Insurance Verification and Pre-authorizations

The insurance verification and pre-authorization process is essential to every practice’s bottom line. Outlining the patient benefits and coverage for specific medical procedures before the point of service is the most important step to ensure a successful practice. Pre-authorization or prior approval is necessary to acquire reimbursement for many non-emergency medical procedures and services. Failing to obtain this information could subject your practice to delayed payments, the need for claim rework and resubmission, errors and nonpayment and more. Outsource Strategies International (OSI) can help you verify whether or not a particular medical procedure is covered as well as obtain prior approval from payers when necessary. This will ensure timely and appropriate reimbursement.

Our experienced insurance verification specialists call insurance companies and get authorizations in the most efficient manner. We get paperwork filled out, work on clients’ software and gather information to obtain prior approval. As a leading insurance authorization company, we work with all government and private insurances such as Medicare, Medicaid, Workers’ compensation (for all states), Aetna, Hip, UnitedHealthcare, GHI, Oxford, Humana, EMI, BCBS and No Fault. Our team also works on insurance website portals to gather information and apply for authorizations.

We serve almost all major clinical specialties including:

  • Physical Therapy
  • Orthopedics
  • Dental
  • Oncology
  • Ophthalmology
  • Obstetrics and Gynecology
  • Chiropractic
  • Physical Medicine and Rehab
  • Radiology
  • Surgery
  • Sleep Medicine

Call 1-800-670-2809 to learn how our services can reduce your AR cycle and streamline your revenue flow. Get started today with our Free Trial.

Comprehensive

Verification Services

We obtain benefit information before a patient arrives for an appointment and verify the details thoroughly to ensure clean claim submission. Our team checks the following details:

  • Type of plan and detailed coverage details
  • Major medical and/or pharmacy benefits
  • Settings of care
  • Any special distribution requirements
  • Out-of-pocket costs
  • Whether annual deductible has been met
  • Effective date and plan exclusions
  • Life time maximum

Our comprehensive verification process helps prevent revenue loss and enhances your bottom line.

Speed Up Your

Billing Process

with Preauthorization

We collect all details regarding procedures. We contact payers and obtain pre-authorization quickly. Our team will ensure that payer criteria are met before submitting the request and can outline how long it will take to review and approve/deny the pre-authorization. We ensure that requests are submitted along with all necessary documentation:

  • Letter of medical necessity
  • Payer-specific prior authorization form (if available)
  • Patient medical records with appropriate chart notes
  • History of past therapies and results
  • Other information specified by the payer

It’s important that you are reimbursed for the care you provide. With OSI handling the process, you don’t have to worry about these issues. We help speed up your billing process so that you get paid faster.

Service Benefits

  • Higher number of clean claims
  • Minimal rejections and denials
  • Increased upfront collections
  • 30% to 40% reduction in operational costs
  • No long-term yearly contracts

For more details regarding our insurance verification and pre-authorization services, call 1-800-670-2809.