Streamlined Patient Eligibility Verification

Experience Hassle-free Healthcare Access with Our Streamlined Eligibility Verification
  • Real support with dedicated managers
  • We serve all 50 states within the US
  • No long-term yearly contracts

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Do what you do best, we’ll do the rest.

Optimizing Patient Eligibility Verification

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
Benefits of Patient Eligibility Verification Services

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
Stay 3-5 Days Ahead Of Your Patient Visits!
Hire a full time equivalent (FTE) – save on taxes and benefits.

Our Streamlined Patient Eligibility Verification Process

Our comprehensive health insurance eligibility verification process involves the following steps:

Our Streamlined Patient Eligibility Verification Process

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.

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.

We can reduce your A/R days and help improve your collections.

No long-term yearly contracts!

No set up fees or training fees!

Help Improve Your Collections


When is patient eligibility verified?

Verification is done before each appointment or as determined by the healthcare provider’s policies.

How is patient communication handled during verification?

Patients may be contacted for additional information, clarifications, or to update their records if discrepancies are identified.

How does the verification process contribute to a streamlined workflow?

By ensuring accurate and updated patient information, the verification process minimizes administrative burdens and contributes to a more efficient healthcare workflow.

Can the verification process be customized to fit specific needs?

Yes, we offer customizable solutions to meet the unique requirements of different healthcare providers and practices.