Healthcare and Outsourcing: Why its the Perfect Alchemy
Recent research has shown that for hospitals and medical care service providers to break-even, hospital costs have to be cut down by 24% by 2022. Consequently, hospital leaders are now looking at new options like outsourcing their services so that they can free up their resources and cut down on costs.
Another survey points to the fact that 98% of doctors consider healthcare outsourcing as a suitable choice for cost-effectiveness in both clinical and non-clinical functions.
Healthcare BPO services have been the go-to choice for many hospitals to transfer daily routine administrative tasks. Healthcare call center outsourcing services let hospitals to focus on more value-based care by taking care of non-core functions.
Two of the areas in which hospitals are looking to consider medical outsourcing are in the diagnostic imaging service lines – medical imaging equipment and teleradiology. Outsourcing, especially in the healthcare sector, does not carry a bad reputation as it does in other industries. This may be attributed to a more profound understanding of handling dealers.
Common Healthcare BPO Services –
The role of outsourcing in healthcare can be understood by taking a look at all the services that BPOs offer to the healthcare industry. A major reason for the practice of outsourcing is that the BPO sector hosts a wide range of services ranging from data entry to medical claims processing. There are some medical outsourcing services that the BPO industry offers that are quite dependable and have achieved a trusted status over the years.
- Medical Billing and Coding –
Processing huge records of medical data is a daily task for hospitals and healthcare professionals. Coding and billing in the healthcare industry can be quite complex, unlike the other industries
Knowledge of scientific codes like ICD (International Classification of Disease), CPT (Current Procedural Terminology), HCPCS (Healthcare Common Procedure Systems) is critical in this segment. It is crucial to employ only staff trained in such fields are employed to deal with these records. As they are trained professionals, they would have the necessary expertise and resources to do the job proficiently.
- Claims Processing –
Patients need accurate medical claims processed for insurance companies. It becomes a much more difficult job when the number of claims to be processed run to hundreds of thousands in number each day.
Since outsourcing services have skilled resources and technologies they are well equipped to process large volumes of medical data with quick turnaround.
- Data Entry Services –
Besides processing and billing, healthcare providers have to process and update other forms of medical data every day. Tests and data reports, drug inventory, prescriptions, patient insurance details and other hospital data records need to be managed and updated constantly.
Outsourcing data entry services can free up time and resources for other core healthcare activities. Since data entry is simple it is usually the safest service to be outsourced, however medical data entry is very technical, so it is best to outsource to a trusted healthcare BPO.
- Medical Collection Services –
The collection of outstanding amounts is essential for the financial health of any industry. Almost every other company outsources its medical collection services to experts in the field. Such outsourcing practices are necessary to gain an edge in the market.
The rising cost of healthcare, high deductible insurance plans shift fiscal responsibilities to patients. A hard look at facts shows that almost 10-15% of debt revenue is lost by healthcare companies when they try to recover it themselves. It becomes a waste of time and resources to settle unpaid bills and costs the hospital undue financial burden. Outsourcing can lend a helping hand in this regard.
Pros of Outsourcing in the Healthcare Business
A recent study has shown that the healthcare BPO market would have the potential to reach around 450 million USD by 2023. The numbers are huge and it is only an eventuality that the industry would grow more exponentially over the coming years. The reason for such a huge growth in this industry and how the BPO industry can help in serving the healthcare industry can be learned below –
- Focus on Core Competencies –
As medical companies no longer have to waste time on managing bills, processing claims, logging data entry and resolving patient disputes, the time can instead be spent solely on patient care. This leads to a rise in customer approval ratings and the company’s reputation in the market which results in capturing more customers down the line.
As outsourced companies deal with the patients directly in case of disputes, it ensures that the healthcare providers don’t end up tangled in these and can focus on high-value services that require their expertise.
- Access to Specialists at a lower cost –
Many healthcare companies outsource their activities to BPO companies in countries like the Philippines, India, China, etc where talented workers are available at lower wage rates.
As BPO companies rigorously train their employees, there is no worry of any mistakes in the activities outsourced.
- Improvement in Customer Ratings –
The limited staff in a hospital or healthcare service provider’s office cannot comprehensively take care of all the routine processing and administrative functions without neglecting other services like patient care.
Outsourcing non-core activities of a company lead to the staff concentrating more on patient care and the core functions of a company.
- Data Security –
One of the biggest risks that the healthcare industry faces is data breaches and privacy issues. 2018 saw a whopping 15 million patients’ data records breached; the number has since tripled in the following years. Hackers and data breaches are a threat to any industry but the healthcare industry is especially prone and vulnerable to such attacks as the medical records of patients go for a high sum in the black market.
Undoubtedly, it is hard to trust a third party with sensitive data about a company without checking if there are stringent and comprehensive risk management measures in place to protect the said data.
What to look for in a Healthcare BPO Provider
Looking at all the services that outsourcing companies can offer, it is only valid to wonder which BPO company is the one for you. There are a lot of options available to choose from but it makes sense to select one that is a trusted name and offers quality services. Here are some qualities that shouldn’t be compromised on –
- HIPAA Compliance –
Since the healthcare industry has become digitized, questions over the security of patient’s information records arise. It is sensible to opt for a BPO that is HIPAA ( Health Insurance Portability and Accountability Act) compliant. This act has regulations in place specifying how companies should handle patient data. In case of any violation or breach of this law, the medical company or health practitioner in question can face criminal charges and up to 50,000 USD in fines.
For a BPO to be HIPAA compliant, they must have strict security measures in place to prevent data leaks. Hiring such a BPO ensures that the company’s confidential information doesn’t fall prey to hackers or data breaches.
- Proven Healthcare Expertise –
Healthcare BPOs specialize in this field and stand out from other run of the mill BPO companies. An employee of a healthcare BPO undergoes exhaustive training to gain expertise in this field. They should also be knowledgeable with regard to medical codes, department-specific information and follow government laws and regulations.
To verify the competence of a healthcare BPO provider, you can follow the below steps:
- Examine and judge them just as you would do it for your employee.
- A background check of their approval ratings and reviews and referrals provided by industry peers.
- Find out if they have a history of being able to strike a balance between professionalism and costs.
Performing Monitoring Measures
Healthcare activities like management of claims and billing are crucial and need complete focus. In such cases, trusting a BPO service provider that is thousands of miles away can be hard, especially when you have no idea if they are being productive or not or if their work is being competently done, etc.
Some BPO service providers have monitoring procedures in place but that is not always the case. This can be easily resolved by finding out if the company has relevant performance monitoring software in place.
It also remains true that the decision to outsource the activities of a company isn’t one that can be taken overnight as it involves a lot of factors that need to be taken into consideration.
Healthcare providers should identify the activities they want outsourced and also assess BPO service providers in the market and make an informed decision. Once the company begins outsourcing activities, it allows them to personally witness how advantageous BPO services can be.
It can be hard for a company to employ both medical staff and staff who look after administrative and other functions. Expertcaller’s Healthcare outsourcing services can help a company save a lot of money and time letting its professionals and staff concentrate on giving patients the care they deserve. In addition to this, Expertcallers BPO services provide access to experts in all domains required.
Founded in 2002, Expertcallers has spread its reach to 3 continents with over 100 clients and a 2000+ workforce. With 100% HIPAA compliance, we assure the utmost safety for your data. Our range of services includes 24/7 telephonic assistance, appointment setting services, insurance verification services, a host of inquiry services and many more. Speak to our representative today to know more about healthcare outsourcing services.