Case Study: Insurance Verification Deftly Handled for Healthcare Company Clients

Insurance VerificationOverview

Outsource Strategies International (OSI), a Managed Outsource Solutions company, provides insurance verifications for all medical specialties including urology. Our client, the Minneapolis, MN based Coloplast, provides products and services to help people suffering from various private medical conditions such as those affecting the testicles and penis, erectile dysfunction and Peyronie’s disease.

The Challenge

Coloplast was on the lookout for a cost-effective solution to enable urologists to carry out procedures with their products. They needed a partner to work with the urologist and secure insurance information for each of these procedures for which Coloplast was providing products. This insurance information was a service Coloplast offered since it was committed to extending support to physicians all over the United States to help them serve patients better.

The Solution

OSI devised a scheme by which the urology offices can contact us directly to get themselves set up for our service. Before a urology office schedules a patient procedure, OSI verifies the insurance eligibility and benefits of the patient. We also check the active primary and secondary medical coverage of the patient with the insurance company and confirm details including:

  • Co-payments
  • Deductibles
  • Co-insurance
  • Patient policy status
  • Plan type
  • Effective date
  • Procedure coverage
  • Prior authorization requirements
  • Claims mailing address

This enables the urology offices to schedule procedures confidently and have a clear idea of the available coverage under their respective insurance plans.

Results

Beginning with one urology office in July 2013, OSI now works with 16 offices all over the United States as part of the ongoing project with Coloplast. Coloplast is now able to raise its revenue thanks to this very useful service it provides through OSI. There are no longer any issues in getting the verifications done. Coloplast is now able to fully focus on helping its clients.

The client is very happy with our service. As L. Doran, CPC – the reimbursement specialist of Coloplast says, “I’m very grateful for the work you and your team have put in to make our Benefits Verification Service work so well. Thank you for handling everything quickly, efficiently, and always with grace and humor.