Insurance Benefit Verification
Insurance benefit verification is the process of verifying the patient’s active medical coverage with the insurance company and preventing billing issues. With the number of insured patients increasing as a result of the Affordable Care Act (ACA), many practices find it difficult to manage this function in-house. With years of expertise in this area, Outsource Strategies International (OSI) can help you understand patients’ coverage before they arrive for treatment. Our services increase collections, minimize non-payments, and boost patient satisfaction.
With OSI to take care of your insurance verification, you can focus on patient care. Our HIPAA-compliant company has vast experience in verifying coverage with major insurers in the country such as Blue Cross Blue Shield, United Healthcare, AETNA, and GHI.
Enjoy 30% to 40% savings on your operational costs with our comprehensive patient benefit verification service.
At OSI, each specialty is assigned an experienced team. Our team can provide specific eligibility checks for a wide range of specialties, such as:
- Physical Therapy
- Obstetrics and Gynecology
- Physical Medicine and Rehab
Our Patient Eligibility Verification Process
The success or failure of the revenue cycle management process begins at the front desk – from the moment the patient contacts your office. We access online verification portals and call the insurance companies to get the required information. We use your practice software and scheduler.
Our team checks procedure-specific coverage and benefits and all out-of-pocket costs so that patients know what is due from them at the earliest encounter. Our team will also obtain all the required authorizations and referrals. This helps patient collections and prevents them from aging and becoming uncollectable. Details we verify include:
- Type of plan and coverage details
- Medicare coverage
- Payable benefits
- Patient policy status
- Effective date
- Plan exclusions
- Health insurance caps
- Out of network benefits
- DME reimbursement
- Experience in working in different states across multiple specialties as well as different settings such as outpatient, inpatient, surgical centers, rehab centers, and so on.
- Proficiency in verifying different benefits for in-patient and out-patient stays, length of stays, rooms and different types of beds, including hospital verifications.
- Expertise in DME insurance verification – have authorized up to 300 DME cases per day.
- Expertise in all types of claims verification – Workers’ Compensation, Personal Injury Protection (PIP) or No-Fault
- Knowledgeable about all major private medical insurances, Medicaid, and Medicare.
Key Benefits of Partnering with OSI
- Affordable pricing
- Customized TAT – from hours to days
- Stringent QA checks
- Daily, monthly and weekly reports
- System-based eligibility checks
- Flexibility – no client is too small
- No long-term yearly contracts
- No set-up fees or training fees
To learn more about our insurance benefit verification services, call our toll-free number (800) 670-2809.