VARO executes patient pay strategies on behalf of the client.

Patient Information Needed (PIN)

VARO Healthcare assists “additional information needed from subscriber” denials by contacting patients to resolve “patient information needed” for the payer (ex: coordination of benefits, questionnaires, PIP applications, etc.)

Medical Necessity

VARO’s Insurance Team reviews Current Procedural Terminology (CPT) for appropriate medical necessity diagnosis codes. If there are any updated diagnosis codes, physicians will immediately be contacted and script will be reviewed for verification of service.

Pre-Authorization

VARO’s Insurance Team can verify eligibility, referrals (if needed) and medical necessity. We will also ensure that authorization matches the scheduled services and clinical policy requirements are met. After radiology services are performed, VARO’s pre-authorization process allows providers to determine coverage in advance and secure approval for a proposed treatment prior to the patient’s service date. In cases where you are required to appeal, pre-authorization will provide you strong ammunition to help avoid those unnecessary denials.

For unscheduled outpatient diagnostic testing, eligibility verification and referral verification prior to claim being dropped.

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Success Story

Comprehensive Sourcing Solution

Provider Type: 1,100 Bed Health System

Problem: This health system needed help finding cash to fund a system conversion.

Solution: VARO developed a comprehensive sourcing solution that included BPO services such as self-pay customer service, accounts receivable collections, insurance found strategies, lockbox services, and bad debt collections.

Results: After our 31-month engagement evaluation, the results were clear

  • Generated $101M in self pay cash
  • Surpassed client benchmarks, generating an additional $22.7M in self pay cash
  • Highest patient satisfaction—fielded 474K inbound patient calls with only 0.002% complaint rate
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