Transcription

User GuideABILITY Network Inc

Copyright and TrademarkCopyrightCopyright 2015 ABILITY Network Inc. All Rights Reserved. All text, images, and graphics, andother materials in this document are subject to copyright and other intellectual property rights ofABILITY Network Inc. These materials many not be reproduced, distributed, modified, orrepublished without the express written permission of ABILITY Network Inc.TrademarkThe marks appearing in this document including, but not limited to ABILITY Network (ABILITY),ABILITY logo, and all ABILITY services are trademarks and/or registered trademarks ofABILITY Network Inc. All other brands, product names, or services are trademarks or registeredtrademarks of their respective holders.

ABILITY COMPLETE User GuideContentsmyABILITY Overview . 1About this guide . 1Navigation Bar and Folders . 2My Dashboard. 4Shared Workspace . 5Filter Dashboard . 6Status & Date . 7Unreviewed . 7Owner . 7Payer . 7NPI . 7Create Custom Favorite Dashboard Filter Setting . 8Search Dashboard by Patient . 8Two-Character Name Search . 8Auto-Complete Search . 8Shared Workspace . 9Commands . 10Actions . 11Change Owner . 12Change Follow-up . 13Add Note . 14Add Non-EDI . 15Add to Batch . 16Reports . 17Configure Dashboard . 18Create Custom Follow-up Statuses . 19Default Follow-up Statuses. 19Edit Follow-up Status . 19Hide Follow-up Status . 19Add an NPI . 20Configure Payers . 22Payer Enrollment. 23Payer Notes . 24Edit an NPI . 25Make an Eligibility Request . 26Step 1: Select NPI . 26Step 2: Select Payer(s) . 27Step 3: Enter Patient and Request Information. 32Eligibility Response . 33Service Coverage Overview and Service Types . 33PROPRIETARY AND CONFIDENTIAL iii

ABILITY COMPLETE User GuideSave Responses for Payers as Favorite View . 34Filter Medicare Responses . 35Filter Non-Medicare Responses . 35Eligibility Response Panels . 36View Eligibility State . 39Active Coverage . 39Inactive Coverage . 39Non-EDI Payer . 39Pending Status . 40Review: Other Plan Detected . 40Request Failed . 40View Multiple Payer and Patient Requests . 43Additional Operations . 44Sending Requests to the Dashboard . 44Mark a Response as Unreviewed for Later Follow-up . 45Add a New Request into an Existing Batch . 46User Notes . 47Request History . 50View Previous Eligibility Requests . 50Search Eligibility Requests by Patient . 50Filter Eligibility Request History . 51Save Filter as Favorite on the Request History Tab . 52Filter Results . 52Batch History . 53View Previous Batch Runs . 54View Recurring Batch Schedule . 55View Deleted Batches . 55Rerun Batch Requests . 56Create/Edit Batches . 60Create a New Batch . 60Make Recurring Batches (Optional). 61Add Requests to your Batch . 62Remove Duplicate Requests from a Batch . 63Download Sample CSV . 64Manage Eligibility Batches . 69Edit Batch From the Eligibility Create / Edit Batches Page . 70Delete Batch From the Eligibility Create / Edit Batches Page . 71iv PROPRIETARY AND CONFIDENTIAL

myABILITY OverviewAt ABILITY , our mission is to provide innovative products and services that reduce theadministrative complexities of healthcare. The myABILITY platform provides you withstreamlined, easy-to-use access and navigation to all your ABILITY solutions. As the nameimplies, myABILITY gives you the ability to select and configure network services specific toyour business requirements.About this guideThis guide provides you information for your ABILITY COMPLETE service.PROPRIETARY AND CONFIDENTIAL 1

