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All-Payer Health Insurance Eligibility Verification Software
Combine each step of confirming coverage into one all-payer health insurance eligibility verification software that improves workflows and accuracy.
Eligibility Workflow, Powered by the Inovalon ONE® Platform
Verify eligibility against all payers with a comprehensive search that eliminates the need for logging into multiple portals.
Overview
Eligibility Workflow (formerly ABILITY COMPLETE) streamlines patient access and billing workflows by enabling staff to assign and prioritize patients, payers, and tasks during eligibility verification. This technology goes beyond basic eligibility needs, providing a dashboard to confirm, manage, and store every inquiry.
Single sign-on efficiency
Replace various tabs and logins with a single health insurance verification platform that can manage all eligibility checks in one user-friendly format, with 24/7 access.
Batch eligibility verifications
Perform multiple eligibility inquiries at once with batch file uploads that verify Medicaid, Medicare, and commercial coverage quickly and efficiently.
Customizable workflows
Easily assign tasks to team members, apply follow-up flags, and create eligibility documentation for future reference. Manage patients between batches and resolve issues with just a few clicks.
Benefits
Save time and ensure coverage accuracy with one could-based, all-payer health insurance eligibility verification software that empowers staff to manage benefit inquiries however works best for them.
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Unlimited eligibility checks
Perform eligibility verifications after hours and on weekends with 24/7 availability that doesn’t restrict user access.
Validation transaction storage
Automatically save all validation transactions to have historical proof of eligibility status on-hand if challenged retroactively.
Flexible revalidation options
Confirm eligibility for a single patient or a batch file as many times as you’d like, without having to re-key demographic data into the system.
One inquiry performs multiple checks
Check multiple patients’ eligibility against multiple payers simultaneously, increasing speed to claims creation and submission.
How it Works
Fast-track all-payer eligibility verifications and maximize staff efficiency with front-end workflow capabilities that standardize and automate repeatable processes for your team.
Take the stress out of eligibility verification.
Eligibility Workflow is the easily configurable, comprehensive eligibility verification solution that transforms traditional single-patient, single-payer inquiries into quick eligibility checks.
With single-sign-on access to one dashboard, staff confusion between multiple payer portals and logins is replaced by a clear path to success for every eligibility need. Staff can confirm one patient or multiple patients, saving time and ensuring accurate eligibility. Managers can assign and prioritize tasks by patients or payers and set custom filters to flag accounts that need follow-up work.
Collectively, these small advancements in how each person approaches eligibility become significant progress for the organization. Admissions processes improve, billing and claims submission go much smoother, and backend revenue issues become easier to resolve – all made possible by faster, more reliable access to the eligibility information you need in one tool.
Real-World Applications
Realize how simple confirming eligibility details can be, no matter your care setting or number of patients to verify.
Ambulatory providers
Trust every claim is sent to the appropriate payer for reimbursement by better managing eligibility at the start of the revenue cycle.
Acute care
Ensure every patient’s eligibility is active and accurate with just one quick validation inquiry that checks every payer.
Home health and skilled nursing
Be proactively informed of any and all eligibility changes with automatic revalidation checks that take the stress out of managing patient coverage.
Frequently Asked Questions
Do you have access to all payers?
We work with most major payers. If there is a payer that is not on our list, we do everything we can to make that connection.
Does your software support custom eligibility workflows?
Yes. You can set up your processes to best suit your team.
Can you do batch eligibility checking?
Yes. You can submit one batch file of multiple patients rather than checking eligibility patient-by-patient.
How do you discover changes in coverage?
Our all-payer health insurance eligibility verification software can perform recurring batch eligibility checks automatically for you. All you have to do is establish the frequency at which you’d like this done, and the software will notify you of any coverage changes upon each automatic check.
Can we store response data?
Yes. You will have access to all your response history.
Payer List
Get comprehensive eligibility information for all your payers, including alerts if multiple insurance plans are detected. Speed up and simplify your admissions process by creating your own custom filters and running multiple payers and patients in one session.
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Provider Resources
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