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Verify Patient Insurance Eligibility and Optimize Billing
Bariatric surgery or weight loss surgery is a common treatment for obesity. There are various types of metabolic and bariatric operations to help individuals lose weight when traditional methods fail. Despite its high cost, many health insurance plans cover bariatric surgery due to its medical necessity. However, navigating insurance coverage can be complex.
Outsource Strategies International (OSI) provides comprehensive insurance verifications and authorizations for weight loss surgery. We are knowledgeable about the requirements of both Medicare and private insurance companies. With efficient verification of coverage and benefits, our team ensures a smoother process for both you and your patients.
Optimize Your Revenue Cycle with Efficient Verifications and Authorizations
Our comprehensive insurance verifications and authorization are focused on maximizing your reimbursement and ensuring that patients receive the financial support they need to undergo life-changing bariatric procedures.
Insurance Verifications
We analyze patients’ insurance policies to determine coverage for their weight loss surgery. By clarifying pre-authorization requirements, deductibles, co-pays, and limitations, we help you price procedures and enable patients to understand their financial responsibilities.
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Pre-Authorizations
Obtaining the necessary pre-authorizations is a critical step in the insurance verification process for bariatric surgery. Our experts will work closely with insurance providers to secure timely pre-approvals, ensuring your claims are not denied due to lack of authorization.
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With our support, you can focus on delivering exceptional care, while patients can begin their weight loss journeys without the burden of insurance-related concerns.
Highlights of Our Insurance Verification Services
- Dedicated team of insurance verification experts
- Multi-level QA checks
- Cost savings of 30-40%
- Timely reporting based on your needs
- HIPAA compliance
Why Choose Us?
Expertise
Our team has extensive experience in medical billing and insurance verification for bariatric surgery. They are knowledgeable about the coverage policies across various insurance providers.
Live calls
Our live calls to the carrier helps obtain detailed and up-to-date coverage and benefits information. With immediate confirmation of coverage and pre-authorization for upcoming bariatric surgery, including complex procedures, you can provide timely care.
Open communication
Our insurance verification specialists maintain open communication and rapport with insurance companies. This helps resolve any coverage challenges efficiently. It also helps you to provide patients with a clear explanation of their benefits and financial responsibilities in easy-to-understand terms.
We serve all 50 states
How Our Insurance Verification Process Works
The steps in our proven verification process are as follows:
1
Setting up an insurance file for each patient
2
Verifying patient eligibility
3
Documenting all coverage details
4
Educating patients on costs of care
Setting up an insurance file for each patient
A dedicated file is set up for each patient, making it easier to access and update patient insurance information as and when required.
Verifying patient eligibility
This process involves through checks to ensure that the patient’s insurance plan is active and covers bariatric surgery, potentially preventing claim processing issues.
Documenting all coverage details
After confirming the patient’s insurance eligibility, we thoroughly document all coverage details in their file, including policy numbers, limits, co-pays, deductibles, and any applicable exclusions or limitations.
Educating patients on costs of care
We educate patients about their coverage and treatment costs, empowering them to make informed decisions regarding their treatment options and understand their financial responsibilities. We also explain the claims submission and processing procedures, so that they are aware about the process works, with the aim to increase claim submission accuracy.
Pricing for Bariatric Surgery Insurance Verification
We offer different pricing options to meet the needs of bariatric surgery practices:
Full-Time Equivalent
In this model, services are billed based on the equivalent cost of a full-time employee (FTE) for a specified duration, usually monthly or annually.
Per Verification Billing
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.
FTE/Per Verification Billing
This option is ideal for a practice that is unsure about their work requirements. This can have per request pricing for eligibility and other functions.
AR is only FTE
In this model, you will be charged a fixed monthly or annual fee based on the number of full-time equivalent staff required to manage your practice’s AR follow-up activities. We are also considering a blended model for AR.
FAQs
Why is insurance verification necessary for bariatric surgery?
Insurance verification is essential to determine the extent of coverage for bariatric surgery, including benefits, co-pays, deductibles, and any exclusions or limitations. It helps patients and healthcare providers understand the financial aspects of the procedure.
How long does the insurance verification process take?
The time taken for insurance verification process can vary depending on several factors, such as the complexity of the insurance plan and the responsiveness of the insurance company. Our dedicated team is focused on completing the verification process as efficiently as possible.
Can insurance verification be done retroactively?
While best practice is to initiate insurance verification before the bariatric surgery process, it is sometimes possible to perform retroactive verification. However, it is important to note that retroactive verification may involve certain challenges and potential limitations.
How can outsourcing insurance verification and authorization benefit my healthcare practice?
Partnering with a specialized insurance verification and authorization company like ours can save you practice time and resources. It allows you to focus on providing quality care while ensuring that verification and authorization processes are handled efficiently and accurately.