ABILITY COMPLETE User GuideNavigation Bar and FoldersThe Navigation Bar and folders with tabs appear on the My Workspace page and provide youwith easy access to all of your myABILITY services. The Navigation Bar appears at the top of allmyABILITY pages. The folders and tabs only appear on the My Workspace page.The Eligibility selection on the Navigation Bar (Figure 1) and the ABILITY COMPLETE tab(Figure 2) on the Eligibility folder both provide you with the following options: Make an Eligibility Request – Make a Request tab on the Make an Eligibility RequestpageMy Dashboard – Dashboard tab on the My Dashboard pageEligibility Request History – Request History tab on the Eligibility Request History pageBatches – Batches tab on the Eligibility Request Batches pageFigure 1: Navigation Bar with Eligibility (ABILITY COMPLETE) selectedFigure 2: Eligibility Folder with ABILITY COMPLETE tab selected2 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideThe ABILITY COMPLETE tab on the Eligibility folder also provides you with one-click accessto the My Dashboard page filtered by Eligibility State. For example, to see only Active Coverageitems click anywhere on the Active Coverage line within the tab (Figure 3).Figure 3: Eligibility Folder with the ABILITY COMPLETE tab selected (Active Coverage items indicated)The My Dashboard page opens with only those items with Active Coverage (Figure 4).Figure 4: My Dashboard page with Eligibility State in Active items indicatedPROPRIETARY AND CONFIDENTIAL 3

ABILITY COMPLETE User GuideMy DashboardThe Dashboard tab lets you manage all eligibility requests that require follow-up in one location.You can see requests sent to the Dashboard for all NPIs you are affiliated with. The top of yourdashboard provides quick links (Figure 5) so you can filter requests by the following categories: Category (Ownership, Unreviewed, or Past Due)Follow-up statusEligibility stateFigure 5: My Dashboard tab with quick links indicated4 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideShared WorkspaceYou can share information about eligibility requests with other users and assign custom follow-upstatuses and dates to requests that require additional follow-up. All users have access to thedashboard.The Dashboard displays the following columns.Column HeadingDescriptionSelect All on thispage / Clear all onthis pagetoggle between selecting all and clearing all requests on this pageEligibility Statethe seven types of eligibility states appear at the top of your dashboardRequestthe patient, NPI, and payer informationOwnerperson at your facility handling this requestFollow-up Statusstatuses are defined at the top of your screenFollow-up Datedate and time the request to be followed-upRundate and time the eligibility request was submitted(no heading) click NOTES to see notes for this requestclick DETAILS to open the Eligibility Response pageclick RERUN to run the request directly from this pageclick ATTACH to attach up to two files to an eligibility response on theDashboard page. Files must be either in .csv, .pdf, .doc or .docxformat.NOTE: After attaching a file, the paper clip icon and a red x ()appear in the Select all on this page / Clear all on this page column.Click the paper click icon to download the attachment. Click the red xif you need to delete the file from the request.If you attach two files and need to delete or download one or both,click the multiple paper clips icon (Remove Attachments dialog box.) to open the Download /PROPRIETARY AND CONFIDENTIAL 5

ABILITY COMPLETE User GuideFilter DashboardYou can customize the dashboard display by filtering the information you are working on. TheFilter Dashboard button opens the Filter Responses dialog box (Figure 6) that lets you selectwhich items you want to see on the dashboard at any given time and lets you access additionaldashboard items when needed.Figure 6: Filter Responses page with types of filters indicated6 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideStatus & DateYou can choose to view items by the part you have in your organization’s workflow. Selectionscategories are Follow-up Status, Eligibility State, and Date.UnreviewedClick the Show Only Unreviewed checkbox at the top of the Filter Responses dialog box to filterrequests that have not been reviewed. ABILITY COMPLETE automatically marks a request as“unreviewed” if the response page has not been opened. After the response page has beenviewed, you are able to mark an eligibility response as “unreviewed” manually from the eligibilityresponse page or when you send a request to the dashboard.Click Apply Selections to save your changes.OwnerYou can choose to view just items assigned to you and/or selected people with whom you work.Click Apply Selections to save your changes.PayerYou can choose to view items by selected Payers. Your Top Payers appear at the top of thisdialog box. Click Apply Selections to save your changes.NPIYou can choose to view items according to NPI (National Provider Identifier).Click Apply Selections to save your changes.PROPRIETARY AND CONFIDENTIAL 7

