Comprehensive Support for IVF Insurance Verification and Authorization

  • Dedicated manager and insurance verification specialists
  • Verification during appointment scheduling
  • Flexible pricing with no start-up fees or long-term contracts
  • Customized solutions
Call: (800) 670-2809
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Expert Support to Navigate IVF Verifications and Authorizations

Expert Support to Navigate IVF Verifications and Authorizations

Coverage for In vitro fertilization (IVF), the leading form of assisted reproductive technology (ART), can vary according to state, among private and government insurance companies, and between policies. Some plans cover in vitro fertilization procedures as part of their benefits, while others may exclude it or offer limited coverage.

Due to these differences, verifying a patient’s specific coverage for expensive IVF treatment requires a detailed review of their plan documents.

We provide comprehensive IVF insurance verification and authorization services for fertility clinics. With our support, you can obtain the most accurate and up-to-date information about the patient’s coverage for IVF. Our team will verify coverage and benefits in advance of the office visit, so that your patients can make informed decisions.

Empower Your Patients and Improve Workflow with Real-time Insurance Verifications

Our patient insurance eligibility checks can optimize your workflow while helping patients understand their insurance coverage and financial responsibilities:

Insurance Verification

Our team will verify demographics, social security number, the name of the insurance carrier, type of plan, and other specifics of the patient’s coverage, benefits, and policy status. Our robust process helps identify if the plan covers IVF, medical/pharmacy infertility benefits, and out-of-pocket costs. We confirm these aspects with the payer before the office visit.
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Authorizations

Out-of-network services and many fertility medications require prior authorization from the insurance company. IVF medications cannot be started without obtaining a prior authorization. We help you overcome the administrative hassles, submit these pre-approval requests, and obtain authorizations from payers quickly, preventing treatment delays.
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Coding

Accurate claim submission depends on reporting services correctly. For pre-approvals, the requested services should have appropriate CPT code and diagnosis with the right ICD-10 code. After you provide IVF services, our
expert coding team assigns the appropriate medical codes, preventing denials and ensuring you receive appropriate reimbursement.
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Key Benefits of Partnering with OSI

Live Calls

Our team calls up the insurance company to check patient insurance coverage. This provides more detailed and up-to-date information than online/automated verification. Live calls ensure immediate information about the level of coverage, requirements for authorization, and any associated costs.

Open communication

Our team maintains open communication and rapport with insurance companies throughout the verification and prior authorization process. This allows you keep patients informed about their benefits, financial responsibilities, the status of their pre-approval requests, and any decisions made by the insurance company. Our team works to quickly resolve any coverage challenges efficiently.

Expertise

Our insurance verification specialists have years of experience. They are well-versed in the coverage policies of both commercial and Medicare for IVF treatments, which is crucial for accurate claim submission.

We serve all 50 states

Call to action

Let our experienced team handle your IVF insurance verification and authorization needs.

Call (800) 670-2809

Why Choose OSI?

When you partner with OSI, you can rest assured that your patient insurance eligibility checks and authorization needs will be handled correctly and in a timely manner. Our support can ease your administrative burdens, allowing you to better focus on care.
Why OSI?
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Dedicated team of insurance verification experts

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No long-term contracts or hidden fees
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Multi-level QA checks
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Cost savings of 30-40%
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Timely reporting based on your needs
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Reduced denials

How Our Insurance Eligibility Verification Process Works

1

Patient Intake and Data Collection
2
Detailed Insurance Verification
3
Pre-Authorization Support
4
Patient Communication
5
Comprehensive Documentation
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Patient Intake and Data Collection

The first step is collecting patient personal and insurance details during registration. This includes capture of details such as full name, address, date of birth, contact information, and insurance card data.

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Detailed Insurance Verification

Our team leverages live outreach and specialized tools to confirm the patient’s health plan coverage. It involves verifying policy status, copays, deductibles, coverage limits, and pre-authorization requirements.
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Pre-Authorization Support

Our experts assist you with submitting all necessary documentation for insurance pre-approval. They also help you navigate administrative processes to reduce burdens and secure approvals. They will also proactively manage appeals when required.

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Patient Communication

Our team works with your practice to inform patients of the insurance verification results, including their financial responsibilities. When patients understand their coverage details and out-of-pocket costs, they can plan better for their treatment.

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Comprehensive Documentation

The final step is updating the patient’s electronic medical record or your practice management system with verified insurance data. Integrating the coverage information into the patient’s treatment plan avoids disruptions.

Flexible Pricing Options for Insurance Verification and Authorization Services

We offer different pricing options to meet the needs of fertility clinics:

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.

Healthcare and Dental Revenue Cycle Management Process
Don’t let insurance uncertainties delay IVF treatments.
Contact Us Today

FAQs

Why is IVF insurance verification important?

IVF is a complex and expensive medical procedure. Insurance coverage for IVF varies widely, so verifying benefits is crucial to managing the financial aspects of treatment. Knowing your coverage upfront allows patients to plan and budget accordingly. It also allows healthcare providers to plan and deliver services efficiently, reducing the likelihood of denied claims and unexpected costs.

How long does the verification process take?

The duration of the IVF insurance verification process can vary, but it usually takes between 3 to 7 business days. This timeframe depends on the responsiveness of the insurance provider and the complexity of the patient’s coverage.

Can you help with pre-authorization for IVF procedures?

Yes, we assist with obtaining pre-authorization from your insurance provider for IVF procedures. Pre-authorization is often necessary to minimize the risk of claim denials.

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