Why Outsource Insurance Eligibility Verification and Authorization, a Key Step in Revenue Cycle Management?

by | Published on Jul 25, 2023 | Podcasts, Insurance Verification/ Authorizations (P) | 0 comments

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Verifying patient insurance coverage and obtaining authorization are crucial components of a hospital’s or other healthcare provider’s program for managing claims denials. Outsource Strategies International (OSI), a prominent medical billing outsourcing company, has extensive experience in providing insurance verification and authorization services across various medical specialties.

In today’s podcast, Rajeev Rajagopal, our President, discusses why outsourcing insurance eligibility verification and authorization, an important part of healthcare revenue cycle management, is important for healthcare providers.

Podcast Highlights

01:37 Importance of Insurance Eligibility Verification and Authorization

03:12 Why Outsource?

Read Transcript

Hello, everyone. Welcome to today’s videocast on Healthcare Revenue Cycle Management.

Here, we discuss questions and feedback we receive from the industry and clients. Today, I wanted to cover a question we get asked a lot when we discuss revenue cycle management. Revenue cycle management, for most people, seems to be all about billing and collections. They’re worried about the money that’s outstanding and want all the focus to go to AR management. And we explain to them about eligibility verifications, and procedural authorizations, and the importance of that in the overall revenue cycle management. That’s what we want to cover today.

Normally, when we discuss this with them, the first question is, how can you help us? I mean, if it is something that is so important, shouldn’t I be doing it in-house? How can you do it off-site and do a good job? Very exciting topic for us. We’ve been doing it for 15 years and have seen how it improved practices and enhance their operations. So, first question, why do it? Why should you do it? Why should it be done off-site instead of in-house? Simply, health care is evolving. As much as every practice is about patient care, it is also a business and optimizing resources, streamlining processes, and focusing on the bottom line gets you what truly matters, well-being of your patients.

01:37 Importance of Insurance Eligibility Verification and Authorization

Insurance eligibility verifications and authorizations are critical to ensure patients receive timely and appropriate treatments and coverage. Verifications confirm insurance plan coverage, while authorizations secure pre-approval for necessary procedures. These processes prevent financial risks. Streamlined revenue management minimizes claim rejections and facilitates prompt patient care. I don’t think I need to explain more.

Why does an outside company make sense to you? A lot of people have trouble, once we explain to them why it is important, they cannot understand how an outside company can do this better than they could do it in-house. Well, imagine improvement in speed, productivity, accuracy, and overall cost-effectiveness of insurance related processes within your practice. That’s what an outside company could provide you. It’s not for everyone, but you might be the right person and the only way to find out is actually ask someone. An option that ensures you have a dedicated team of experts available around the clock, no longer will your staff have to juggle multiple responsibilities and leave you to worry when vacations or sick days suddenly pop up. Now that’s intriguing, right? But let’s talk about cost. Always the big reason. Maintaining an in-house team solely dedicated to insurance-related tasks sometimes can be expensive.

03:12 Why Outsource?

Recruiting, training, retaining skilled staff, finding the right type of people in the city that you might be in, all these adds to your cost. Then there is software, there’s technology, all of this can add up. Well, outsourcing this task to an outside company who specializes in your specialty and I mean very critically, your specialty. It is important to make sure they know how to get verifications or get authorizations for your specialty. It is a cost-effective solution because this eliminates the overhead expenses, allows you to be more efficient, spend that money more efficiently in your practice. Basically, a good company can save you money, not just in price, but in productivity, opportunity, cost, and services. Well, I told you earlier, this is a long subject. There are so many things to cover, so I’m going to stop here. But stay tuned for the next segment, where we’ll dive deeper into the specific advantages and considerations of outsourcing.

Thank you for joining us today. And remember, a more efficient practice starts with making smart decisions. See you.

Rajeev Rajagopal

Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.

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