MyABILITY software is developed by Inovalon, and it provides long-term care facilities with comprehensive solutions to optimize revenue cycle management, care quality management, and workforce management in the long-term care industry. The software offers an easy-to-use portal called the Inovalon Provider Cloud, which serves as a central, cloud-based hub for various operations related to patient care.
This software’s capabilities are enhanced when paired with Experience Care’s long-term care software system. Thanks to the easy integration of the CAREWATCH portal, and InfectionWATCH, users can now automatically upload and submit MDS data from Experience Care directly into CAREWATCH or InfectionWATCH, making the management of quality measures and reimbursement optimization even easier.
Furthermore, integrating the ABILITY EASE All-Payer system allows for better claims management and resident insurance verification. By automating these processes, facilities can streamline workflows to minimize human error while automating auditing and appeals, leading to increased accuracy in claims revenue.
Meanwhile, integrating ABILITY’s Revenue Cycle Management system with Experience Care results in accurate and synchronized data and more efficient claims management for Medicare and Medicaid reimbursements. By integrating myABILITY’s billing system with this long-term care software, users can automate invoicing, claims submission, and tracking of financial transactions, thus reducing potential manual entry errors.
What are the advantages of using myABILITY?
Before we discuss integration with Experience Care, it is worth highlighting the key features and benefits of utilizing myABILITY software, which includes:
- Revenue Cycle Management: The software automates and streamlines the revenue process. It includes customizable configurations to ensure accurate patient data, improved staff efficiency, real-time eligibility checks, claims status tracking, and payment retrieval for government and commercial claims. The system also provides detailed analytics and comprehensive dashboards to identify performance trends while managing revenue processes effectively.
- Care Quality Management: myABILITY software manages post-acute quality reporting, infection control, risk management, and other aspects of care quality. It offers a consolidated system for documentation, submission, and advanced reporting, simplifying compliance with quality measures while enhancing a facility’s overall care delivery.
The myABILITY software combines various aspects of long-term care management into one unified platform. By integrating these areas of operational management—revenue cycle management and care quality management—long-term care facilities get a comprehensive solution that enhances operational efficiency, productivity, and financial outcomes. Next, we will discuss how facilities can use myABILITY’s software solutions in a clinical setting.
Clinical Integration: CAREWATCH Portal and InfectionWATCH
The clinical solutions provided by myABILITY include the ABILITY CAREWATCH portal and the ABILITY InfectionWATCH. The CAREWATCH portal has built-in tools for facilities to review and analyze quality and data outcomes, enabling more informed care decisions and improved resident outcomes. In addition, the portal aids facilities in quality management while ensuring compliance with federal and state regulations.
Some notable advantages of using the myABILTY CAREWATCH portal include:
- Improved reimbursements: One of the primary functions of the portal is to help facilities achieve more accurate Minimum Data Set (MDS) assessments, leading to higher reimbursements. The portal identifies MDS issues early, assisting facilities with better MDS assessment accuracy. CAREWATCH can also identify untapped revenue opportunities, estimate reimbursements under the Patient-Driven Payment Model (PDPM), and manage Medicare Value-Based Purchasing (VBP) Program revenue, improving the accuracy of data submission and consequently improving reimbursements.
- Reduced survey citations: CAREWATCH reduces survey citations by identifying risks associated with survey tags. The software has built-in functions enabling users to identify errors quickly, spot logic mismatches, and transmit MDS assessments directly to the CMS. Additionally, the portal simplifies quality reporting, making it easier for facilities to comply with survey requirements.
- Continuous improvement: The CAREWATCH portal supports Quality Assurance and Performance Improvement (QAPI) initiatives. It steers facilities by providing valuable insights and data analysis. CAREWATCH also helps to decrease hospital readmissions by identifying areas for improvement and implementing appropriate interventions. The portal allows facilities to monitor their Five-Star quality rating status and compare performance with state and national benchmarks.
- Better patient engagement through telehealth services: The ABILITY telehealth services are secure and reliable cloud-based services focused on virtual consultations. Key features include:
- High-definition video calls for patient visits
- Easy appointment setting
- Automated patient reminders via text and email
- Pre-appointment access verification
- Full compliance with HIPAA regulations for data security
- Mobile applications.
Users can also create a patient profile that provides eligibility information, including recent eligibility checks, secondary payer confirmation, and patient details. These features aim to enhance the telehealth experience, improve scheduling efficiency, ensure patient engagement, and maintain the privacy and security of patient data.
ABILITY’s InfectionWATCH
Another helpful tool by ABILITY is the InfectionWATCH software designed to improve their infection surveillance and antibiotic stewardship efforts. InfectionWATCH enhances access to relevant and actionable data so facilities can identify problem areas, reduce antibiotic resistance, ensure regulatory compliance, and improve resident outcomes.
Long-term care facilities benefit from using InfectionWATCH to enhance their infection surveillance capabilities. The software helps them track and monitor infections more effectively, allowing for rapid identification of problem areas. Also, by analyzing the data provided by InfectionWATCH, facilities can identify trends, patterns, and potential outbreaks, enabling them to take proactive measures to prevent the spread of infections.
