Patient Eligibility Verification
Complete Revenue Cycle Management for
Medical & Dental Clinics, Practices and Hospitals
- Shared Vision: Your Business is our Business
- Cloud Based Billing Software or Work on Yours
- Certified Coders: ICD 10 Coders
- Real Support with Dedicated Managers
Patient Eligibility Verification
Physicians need to verify each patient’s eligibility and benefits to ensure they will receive payment for services rendered. Outsource Strategies International (OSI) offers comprehensive patient eligibility verification services to help healthcare providers check coverage prior to the office visit. Our focus is on preventing denials and avoiding delays in payment, which will boost revenue at time of service, save time on the back end, and also enhance patient satisfaction.
Verifying eligibility is an essential process in sustaining a good revenue cycle. Our health insurance eligibility verification specialists will confirm the following patient benefits on each date of service:
- Demographic data – if the information on the insurance identity card is up to date and correct for that date of service
- Coverage – whether the patient has valid coverage on the date of service
- Benefit options – patient responsibility for co-pays and coinsurance
- Prior authorization requirements – confirming authorization for treatment from appropriate sources, if applicable
OSI has extensive experience in working with government insurance as well as commercial insurance companies such as Blue Cross Blue Shield, United Healthcare, AETNA, and GHI. We provide customized insurance eligibility verification services for all medical specialties and practices of all sizes.
Our medical eligibility verification services will:
- Eliminate the need for tedious in-house verification processes
- Free up your staff for other tasks
- Minimize bad debt
- Increase cash collection
- Reduce billing errors and denials
- Improve patient satisfaction
- Save 30-40% on your operational costs
Benefit from a Streamlined Insurance Eligibility Verification Process
Our comprehensive health insurance eligibility verification process involves the following steps:
- Receiving patient schedules from the hospital or clinic
- Demographic information entry or update
- Verifying coverage on all primary and secondary payers
- Confirming authorization for treatment from appropriate sources, if applicable
- Updating the billing system with the verified details
We verify patients’ insurance eligibility by checking the carrier website or calling up the company. As the success or failure of each patient claim starts at the front desk, we confirm the following before the appointment:
- Spelling of the patient’s name
- Date of birth
- SS number
- Insurance carrier name
- ID number
- Group number
- Type of plan and coverage details
- Patient policy status and effective date
- Plan exclusions
- Payable benefits
- Co-pays, co-insurance and deductibles
- Referrals and pre-authorizations
- Claims mailing address
- Life-time maximum
- Address for claims submission
- In-network or out-of-network status
- Type of Medicare coverage
- DME coverage
Our end-to-end medical eligibility verification services improve patient collections and prevent accounts from aging and becoming uncollectable.
We are also experienced in providing dental eligibility verification services for General Dentists, Orthodontists, Endodontists, Oral Surgeons and Pediatric Dentists.
Why Choose Us?
- Eligibility and benefits verification performed in batch and real-time
- Stringent QA checks
- Readily available reports
- Customized TAT
- HIPAA compliance
- No long-term yearly contracts
- No set up fees or training fees
What Makes Our Insurance Eligibility Verification Services Unique?
- Let your staff focus on your core work. Free them up from waiting on hold with insurance companies.
- Our team can work directly on your software or offline, based on your needs.
- With us, you can stay 3 to 5 days ahead of your schedule.
- We will save you money! Hire a full time equivalent (FTE) – save on taxes and benefits.
- Dependable coverage- no worries about turnover, vacations, sick days etc.
- Complete comprehensive verifications, with coverage information for all procedures and tests.
- Identify any prior authorization needed before you see your patients.
- We help you know your patients’ dental or medical coverage, and plan and identify non-covered services before providing treatment.
- Our QA team ensures 98% accuracy. We also record the phone calls with the insurance representatives for QA purposes.
Outsource your dental insurance verification and focus on patient care!
To get additional information and to learn more about our patient eligibility verification services, call (800) 670-2809 and speak to our senior solutions manager.
Outsourcing your medical billing to OSI can save you up to 40% on your operational costs.
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OSI Featured Experts
Natalie TorneseCPC: Director of Revenue Cycle Management
Natalie joined MOS’ Revenue Cycle Management Division in October 2011. She brings twenty five years of hands on management experience to the company.
Meghann DrellaCPC: Senior Solutions Manager: Practice and RCM
Meghann joined MOS’ Revenue Cycle Management Division in February of 2013. She is CPC certified with the American Academy of Professional Coders (AAPC).
Amber DarstSolutions Manager: Practice and RCM
Hired for her dental expertise, Amber brings a wealth of knowledge and understanding of the dental revenue cycle management (RCM) services to MOS.
Loralee KappSolutions Manager: Practice and RCM
Loralee joined MOS’ Revenue Cycle Management Division in October 2021. She has over five years of experience in medical coding and Health Information Management practices.