Flatworld Provided Insurance Eligibility and Verification Services to a Birth Control Telemedicine Provider

Case Study on Insurance Eligibility Verification

The Client

The customer is a birth control telemedicine provider and a medication delivery service. Currently, their licensed medical providers can write year-long prescriptions for Arizona, California, Illinois, Nevada, Pennsylvania, and Washington residents. If you already have a prescription, they can transfer that prescription from your old pharmacy to a partnering pharmacy. They will pick up your medication and deliver it at your designated address.

Client's Requirement & Challenges

The client was unable to check pharmacy insurance as well as medical insurance eligibility on time for all members who were ordering birth control pills. It was also the client's responsibility to send text messages to every member about the status of their order. However, this was causing a delay in delivery services.

Checking insurance eligibility and texting members impacted a multitude of process areas, including prescription delivery and sharing cash price quote for each member. So, the client approached us to help them in checking insurance eligibility and texting the status. This insurance information can only be obtained by referring to the insurance carrier's website. Alternatively, you can also call a representative of the insurance carrier.

Our Solution

We started getting information by checking the insurance carrier's website and calling their representatives. Based on our verification procedure, we obtained the following information and updated the same on their web portal -

Medical Insurance

  • Name of insurance company
  • Medical ID #
  • Group # (if any)
  • Effective Date (will usually not be on the insurance card)
  • Primary cardholder (who does not this insurance plan belong to)

Pharmacy Insurance

  • Pharmacy ID # (if on a separate pharmacy insurance card)
  • Rx BIN - usually a 6-digit number
  • Rx PCN (if any)
  • Rx Group (if any)

The Results

With core experience in pharmacy insurance and medical insurance, the eligibility verification was completed successfully and within the stipulated time. The information we obtained was updated on the website. Our cost-effective services enabled the client to fast track member applications that met the criteria and distribute medications without delay.

Outsource Insurance Eligibility Verification Services to Flatworld Solutions

Flatworld Solutions is an ISO certified company with the right merits to undertake insurance eligibility verification services. 12 years after we began our services, we continue to provide cost-friendly healthcare BPO services to clients internationally. We have a team of healthcare insurance experts who carry 10+ years of experience in healthcare backend services. With many global centers and state-of-the-art infrastructure, we deliver reliable services in brief time. Get 24/7 support via phone and email as your local time zone.

Save more by outsourcing insurance eligibility verification to us. Get in touch with us to get customized pricing for the project.

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