Integrating CAREWATCH with Experience Care
The capabilities of ABILTY’s CAREWATCH portal and InfectionWATCH software are enhanced when they are integrated with Experience Care’s long-term care software, as this improves reporting processes for clinical data and allows one to obtain more accurate data trends.
The users single-sign-on ability into CAREWATCH and InfectionWATCH via Experience Care’s application, and from there, they can automatically upload and submit MDS data from Experience Care directly into CAREWATCH or InfectionWATCH, which will then upload the same data to the CMS’ iQIES server. This streamlines facility data transfer processes to improve accuracy while minimizing human errors.
The key takeaway is that this integration helps facilities manage their quality measures and reimbursements better because the clinical data is submitted automatically, resulting in timely submissions in line with compliance requirements.
Contact us here to learn about our long-term care software and how it submits timely clinical data.
Financial Solutions: myABILITYnetwork and Claims Management
Now that we have discussed how myABILITYnetwork supports clinical operations in long-term care facilities, we will now look at myABILITY financial solutions with an emphasis on claims management.
It is essential for facilities to properly manage their claims to ensure financial stability with accurate and timely reimbursements that cover resident care costs. Effective claims management helps facilities comply with regulations while providing accurate documentation, claim denials, delayed payments, or financial penalties.
When facilities join the Inovalon Provider Cloud network, they will gain access to several features to enhance their revenue cycle management, allowing them to streamline and automate the complexities of revenue cycle management, such as:
- Patient claims and billing: These solutions help to optimize the billing and claims process for facilities and include the following services:
- All-payer revenue cycle management
- Medicare revenue cycle management
- Patient payment management
- Revenue cycle management analytics
- All-payer claims management
- Patient statements
- Medicare ADR submission
- Medicare claims management
- Medicare billing
- Patient access services: The patient registration services offered include accurate patient data collection at intake, patient identity validation, eligibility verification, and insurance coverage discovery. These services aim to reduce denials and reimbursement delays by ensuring accurate and up-to-date patient information and identifying all available insurance coverage.
The solutions provide streamlined workflows for eligibility verification, assigning and prioritizing patients and payers, and managing inquiries. Additionally, the following services are available to enhance patient access via the CAREWATCH portal or another system, improve revenue collection, and provide real-time eligibility and benefit information to streamline billing processes:
- Healthcare propensity to pay
- Medicare eligibility verification
- Connectivity to Medicare systems, such as DDE and FISS. These services
Integrating myABILITYnetwork with Experience Care
Integrating long-term care software programs, such as ABILITY’s RCM or CAREWATCH app, with other long-term care software providers, like Experience Care, is a game-changer for long-term care facilities. It streamlines workflows by automating data transfer and eliminating manual data entry, saving facilities both time and money. With accurate and synchronized data, claims management for Medicare and Medicaid reimbursements becomes significantly faster and more efficient.
Furthermore, the improved processes, such as having a single sign-on, enable users to open myABILITY applications from within Experience Care. This makes it easier for users to send and receive 270/271 messages to check residents’ eligibility benefit inquiries from healthcare providers, insurers, and Medicare insurance coverage, upload electronic Medicare billing files like 837P and 837I when claims are submitted, and download 835 electronic remittance files and import them as a batch receipt.
This integration improves revenue cycle management efficiency, from insurance verification to submitting claims. And when added to the consolidation of data, it allows facilities to produce comprehensive reports and analytics, empowering leaders to make more informed decisions while identifying key areas for improvement.
The integration between myABILITY and Experience Care ensures compliance with federal and state regulations, reducing the risk of penalties and facilitating audits. By embracing this technological advantage, long-term care facilities can enhance their claims management processes, streamline operations, and achieve greater financial success.
Why Integrate myABILITY with Experience Care’s Applications?
Key advantages of integrating long-term care software systems, like myABILITY and Experience Care, include:
- Data exchange: Integrating these long-term care software programs or electronic health record (EHR) platforms helps facilities share relevant resident information securely. This integration enables seamless data exchange between different software systems, such as medical history, allergies, medication lists, and care plans.
- Billing and financial integration: Long-term care software can integrate with financial and billing systems to streamline the billing and reimbursement processes. This integration allows for automated invoicing, claims submission, and tracking of financial transactions, reducing manual entry and potential errors.
- Communication and collaboration: Long-term care software can integrate with communication tools, such as secure messaging platforms or video conferencing software, to enable efficient communication among care providers, staff members, and families. This integration promotes real-time collaboration and enhances overall care coordination.
- Reporting and analytics: Integration analytics and reporting tools allow long-term care facilities to generate comprehensive reports on various aspects of care, including patient/resident outcomes, quality indicators, staffing levels, and financial performance. These reports can provide valuable insights for decision-making and performance improvement.
To fully maximize the benefits of different software programs, facilities should look into effective integrations between other software systems to enhance the efficiency and effectiveness of long-term care management.
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