve your customers.


If you’re an ABILITY Strategic Partner, you may be taking advantage of this REST-based API toolkit which offers a single platform that makes obtaining data within the CMS shared systems simple, addresses ongoing CMS changes (such as the transition of CWF eligibility to HETS), and provides real-time eligibility for Medicare and commercial payers.

Over the last few months, we’ve added several exciting enhancements to ABILITY | ACCESS that help automate and streamline processes for the end user.

Serve the hospice market?

ABILITY | ACCESS now includes the ability to create and update Medicare DDE applications, including hospice related features such as NOE (Notice of Election), NOTR (Notice of Termination), and NOE and benefit period cancellation. This programmatic automation not only helps hospice organizations file high-volume claims in a timely fashion, it enables automatic retrieval of offline claims for revenue cycle management companies and healthcare consulting agencies to conduct claims reviews and adjustments.

Access to archived claims is typically required when a partner needs to review claims for errors such as unqualified transactions, quality of care or type of skilled facility. Additionally, partners may need to make claims adjustments to claims that have been archived. Through the capability to retrieve offline claims, adjustments or claim cancellations can still be conducted after a claim has been archived provided its date of service complies with Medicare timely filing requirements.

Provide connectivity to all commercial payers

We know our partners are constantly looking for ways to expand the service offerings they’re able to provide their customers. That’s why we added all-payer eligibility to ABILITY | ACCESS! Whether you’re a practice management vendor, a revenue recovery agency, a billing service or another type of partner that could benefit from access to all-payer eligibility, ABILITY | ACCESS provides eligibility inquiries and responses for Medicare and all-payers while integrating the ability to create and update eligibility inquiries.

With a User Acceptance Test (UAT) environment, partners are provided access to a pre-released version of the ABILITY | ACCESS API in order to make development changes in a true test environment. This allows for any issues to be addressed before the partner applications go into production in a live environment, resulting in a faster time-to-market and time-to-revenue.

Simplified process, increased usability

Oftentimes, hospice and home health agencies encounter RTP (Return to Provider) claims which do not need to be corrected. Because FISS does not allow a RTP claim to be deleted, hospices and home health agencies should suppress the view of these claims. Suppression of the claim cannot be reversed and the suppressed claims will still appear when viewing claims in the Summary Inquiry screen. Through the ability to update and write claims through ABILITY | ACCESS, healthcare organizations can easily suppress the view of RTP claims.

Secure Exchange Server (SES):

The ABILITY Secure Exchange Server provides a centralized aggregation point for automating all your EDI workflow and connectivity. Seamlessly handling all MAC updates and password management, the SES ensures consistent technical performance. Recently, ABILITY added all-payer claims (837), remits (835) and eligibility access for our server customers, creating a single platform to submit Medicare and all-payer claims and eligibility.

The integration of all-payer claims and eligibility into the SES platform simplifies your operations by:

  • Operationally creating a single path for all claims and eligibility connectivity
  • Reducing the number of outside vendors simplifying accounting and internal transaction reporting

ABILITY Integrated EDI Connectivity:

ABILITY provides the tools to embed mission critical services your clients depend on directly into your software. Eliminating the need to access multiple and often confusing systems will provide an embedded solution that increases the value of your software.
In addition to benefiting from direct connectivity to Medicare for claims and eligibility processing, the service now enhances the value of your software by providing access to all-payer claims, which allows you to better serve a wide range of the healthcare sector, including Part A, Part B and DME claims.

Service enhancements are an ongoing process at ABILITY Network. We look forward to offering even more capabilities to our Strategic Partners over the next few months. Stay tuned for additional capabilities to your services with ABILITY in the next edition of the ABILITY Strategic Partner newsletter.

Is there a feature you would like to see incorporated into an ABILITY service? We want your feedback! Send us an email at partner.sales@abilitynetwork.com with the enhancements you’d like to see—we’re always looking for ways to improve our service offerings.

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