ABILITY COMPLETE User GuideCreate Custom Favorite Dashboard Filter SettingYou can save your favorite dashboard filter setting by clicking Save Selected Filters asFavorite. When you log into ABILITY COMPLETE, you are able to quickly reference items onthe dashboard that you want to work on by clicking Restore Favorite Filter Setting.Search Dashboard by PatientEnter as much information about the patient as you know and click Search. Available fields areLast Name, First Name, and DOB (Date of Birth). You are allowed partial entries for first nameand last name searches. Searches are performed using a full wildcard or “contains” method.Two-Character Name SearchIf you enter two or more characters in the first or last name field and click Search, the Requestcolumn on the dashboard re-appears with all names containing those characters. For example, ifyou enter “en” in the First Name search field, you will match on “Benjamin,” “Wendy,” “Endira,”and “Loren” if those names are in your system.Auto-Complete SearchIf you enter three or more characters in the first or last name field, a drop-down box appears withall names in your system containing those letters. For example, if you enter “end” in the FirstName search field, a dropdown box appears with “Wendy” and “Endira” if both of those namesare in your system.8 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideShared WorkspaceThe Dashboard is a shared workspace for you and other users to manage eligibility requests thatrequire follow-up. You can configure it to meet various business needs. You can shareinformation about eligibility requests with other users and assign custom follow-up statuses anddates to requests that require additional follow-up. All users have access to the dashboard.Table 1 displays Dashboard column headings and descriptions.Table 1: Dashboard Column Headings and DescriptionsColumn HeadingDescriptionSelect Alltoggle between selecting all and clearing all requests on this pageEligibility Statethe seven types of eligibility states appear at the top of your dashboardRequestthe patient, NPI, and payer informationOwnerperson at your facility handling this requestFollow-up Statusstatuses are defined at the top of your screenFollow-up Datedate and time the request to be followed-upRundate and time the eligibility request was submitted(no heading) click DETAILS to open the Eligibility Response page click RERUN to run the request directly from this page click NOTES to see notes for this requestPROPRIETARY AND CONFIDENTIAL 9

ABILITY COMPLETE User GuideCommandsYou must select at least one transaction prior to using any of the dropdown boxes (except AddNon-EDI) available to you on My Dashboard (Figure 3). To select all transactions on thedisplayed page, click the Select All column heading on this page.Figure 7: My Dashboard with dropdown boxes and Select all on this page indicated10 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideActionsThe following actions are available under this dropdown box (Figure 8): Remove from Dashboard – Removes the selected transaction(s) from the DashboardMark as Reviewed – The eligibility response has been reviewedMark as Unreviewed – This eligibility response needs to be reviewed and appearshighlighted. You can update the status when you resend the request to the Dashboard.Save PDF – Export the selected records (up to 10 at a time) into PDF format.Figure 8: My Dashboard with Actions dropdown box indicatedPROPRIETARY AND CONFIDENTIAL 11

ABILITY COMPLETE User GuideChange OwnerFrom the Change Owner dropdown box (Figure 9), you can change the owners on the selectedtransactions.Figure 9: My Dashboard with Change Owner dropdown box indicated12 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideChange Follow-upYou can use the Change Follow-up dropdown box (Figure 10) to change the follow-up dateand/or status of a request that appears on the dashboard. The following follow-up status optionsare available to you as defaults that you can also edit or delete. Front DeskPOS Collection (Point of Service Collection)Financial Counseling/Self PayFigure 10: My Dashboard with Change Follow-up dropdown box indicatedClick Apply to save your changes.You can add additional customized follow-up status options on the Configure Dashboard page, afeature available to users who have Configure Services permissions.PROPRIETARY AND CONFIDENTIAL 13

