Integrate intelligent data into your services

October 21, 2015 ABILITY

When CMS announced that, for the first time, innovators and entrepreneurs would be allowed to access CMS’ powerful store of healthcare data, it created a tremendous opportunity to encourage research that will ultimately improve the quality of care and outcomes, and in turn reduce costs and improve population health.

ABILITY is already providing ways to help our customers look at their data, and continually adding to those possibilities. In the last edition of the Strategic Partner newsletter, we shared how ABILITY | ACCESS successfully helped a healthcare revenue consulting firm shorten time-to-revenue by implementing a programmatic data retrieval API system. In addition to easing maintenance, providing customization for partners’ IT departments and reducing the time-to-revenue, ABILITY | ACCESS builds intelligence into your data and third-party data to streamline administrative processes.

ABILITY | ACCESS is a REST-based API toolkit with a single platform that makes obtaining and writing data within the CMS Shared System simple, while also providing real-time eligibility status for Medicare and commercial payers.

How does ABILITY | ACCESS provide intelligent data?

ABILITY | ACCESS integrates data from CMS—through the Common Working File (CWF) and DDE—directly into your application and then provides that data back to CMS through the API. Our Strategic Partners can rest assured knowing that their data is completely safe through secure computing while benefiting from providing seamless access to the nation’s largest payer, Medicare.

When CMS sends hospitals and other large healthcare entities Additional Documentation Requests (ADRs) in order to adjudicate claims, the process of gathering all necessary documentation and submitting it to CMS can be quite the arduous process—each ADR often requires hundreds of pages to support payment of the claim! Strategic Partners who utilize the ABILITY | ACCESS API can access their ADRs quickly and seamlessly, allowing them more time to prepare the documentation in order to send it to Medicare in a timely manner.

The costs of printing and mailing hundreds of pages of documentation to CMS is not only time-consuming, it’s costly. That’s why ABILITY is proud to offer a convenient service known as AuditDocs to connect providers and healthcare vendors to the esMD gateway. esMD (Electronic Submission of Medical Documentation) is a program CMS established to reduce administrative processes and paper waste associated with providers responding to ADRs. Because AuditDocs can be seamlessly integrated into a healthcare vendor’s application, a vendor who integrated both ABILITY | ACCESS and AuditDocs into their software would save their customers hundreds of hours of costly, slow-going documentation gathering and submission by not only providing the mechanism for receiving their ADR online, but also submitting their response through the same application.

The provider-facing portal provides esMD submission and tracking, which significantly reduces the overhead spent managing the process manually. Furthermore, AuditDocs enables healthcare vendors to seamlessly embed audit responses and Power Mobility Device (PMD) authorizations into the applications they provide to their customers in addition to ADR responses. With access to a convenient way to receive ADRs and a seamless process for submitting responses, healthcare providers can take advantage of the intelligent data provided directly from CMS through their healthcare vendor’s application.

Questions? Give us a call at 888.271.8222 or email us at!


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