Abilis Health Plan
Abilis Health Plan is a regional health plan operating in Kentucky and Tennessee. For an ASC, what matters isn't the logo. It's how Abilis Health Plan pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Abilis Health Plan analysis
Tell us where to send it. Our team will prepare an analysis of Abilis Health Plan covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Abilis Health Plan pays
See how Abilis Health Plan reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
Abilis Health Plan's presence spans Kentucky and Tennessee. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Abilis Health Plan and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Abilis Health Plan's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Abilis Health Plan up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Abilis Health Plan
- Payer ID
- SA001 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Abilis Health Plan through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Abilis Health Plan members are verified before the date of service, through a clearinghouse using payer ID SA001or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Abilis Health Plan directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Abilis Health Plan the way it pays.
- What is Abilis Health Plan's payer ID?
- Abilis Health Plan's electronic payer ID is SA001. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Abilis Health Plan through a clearinghouse.
- How do ASCs verify eligibility for Abilis Health Plan members?
- Eligibility and benefits for Abilis Health Plan members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID SA001) or through the payer's provider portal.
- Does Abilis Health Plan require prior authorization for ASC procedures?
- Prior-authorization requirements for Abilis Health Plan are set per plan and per procedure. Confirm whether an authorization is required with Abilis Health Plan directly before the date of service.
- What type of payer is Abilis Health Plan?
- Abilis Health Plan is a regional health plan operating in Kentucky and Tennessee.
- How does Abilis Health Plan compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Abilis Health Plan pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Abilis Health Plan paying my ASC below market?
- Put your own Abilis Health Plan contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.