ABILITY COMPLETE User GuideAdd NoteUse the Add Note dropdown box (Figure 11) to enter customized messages that can be viewedby other users. This helps to track work that has been completed or is needed for a 270/271Medicare Eligibility request. Click Add to save your change.Figure 11: My Dashboard with Add Note dropdown box indicated14 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideAdd Non-EDIUse the Add Non-EDI dropdown box (Figure 12) for payers and self-payers are those who do notsupport the 270/271 electronic Medicare Eligibility request/response. You can use the non-EDIpayer tab to document and track no-EDI payer information or self-pay patient information.Select this tab to open a drop-down dialog box to enter Payer and Patient information. Completeall required fields and click Save. This information is then available for you to use with yourdashboard functions, just as any other type of dashboard request.A Non-EDI Payer / Self Payer icon (created this way.) appears on the Dashboard for eligibility requestsFigure 12: My Dashboard with Add Non-EDI dropdown box indicatedPROPRIETARY AND CONFIDENTIAL 15

ABILITY COMPLETE User GuideAdd to BatchUse the Add to Batch dropdown box (Figure 13) add single or multiple records from theDashboard to an existing batch. After selecting the records you want to add and the batch, clickSave to display a message that the selected items have been added successfully.Non-EDI Payer/Self Pay transactions will not be processed.Figure 13: My Dashboard with Add to Batch dropdown box indicated16 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideReportsUse the Reports dropdown box to generate either of these two reports. Wellness Report – For Medicare patients, only. Select this report to open a WellnessReport dialog box where you can select from a list of preventative codes and eligibilityresponse details. Available only after you have selected one or more Medicare patients. Basic Eligibility Report (STC 30) – Provides patient information and eligibility status forSTC code 30. After selecting one or more patient records, you can run a report that savesthose records to one CSV file.Figure 14: My Dashboard with Reports dropdown box indicatedPROPRIETARY AND CONFIDENTIAL 17

ABILITY COMPLETE User GuideConfigure DashboardIf you have Configure Services permission, the Configure Dashboard option will appear on yourdashboard so that you can create custom follow-up statuses (Figure 15). Follow-up statuses canbe appended to customer service requests. You can use follow-up statuses to communicate toother users additional work or alerts based on the status of the eligibility request.Figure 15: My Dashboard with Configure Dashboard selected18 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideCreate Custom Follow-up StatusesYou can add custom follow-up statuses and assign colors to those statuses on the ConfigureDashboard page (Figure 16). Depending on the needs of your facility, you can choose to show orhide default follow-up statuses that are available. The follow-up status you create can be up to30 characters long.Follow-up statuses can be filtered as a group on the Dashboard so that you and other users caneasily work on similar types of requests.Figure 16: Configure Dashboard pageDefault Follow-up StatusesPOS (Point of Service) Collection, Self Pay Patient, and Front Desk are default Follow-upStatuses ABILITY makes available that you can edit.Edit Follow-up StatusIf you edit a Follow-up Status, all eligibility requests with that status that appear in filters, followup actions, and dropdown boxes are also updated.Hide Follow-up StatusIf you hide a Follow-up Status, the eligibility requests for that status do not display in filters,follow-up actions, and dropdown boxes, but the requests themselves previously associated withthis Follow-up Status are not affected.PROPRIETARY AND CONFIDENTIAL 19

