Eligibility Verification

Eligibility verification is one of the challenging tasks faced by healthcare facilities. This challenge has become even greater with changing insurance rules and guidelines, and the flood of newly insured patients and patients who are changing plans. To improve cash flow, physicians need to verify eligibility and benefit coverage before claim submission.

As an established U.S. based medical billing company, Outsource Strategies International (OSI) can take care of all your insurance patient eligibility verification and authorization requirements. We provide professional solutions to help you

  • Reduce denials
  • Minimize delayed payments
  • Improve patient care and satisfaction
  • Enhance workflow
  • Save time

Our team can provide accurate real-time data on patient benefits before the visit. We are experienced in serving major insurance companies in the country including Blue Cross Blue Shield, United Healthcare, AETNA, and GHI.

Call our toll-free number 1-800-670-2809 and ask for a Free Trial to see how we can help you!


Eligibility Verification Process

More than just basic verifications, our services are all inclusive and much more robust. We can work with your software and login in via VPN or use our own billing software.

We receive schedules from the hospital via EDI, email or fax. Our team verifies all patient benefits based on the reason for the office visit. Instead of just relying on websites, we directly call up the carriers, and document and record the calls to save the practice crucial time.

Our team verifies:

  • Co-pays
  • Co-insurances
  • Claims mailing address
  • Deductibles
  • Patient policy status
  • Effective date
  • Payable benefits
  • Plan exclusions
  • Health insurance caps
  • Type of plan and coverage details
  • Referrals and pre-authorizations
  • Out of network benefits
  • DME reimbursement

Importantly, our benefit verifications are customized to each practice specifics. We verify and authorize patients for Durable Medical Equipment (DME). OSI is highly qualified in DME insurance verification and has experience in authorizing up to 300 DME cases per day.

Our services cover specific codes, procedures, surgeries, drugs, Medicare Managed Care plans and more. When necessary, we call the insurance company and/or patients for detailed verification of insurance benefits. We also update your billing system with the information.

We can help with any type of insurance claims – No-Fault or Personal Injury Protection, Workers’ Compensation and Liability.

Why OSI?

  • All-inclusive, timely benefit verification services
  • QA in all departments
  • Reports provided on request
  • HIPAA compliance
  • 24X7 professional support
  • Fast turnaround time
  • Customized solutions

We are well equipped handle large volume tasks. Our services can help you save up to 30 to 40% on your operational costs.

An infographic presentation of the insurance verification process is given here.