Opry Medical Group’s Specialists handle patient verification of benefits and prior authorizations. We take great pride in helping our fellow Health Care Providers similarly Orthopedicians/ Rheumatologists / Physiotherapists/ Chiropractors/ DME Suppliers and other medical practices complete paperwork and run insurance for a variety of procedures.
Our insurance verification specialists have experience working with government and commercial payers and have extensive knowledge about different types of coverage and policies. OMG verifies coverage for all major insurers Nationwide.
Verification & Authorization
Thoroughly verifying patient information with the insurance carrier for all possible services/products covered is our goal. We get in contact with the appropriate insurance payer to obtain approval for any authorization request when needed.
Complete criteria sheets and the prior authorization forms are handled and submitted when required. The following information is obtained on verifying a patient.
- Payable benefits
- Co-pays
- Co-insurances
- Deductibles
- Out of Pocket
- Patient policy status
- Effective date
- Authorization Requirements
- Type of plan and coverage details
- Plan exclusions
- Benefits Exclusions and Limitations
- Claims mailing address
- Referrals & pre-authorizations
- Health insurance caps
- DME reimbursement
Secure & Expedient
We have a HIPAA secured web database and uptight security protocols. Every client has their own secure login to submit information directly to our portal. Once the information is submitted all requests are worked within 24-48 hour. In most cases, a decision is made the same day. We process most STAT requests within an hour, though certain exceptions may apply.
Communication
Daily status checks are available for any pending request, and we communicate with your facility until the authorization is obtained. Once the verification process is complete and authorization is obtained.
- Stringent QA checks
- Daily, monthly and weekly reports
- System-based eligibility checking
- Customized TAT (from hours to days)
- No set up fees or training fees
In order to provide superior quality services, we have a dedicated QA team to monitor the production of the agents doing verifications and authorizations. Opry Medical Group has experience in authorizing up to 500 DME cases per day. The work of each agent is thoroughly audited to ensure that they are meeting a quality service standard of 98% or above.
Why Opry Medical Group For Verification & Authorization
The healthcare landscape is changing. Providers are challenged more than ever to adapt to changes in how care is delivered. At Opry Medical Group we understand those challenges and offer solutions that both care providers and administrators can benefit from and rally around.
We help in delivering a truly patient-centric approach to our fellow providers in all measurable better practice performance.
How Can We Help?
Take some time – Get in touch, and we’ll show you the difference Opry Medical Group can construct with your Revenue cycle. Fill out the form below to hear from a member of our team within 24 hours.