21+
Years of Experience
98%
Ensure Seamless Patient Onboarding 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:
Checking if the patient’s plan covers the services you provide and is in your network
Boost RCM Efficiency with Proper Insurance Verification
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.
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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.
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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.
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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.
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Unique Benefits of Partnering with OSI
Live calls
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
1
5
1
Pre-authorization
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
Full-Time Equivalent
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
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.
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by Loralee Kapp | Posted: Jan 30, 2023
