Specialized Rheumatology Insurance Verification Services

21+

Years of Experience

98%

Claim Submission Accuracy

25%

Decrease in Outstanding AR

Boost RCM Efficiency with Proper Insurance Verification

Ensure Seamless Patient On-boarding with Accurate Rheumatology Insurance Checks

We provide comprehensive rheumatology insurance verification and authorization services, ensuring that all details are checked before the office visit. Our robust insurance verification processes are designed to meet the unique needs of rheumatology practices and include:

=

Verification of patient benefits for complex treatment plans and patients with comorbidities

=

Submitting prior authorization requests to get timely approval for expensive specialty medications

=

Checking if the patient’s plan covers the services you provide and is in your network

Rheumatology treatments may require changes over time. With our team handling the ongoing insurance checks, you can focus on treating patients with this autoimmune disorder.

Overcome the Challenges of Rheumatology Insurance Verification!

Call (800) 670-2809

Boost RCM Efficiency with Proper Insurance Verification

Our patient insurance eligibility checks can optimize your revenue cycle and financial performance:



Insurance Verifications

Our team verifies demographics, social security number, carrier name, type of plan, and other coverage specifics; policy status and effective date, exclusions or limitations, payable benefits, co-insurance, co-pays, and deductibles. We also verify pre-authorizations, referrals, health insurance caps, Medicare coverage, and out-of-network benefits.
Read More



Coding

Accurate claim submission and processing depends on reporting treatments delivered correctly. After rheumatology services are provided, our expert coding team helps you assign the specific medical codes for the office visit, medical services, diagnoses, and procedures. Accurate coding prevents denials and ensures appropriate reimbursement.
Read More



Authorizations

Insurance companies require pre-approval or prior authorization for many rheumatology treatments, especially for specialty drugs. After identifying pre-auth requirements during the insurance eligibility verification process, we help you submit prior auth requests and get the approvals in a timely manner, helping patients get the care they need quickly.
Read More



AR Follow Up

Increased denials and delayed follow-up are usually the result of accounts receivable (AR) greater than 90 days. The AR follow-up process involves tracking and resolving unpaid claims and balances with insurance companies and patients. Our team diligently tracks the status of each claim, identifies and addresses issues quickly, optimizing your cash flow.
Read More

We verify insurance coverage before services are provided. This allows you to calculate and inform patients about service costs and out-of-pocket expenses. Verifying coverage will help them understand if their plan covers office visits, testing, and treatment infusion therapy, which can be expensive. Checking coverage upfront allows them to better plan for their care.

Unique Benefits of Partnering with OSI



Live calls

Our live calls to check patient coverage and benefits help obtain more detailed, up-to-date information than online/automated verification. Immediate confirmation of coverage and pre-authorization for upcoming rheumatology services allows you to provide timely care.



Open communication

By maintaining open communication and rapport with insurance companies, our team quickly resolves resolve coverage challenges efficiently. This also helps you to clearly explain patients’ benefits and financial responsibilities in easy-to-understand terms.



EXPERTISE

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



We serve all 50 states

Our Patient Insurance Eligibility Verification Process

From verifying eligibility to filing accurate claims and beyond, we do exactly what your staff has to.

1

Patient registration

9

Pre-authorization

4

2

Data collection

9

Communicating with the patient

5

3

Insurance verification

9

Documentation

6

1

Patient registration

"

2

Data collection

"

3

Insurance verification

"

4

Pre-authorization

"

5

Communicating with the patient

"

6

Documentation

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

Pricing for Rheumatology Insurance Verification Services

We offer different pricing options to meet the needs of rheumatology 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.

Healthcare and Dental Revenue Cycle Management Process

Improve cash flow through timely, accurate insurance verification and authorizations!

Contact Us Today

FAQs

How long does rheumatology insurance verification take to complete?

The time taken for insurance verification can range from a few minutes to a few days. Various factors influence the time for verifying coverage such as insurance plan complexity, whether it involves checking out-of-network coverage, pre-authorization requirements, manual processes, and holidays. At OSI, our team works with advanced tools as well as live calls to expedite the process and ensure accuracy.

How do you handle a situation where the insurance company denies coverage for a rheumatology service?

Our team will first contact the payers to understand the reason for the denial and what steps can be taken to address it. This may require submitting additional documentation or requesting an appeal.

How can you help my practice boost compliance with payer policies?

Our dedicated team will help you implement a standardized insurance verification workflow. They will track payer policy updates and adjust your internal processes accordingly. By regularly reviewing patient records, they will identify any lapsed authorizations or coverage issues, and take steps to address them.

Comprehensive Rheumatology Insurance Verification