Two key questions about our next-generation RCM application

September 30, 2016 ABILITY

Since the introduction of our all-payer RCM application, ABILITY | ACCESS® RCM, our representatives have been talking with a number of Strategic Partners about how they can integrate it in their own software and services. We’ve also hosted a series of webinars (see an on-demand version here!) to demonstrate its powerful capabilities, which include claim-scrubbing, at-a-glance claim histories, and end-to-end RCM features that eliminate the need for many other programs.

In those conversations, two questions have stuck out as particularly vital to helping our Strategic Partners understand this unique technology and how they can put it to work for their own customers:


1.How are the business rules applied, changed and customized?

ABILITY | ACCESS RCM handles custom rules very differently from other clearinghouses. While the current industry practice is to “hard code” custom rules, which requires significant time and expense, our application is built with a non-code-based rules engine. This allows for custom business rules to be built affordably and far faster than the industry average.

During the implementation process, you can also create a “bundle” of custom rules, so you can ensure the system meets your needs from the very start, and maintain the flexibility to quickly adapt it down the road by simply making a request through ABILITY.


2.Does the application track user edits as well as system edits?

Yes. As you probably know, HIPAA requires that a log is kept any time protected health information (PHI) is accessed or edited. Many software systems currently track who accesses data and when changes were made, but not necessarily what was changed. Not only does ABILITY | ACCESS RCM log all of these factors, but it also notes any instances in which an edit was automatically applied because of the software’s business rules.

For instance, a customer may have a business rule that ensures claims are submitted with the exact name under which eligibility was verified. In this case, if eligibility is confirmed for “Jane Abigail Doe” but a claim is later submitted for “Jane Doe,” the software will insert the middle name to ensure a match. In a case like this, ABILITY | ACCESS RCM will not only document the edit, but also the business rule that led to the change.


Our team continues to work hand-in-hand with Strategic Partners to help them leverage the capabilities of this technology and customize it for their own unique needs.

To learn more about ABILITY | ACCESS RCM and how you can integrate it with your own software, view our on-demand webinar



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