Expert Insurance Eligibility Verification Services

21+

Years of Experience

500+

Practices Served

2,500,000+

Verifications Completed

Save Time with Our Top-Notch Insurance Verification Services

Save Time with Our Insurance Verification Services

Insurance eligibility verification is one of the first steps in the medical billing process. Failing to perform this step can result in unpaid or denied claims. Our team confirms patients’ coverage before their appointment, providing you with instant access to their insurance coverage information.

We handle verification of patient benefits in real time. Professional insurance eligibility verification enables you to quickly confirm patient benefits, ensure proper billing, improve care, and boost cash flow. Our verification specialists are knowledgeable about payer coverage policies and can ensure hassle-free patient eligibility verification for your practice. We work in all 50 states.

Benefits of Our Insurance Eligibility Verifications

Ensures smooth navigation of insurance-related processes
Online verifications
Hassle free services provide more time to focus on care
Accurate coverage checks avoids costly rework
Reduces claim denials and improves cash flow
Improves point-of-service collections and decreases accounts receivable
Enhances the patient experience with upfront cost transparency
Fosters compliance with insurance billing requirements

How Our Patient Insurance Eligibility Service Works

1

Patient Information
Collection

2

Insurance
Verifications

3

PMS
Updates

4

Reporting
& Follow-up

5

Stat Requests
Management

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Collecting Patient Information

During the patient registration process, we collect basic demographic information on a patient, including name, birth date, and the reason for a visit. Insurance information is also collected, including the name of the insurance provider and the patient’s policy number.

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Verifications

Prior to the office visit, our team confirms that crucial patient details and insurance information is accurate and up-to-date. This includes:

Plan type and policy number
Effective dates of coverage
Deductibles, co-pays, and co-insurance
Benefit limits and exclusions
Referral and authorization requirements
Network participation status

In addition to using insurance websites and portals, our experts confirm insurance plan details with the payer via phone.

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Updating the Practice Management System (PMS)

The verified insurance information is updated in the patient’s electronic medical record or in the practice management system. This ensures quick access to accurate information when verifying coverage, minimizes errors, and supports billing processes.

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Tracking, Reporting & Follow-Up

We work with your staff to communicate with patients on their financial responsibilities. Knowing what their coinsurance, co-pays, and deductibles are will help patients make informed decisions about their care.

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Stat Requests Management

Our patient insurance eligibility service goes beyond standard verification. We understand that sometimes you need urgent insurance information to move a patient’s care forward quickly. Our dedicated “stat requests” process takes care of this.

When you need urgent verification, submit a stat request through our user-friendly portal. Our staff instantly processes the request, accessing up-to-date insurance databases or calling up the company to verify coverage details in real-time. Within moments, you’ll receive comprehensive information about the patient’s coverage details, allowing you to schedule appointments, order procedures, or resolve other patient access issues without delay.

Unique Benefits of Partnering with Us



Live calls

Our insurance verification specialists call up the insurance company to obtain more detailed and up-to-date information than online/automated verification. This also promotes timely care.

How Our Patient Insurance Eligibility Service Works

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Open communication

Our team quickly addressing any coverage challenges efficiently by maintaining open communication with insurance companies. They are well-versed in the coverage policies of both commercial and government payers.

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Experience & Expertise

Our insurance verification specialists have years of experience. They comprehensive services cover a wide range of insurance types such as commercial health plans, government-sponsored plans, workers’ compensation insurance, and specialty plans (dental, vision, behavioral health, etc.)

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Update Your EMR

When we complete an eligibility check, we automatically sync that information directly into your EMR. This eliminates the need for your staff to manually enter or update patient insurance details. It keeps your records current, complete, and compliant, reducing the risk of billing errors or claim denials down the line.

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We serve all 50 states

Flexible and Affordable Pricing Plans

Choose from our flexible pricing plans based on your needs:

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.

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.

Per Transaction Pricing

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.

Healthcare and Dental Revenue Cycle Management Process

Clarity at Your Fingertips with Instant Verifications

Contact Us Today

FAQs

What does insurance verification mean?

Insurance verification involves checking and confirming a patient’s insurance policy details, ensuring the policy is active and identifying what services, treatments, and medications are covered.

Why is insurance eligibility verification important?

By verifying eligibility, practices can assess a patient’s insurance coverage status before their appointment and accurately report demographic information on insurance claims.

What is eligibility verification?

Eligibility and benefits verification involves confirming a patient’s health insurance coverage and understanding what services are included and the extent of that coverage.

What services do you offer?

At OSI, we offer comprehensive Revenue Cycle Management services for our clients. Our solutions cover eligibility verification, claims submission, denial management, accounts receivable follow-up, contract negotiations, credentialing, predictive analytics, and billing and coding.

What if your Practice Management software doesn’t interface with my EMR?

Our practice management system currently interfaces with over 200 EHR systems, and with our open API, we can often create new interfaces through third-party integrations.

What are the benefits of outsourcing insurance verification to your company?

Outsourcing insurance verification to us offers several benefits:

Reduces the administrative burden on your staff
Improves accuracy and efficiency in insurance processing
Allows your team to focus on patient care
Decreases overhead costs associated with in-house verification

Can you handle verifications for multiple insurance providers?

Yes, our team has experience working with a wide range of insurance providers, including major national carriers and local health plans. We are equipped to manage verifications across diverse insurance networks.

What if a patient’s insurance coverage cannot be verified?

If we are unable to verify a patient’s insurance coverage, we will promptly notify your practice. We can also assist in reaching out to the patient for additional information or suggest alternative solutions to manage the patient’s care and payment options.

How long does the insurance verification process take?

Typically, the verification process can be completed within 24 to 48 hours, depending on the carrier’s response time. We focus on ensuring timely and accurate verifications for your practice.

What are eligibility verification best practices?

To reduce denials and minimize revenue delays, use your EHR’s electronic eligibility feature to verify a patient’s coverage before their visit.

Boost Efficiency with Insurance Eligibility Verification Services