ABILITY COMPLETE User GuideAdd an NPIComplete the following instructions to add NPI credentials.1. On any myABILITY page, select the Support tab. From the dropdown box that appears, clickAdd or Edit NPIs (Figure 17).Figure 17: Support tab with Add or Edit NPIs indicated2. Click Add NPI on the Add or Edit NPI page (Figure 18).Figure 18: Add or Edit NPI page with Add NPI indicated20 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User Guide3. The Provider Details and User Permissions panels appear (Figure 19).Figure 19: Add or Edit NPI page with Provider Details and User Permissions panels4. In the Provider Details panel, enter information in the following fields:NPI – The NPI is a unique 10-digit identification number issued to healthcare providers inthe United States by the Centers for Medicare & Medicaid Services (CMS).Display Name – Enter a meaningful phrase to identify the NPI.User Permissions – Check the box beside someone’s name to give them access to thisNPI. Uncheck to remove access. People without access will not see this NPI.Federal Tax ID – If this field appears, enter the federal Tax ID number associated with theNPI.5.In the User Permissions panel, select the users who need access to this NPI.6.Select the checkbox displayed if you are a provider of mental health or psychiatric services.All default Service Type Codes supported by Medicare (except A7) are sent on Medicarerequests. If you are a provider of mental health or psychiatric services, you can click EDITand select a checkbox to designate that you need to view A7 STC information. This is asetting that is configured by NPI and monitored by CMS.7.Click Submit NPI for Registration. NPI registration may take up to 48 hours.PROPRIETARY AND CONFIDENTIAL 21

ABILITY COMPLETE User GuideConfigure PayersSome payers require additional information to be sent with the eligibility request. The ConfigurePayers page (Figure 20) is accessible from the myABILITY Configuration tab. You must haveConfigure Services permissions.NOTE: The information on this page is sortable by any of the column headings.Figure 20: Configure Payers pageYou can click the down arrow () in the far right column to expand detail information so youcan configure and enter any information that is missing. A list of the NPIs associated with theaccount is displayed and you are alerted to which NPIs are missing information when you selecta payer row (Figure 21).Figure 21: Selected Payer with NPIs that have Missing InformationClick the up arrow () to collapse the panel.22 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuidePayer EnrollmentSome payers require additional information in order to be registered for sending eligibilityrequests (Figure 22). Depending upon the payer, this may be a form that you fax to the payer orsend to an ABILITY representative. If you have Configure Services permissions, you will seeinstructions for these payers that are provided on the Additional Payer Information tab as well ason the Payer Configuration page.Figure 22: Additional Payer Information requested for this providerOnce you have successfully enrolled the NPI(s) with that payer, you can begin to send eligibilityrequests to that payer. To do this, check which NPIs have completed this process so that thepayer is configured within ABILITY COMPLETE. You are not able to send eligibility requestsfor this payer until the process is complete and you have checked the “I have completed payerenrollment for this NPI” checkbox on the Provider Details page.PROPRIETARY AND CONFIDENTIAL 23

ABILITY COMPLETE User GuidePayer NotesIf you have Configure Services permissions, you can add Payer Notes to payers from the PayerConfiguration admin page. Click Payer Notes (Figure 23) to open the Add a Payer Note field forthe selected payer. The maximum character limit for this field is 140 characters.Payer notes allow you to share payer-specific information with other users. These will appear onthe Select Payer(s) section when creating an eligibility request and on the Eligibility Responsepage.Figure 23: Configure Payer Page with Payer Notes indicated24 PROPRIETARY AND CONFIDENTIAL

ABILITY COMPLETE User GuideEdit an NPIComplete the following instructions to Edit an NPI:1. Click EDIT in the Options column corresponding to the NPI you want to edit (Figure 24).2. Edit the information in the fields that display on the Add or Edit NPI page. These fields aredescribed above.3. Click Update NPI to edit the NPI.Figure 24: Add or Edit NPI page with Edit indicatedPROPRIETARY AND CONFIDENTIAL 25

ABILITY COMPLETE User GuideMake an Eligibility RequestThis page lets you request the eligibility for patients from all payers.Step 1: Select NPISelect an NPI (National Provider Identifier) from the list provided (Figure 25). Click Sele

ABILITY COMPLETE User Guide Navigation Bar and Folders . The Navigation Bar and folders with tabs appear on the My Workspace page and provide you with easy access to all of your myABILITY services. The Navigation Bar appears at the top of all myABILITY pages. The folders and tabs only appear on the My Workspace page.