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Outsource Insurance Eligibility Verification Services

Insurance Eligibility Verification Services

Are you facing challenges in validating your patient's copayment, insurance benefits, and deductible information? And looking to collaborate with an insurance expert to relieve you from the insurance eligibility verification tasks? An accurate eligibility verification process serves two important purposes for healthcare professionals, physicians, and hospitals. The first one is to avoid claim resubmission, claim rejections and denials. The second one is to increase upfront collection through clean claims.

At Outsource2india, we have embraced the 21st-century collaborative business model. And in a span of two decades, we have amassed a vast repository of insurance-related knowledge by interacting with our 200+ global healthcare clients. With us, you can leverage the expertise of our medical insurance experts to revive and revamp your insurance eligibility verification process.

Insurance Eligibility Verification Services We Offer

Our team includes skilled and talented insurance specialists who are always geared to serve you. Some of the services that we offer are -

  • Health Insurance Document Verification

    Once we receive all the necessary documents from the healthcare organization, our team analyzes the insurance E&B a day before the scheduled appointment to ensure that the records are verified. We collate the paperwork in sequential order as demanded by the insurance provider.

  • Patient Insurance Coverage Verification

    We verify the patient's insurance coverage with the primary and secondary payers. They capture details like co-insurance, copay, deductible, PCP name matching, in-network, and out of network benefits, and update in the patient notes. Then, our team completes the verification process by accessing the insurance provider's online portal or by directly calling them over the phone.

  • Patient Information Correction

    Our insurance support executives also follow-up with the patients and call them for any incorrect or missing information/documents. This helps to keep a track of filed/unfiled information and verifying all the collated information prior to the final submission.

  • Claim Submission

    Lastly, we conduct a service procedure check and need authorization before providing the final claim details to our clients. It includes the required documents and other relevant information such as member ID, group ID, insurance coverage dates, copayment (co-pay) information, etc.

Insurance Eligibility Verification Process We Follow

At Outsource2india, we provide a comprehensive range of insurance verification outsourcing services. Our proven insurance eligibility verification model comprises of the following stages -

Patient Eligibility Verification  

01. Patient Eligibility Verification

We check and confirm the documents received from the healthcare organizations and insurance providers. This is taken care by our healthcare support executives before the treatment. It helps them authenticate the patient's coverage details and collate the related documents serially - as mandated by the insurance provider.

Checking with Insurance Company for Payment or Missing Information  

02. Checking with Insurance Company for Payment/Missing Information

We check with the insurance company about any payment obligation or missing/extra information that the patient has, prior or post the treatment. Then, we leverage necessary communication modes to contact the patient. We take the expertise of our healthcare support executives prior to the patient's appointment date and cross verify those details before the final submission.

Patient Follow-up  

03. Patient Follow-up

Before scheduling the appointment, we inform the patient of his/her payment responsibilities. It assists the patient to choose the treatment course and helps the client avoid any last-minute cancellation.

Final Submission  

04. Final Submission

Once the documents are in order, we submit the final report that incorporates all the insurance benefits. It includes details like member ID, group ID, Insurance start and end date, copayment details, etc. This process negates any last-minute schedule changes and saves time for both the healthcare staff and patient.

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16 Reasons to Choose Outsource2india for Medical Insurance Eligibility Verification Services

At Outsource2india, we offer comprehensive range of insurance verification services ranging from document checking to final submission. With us, you will have a quick upturn in your cash-flow, hassle-free follow-up with the payer, and get more time to do what you do best - patient care. Our team consists of some of the best minds in the health insurance service domain.

You can avail following benefits of Insurance eligibility verification with Outsource2india -

  1. Certifications

    We are ISO 9001:2000 certified organization and follow 100% HIPAA compliance standards. We also strictly follow HL7, CPT, HCPCS, & ICD-10 security regulations, which supports standardization of guidelines, provides infrastructure on ICD-10, enhances usability and usefulness of transactions. Moreover, these certifications improve the utility of NCPDP standards, reduce ambiguity and support the standardization of the insurance eligibility verification across the department.

  2. Data Security

    At Outsource2india, we have implemented rigorous privacy, security, and confidentiality safeguards at each rung of our department. We have established SOPs, regular training programs, and Quality Assurance (QA) inspections according to the mandated insurance best practices which helps us offer best quality services to you.

