Medicare and Inovalon/Ability Connectivity Solution
(08/21/2013)
Inovalon/Ability is a Service Vendor Provider that is contracted with CMS as a direct connectivity solution for your Medicare Transactions via secure internet.
As of this newsletter, Medicare Electronic Transaction options available:
Intellect: Clearinghouse, Inovalon/Ability (via secure internet).
Unix: Clearinghouse, modem (modem is ONLY available on Unix platforms).
Prime Clinical Systems has developed the Intellect platform to use Ability as an option.
While not free, using the Inovalon/Ability Solution offers a more cost effective and long term solution for direct connection to any ‘MAC’ Payer. Because Inovalon/Ability is contracted with Medicare directly, the contract will be between Prime Clinical and you (Provider/Client).
A number of advantages to sending your claims directly to Medicare via Ability include:
1) Cost $55.00 per Month per Submitter ID (includes up to 10,000 transactions annually). Any overage fees will be billed accordingly (10 cents per transaction). This includes 837(claims), 835(ERA) and Reports(999 and 277CA) transactions at this time. Your office will need to sign up with Prime Clinical Systems using ACH for direct payment.
2) Direct connection.
3) Same day turnaround for Claims, Reports (Eligibility at a later time).
4) No long distance phone fees.
5) No long distance phone carrier required.
6) No modem, therefore no connectivity issues.
To get started with Inovalon/Ability, your office must already be sending directly to Medicare and have a Submitter ID and Password. If your office is not already sending direct to Medicare, please contact your MAC payer (Palmetto or Noridian) and ask to send claims directly. Once you have received you Submitter ID and password, contact Prime Clinical Systems for set up.
Note: You must be on the Intellect version of OnStaff, and you must have a DSL connection.
8/21/2013