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O2I's Home & Lab Sleep Tests Helped the Client Streamline Their Eligibility Verification Process

Case Study on Eligibility Verification Process

The Client's Business Requisite

Our client, a leading third-party administrator that offers fully customized medical billing services to its US clients was experiencing a drop in their ROI. The main reason for the drop was unsystematic Eligibility & Benefit Verification, Pre-authorization, and A/R follow-up process.

Challenges Faced by the Client

Since our client approached us for a specific set of services, we had to go through their extensive pile of data, collate, digitize, and provide an efficient process alternative that would maximize their earnings.

Our healthcare consultants and support staff faced the challenge of verifying the eligibility and patient's coverage benefits with pre-authorization requirements before any services are rendered to the patient. The turnaround was challenging, and we had to gear up our process.

Other challenges included our unfamiliarity with the Home and Lab sleep test studies that was substantial to reprocess a claim. Moreover, we had to provide support services that could provide 360-degree support on the client's administrative process.

Our Approach

Our client provided us with more than 30 clinical sleep study questionnaires to help us understand their eligibility verification, pre-authorization, and AR follow-ups needs.

We acquired the subject matter expertise on the sleep study services and the diagnostic tools associated with it while gathering their requirements. Upon gaining the know-how, we formed a team of experts who can research and understand the subject related to Sleep studies, both home and lab test. We also changed the team's work timing to EST so that there would not be an iota of lag in the deliverables.

Project Outcome

By gaining perspective on the client's gap areas on verifying its patient's Home and lab sleep test's insurance coverage, our team was able to provide eligibility & benefit verification services with the deadline.

The client experienced a steady growth and was completely satisfied with our services.

Outsource to Healthcare Back-office Support to O2I

Outsource2india is a leading provider of insurance eligibility verification services for Home & Lab sleep tests, RCM, Medical Billing & Coding, Medical Claims Processing, AR Management & Follow Up, Adjudication, Denial Management, and several other healthcare support services. Our healthcare support team includes talented insurance verification experts, medical billers & coders, reimbursement experts, etc. They can improve your organization's cash flow and streamline the back-end administrative functions. With us, you will witness a steady improvement in your facility's cash flow, efficiency, and employees' utilization.

If you are looking for a reliable, accurate, and affordable healthcare support services, then, you can stop searching. Get in touch with us today!

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