Verification Handled Efficiently for Billing Firm

Overview

Verification Handled Efficiently for Billing FirmOutsource Strategies International (OSI) is a Managed Outsource Solutions company and a comprehensive medical services outsourcing provider enabling physician practices to perform more efficiently. Our client, Alta Medical Management from Holladay, Utah is the billing partner for a retina ophthalmology practice, the largest in southeast Texas that specializes in medical and surgical management of diseases of the retina. Alta’s vision is to enable physicians earn more, faster without compromising on patient satisfaction. It provides accurate and cost-effective billing services.

The Challenge

While our client carried out billing for the aforementioned ophthalmology practice, it wanted to outsource the verification process since it consumed too much time and resources. It did not wish to hire staff just for this task. A company to which they had outsourced earlier did not bring about satisfactory results. Alta needed cost-effective verification outsourcing that was accurate and timely, and that’s when they approached us.

The Solution

We gave them a small trial at first with which they were satisfied though there were still concerns about the sheer volume required – 400 verifications per day. So we offered a live trial running for 3 days during which we had no issues in meeting the production. The services that we verify include procedures such as intravitreal injections, ocular trauma repair, laser treatment of the retina, pneumatic retinopexy, sclera buckle, Vitrectomy and Secondary Intra-Ocular Lens Implants including Scleral and Iris Fixation of Intraocular Lens Implant.
We were able to give Alta the confidence to hand over the verification responsibility to us, and they’ve been with us for around a year. We also implemented 5 FTE and a QA manager for handling the project.

The Results

The client has been really happy with the results particularly since we maintain 98% accuracy for all the verifications and handle verification for procedures 2 weeks in advance, while also handling add-ons. We also satisfy the client’s volume requirements. The client was particularly impressed by our recording of the verification calls, which helps provide valuable back-up.