Optimizing Patient Eligibility Verification
Patient eligibility verification services involves checking the patients’ right to receive services based on their enrollment into a healthcare plan. It is an indispensable part of the medical billing process to secure reimbursement and avoid claim denials. Serving as your insurance verification company, Outsource Strategies International (OSI) can verify patient eligibility and help you save the precious time spent calling insurers, waiting for responses and filling out forms. Our patient benefit verification services are available for practices of all sizes and for all medical specialties.
OSI has extensive experience working with government insurers such as Medicare and Medicaid as well as commercial insurance companies such as Blue Cross Blue Shield, United Healthcare, AETNA, and GHI. Our patient eligibility verification company is HIPAA-compliant and ensures complete confidentiality of all sensitive healthcare data we handle.
Let your staff focus on your core processes.
Enjoy customized services along with 30% to 40% savings with OSI as your partner.
Benefits of Patient Eligibility Verification Services
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
Affordable & Flexible Pricing Plans
Fixed Cost Pricing
Like an FTE model, a person is dedicated to your practice. Perfect for a practice that is busy. They work as an extension to your business.
- A dedicated employee or team member
- Team handling multiple responsibilities
- Preset pricing and production guidelines
- No Start-up fees
Per Transaction Pricing
Perfect for a practice that is unsure about their work requirements. This can have per request pricing for eligibility and other functions.
- Dedicated team or employee
- Team handling multiple responsibilities
- A per transaction or hybrid model
- No Start-up fees
- Pay for the worked time
Our Streamlined Patient Eligibility Verification Process
Our comprehensive health insurance eligibility verification process involves the following steps:
Schedule Integration
Receiving patient schedules from the hospital or clinics via FTP, email or fax
Insurance Coverage Verification
Verifying patients’ insurance coverage on all primary and secondary (if applicable) payers
Demographic Information Validation
Verifying demographic information
Account Maintenance
Updating patient accounts
Patient Communication
Contacting patients for additional information if necessary
Billing System Update
Updating the billing system with eligibility and benefits details such as member ID, group ID, coverage start and end dates, co-pay information
What Details Do We Verify?
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:
- Correct spelling of the patient’s name
- Date of birth
- Address
- 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
Why Choose OSI?
Committed to excellence, our reputation is built on providing top-notch insurance verification services that enhance operational efficiency and optimize revenue for our clients’ businesses.
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.