  3. Flexible Pricing Options

    With us, you have the liberty to choose the pricing model. Those are based on hours, per unit work done, percentage collection basis, etc. We also customize our insurance eligibility verification service's pricing based on your niche needs.

  4. Software

    We use state-of-the-art software like Medisoft, QRS, Medical Manager, MISYS Tiger, Ortivus, Surgi Source, and MISYS. These web-based software support single sign-in, where you can submit insurance carrier requests. Thereafter, our insurance experts work on insurance authorization, pre-authorization, and medical insurance eligibility verification.

  5. Infrastructure

    Our delivery centers are equipped with advanced infrastructure required to provide high-quality Medicare eligibility verification services. We have Independent Internet Leased Circuits, built in IT redundancies, 200% power back up, etc. We also mandate that our team members comply with HIPAA's security measures.

  6. Accuracy

    We audit each outgoing file for accuracy and errors and have a dedicated QA team to handle a project. We maintained 98% accuracy surpassing the industry standards.

  7. Faster TAT

    We assure you of accurate medical insurance eligibility authentication within the deadline. Moreover, with our global delivery centers that operate 24*7, you get a time zone advantage.

  8. Ease of scalability

    We have the required resource capability and wherewithal, both in terms of expertise and infrastructure. You can rely on us to manage any surge in your business demands, so that you pay only for the services rendered.

  9. One-point Contact

    We believe in personalized service. That is why we deploy a dedicated insurance expert to you who act as a one-point contact and provide their project undivided attention.

  10. Experience

    We have a cumulative experience of 20 plus years in the insurance eligibility verification domain. Our health insurance experts exceed 200 in capacity. Furthermore, our combined management experience exceeds 100+ man-years. So, when you outsource your requirements to us, you can be assured to highly professional service.

  11. Expert Team

    At Outsource2india, we have a healthcare & insurance support team of 50+ professionals. They are adept at ascertaining prior authorization requirements, preparing and submitting necessary information, following up on submitted prior-authorization requests, and reporting the providers for any authorization issues.

  12. Ease of File sharing options

    We send/receive the insurance eligibility files only via FTP/SFTP servers. And all these files are compressed, encrypted, and password protected. Thus, it provides the necessary security and saves the transmission time.

  13. 24*7 Availability

    We have four different offices and over 10 delivery centers across the globe. The multiple service locations allow us to be flexible and deliver services 24*7. You can be certain that our representative will be always available for calls during your work hours, no matter what part of the world you work in.

  14. Better Productivity

    We follow a systematic approach to update patients' insurance eligibility after validating their records. By collaborating with us, you will see a sudden surge in your productivity level. You will have more interactions with your patients and that too on medical related topics.

  15. Saves Time

    Outsourcing the insurance eligibility verification services to O2I will liberate your healthcare professionals from the monotony of insurance eligibility verification tasks. Doing so, they will get ample time to focus on their core competencies and can be more productive.

  16. Increases Self-Pay Revenue

    We understand that a clean claim keeps the patients well-informed of their financial obligations and limits the payer's work to process those accurate claims. Outsourcing your insurance eligibility verification tasks to us will help you achieve that. And while matching the self-pay patients with the databases, you can find new opportunities for reimbursements as well.

Customer Success Story

Medical Insurance Eligibility Services for Telemedicine Provider

O2I Provided Pharmacy Insurance & Medical Insurance Eligibility Services to a Telemedicine Provider
Read a case study on how O2I provided eligibility services to a US-based telemedicine provider. We checked the eligibility of their clients who furnished application to avail insurance and medications.
Read the case study

Outsource Insurance Eligibility Verification to Outsource2india


O2I provides a reliable and efficient medical billing service. They have helped improve collections and lower receivables for my clients.

Founder & CEO,
Billing Company in the east coast
More Testimonials »

Outsource2india has been a leading provider of health insurance eligibility verification, dental Insurance verification services, and a plethora of medical billing and coding services to clients around the globe. Our team consists of some of the most talented and brilliant medical coders who are capable of handling any of the clients' requirements. We have multiple delivery centers spread across time zones which enable us to provide the required services within a quick turnaround time.

We adhere a systematic approach to streamline insurance eligibility checking process, which ensures more claim acceptances and fewer claim denials. If you are looking for a reliable, efficient, accurate, and cost-effective insurance eligibility verification company, then you have come to the right place. Get in touch with us today!

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