Healthcare BPO Services

Healthcare outsourcing is a business practice where a healthcare organization subcontracts its non-core activities to an external vendor that manages its secondary operations. While some healthcare institutions recruit freelance professionals to do the work, most of them hire providers specializing in healthcare outsourcing, such as call centers.

BPO is the delegation of IT-related business processes to a third-party provider. Its primary responsibility is to supervise these processes for the client based on measurable performance indicators.

The healthcare industry comprises outpatient clinics, specialists’ offices and clinics, assisted living facilities, laboratories and diagnostics clinics, dental offices, nursing homes, orthodontics offices, doctors’ clinics, health centers, and hospitals.

Most organizations in this sector opt to outsource their non-core functions to focus on what they do best: deliver effective and efficient treatment services for patients. Non-medical operations, technology related to information services and computers, and accounting, to name some, are best-taken care of by BPO companies. This way, healthcare companies can put all their time and effort into patient care.

BPO companies and other outsourcing agencies can handle healthcare institutions’ patient and customer relations, human resources, revenue cyles, claims, supply chain, team member training, finance and accounting, and IT functions.

Healthcare Services Typically Outsourced to BPO Firms

Back-office operations of any organization are as vital as its core competencies to continue running at an optimal level. BPO companies have the technology, expertise, knowledge, and human resources to sustain a healthcare provider’s back-end tasks.

Below are some of BPO companies’ outsourcing services:

Medical billing services.
Experienced service providers offer their error-free medical billing services to healthcare professionals and can process a great number of medical records produced every day. The third-party firm follows certain standards, procedures, and rules that assist in promptly addressing medical coding and billing issues.

Data collection and analysis services.
- BPO can provide healthcare organizations with the latest technology and approach for data collection and analysis. They can take on data management processes for clinical research, health outcomes, and billing, to name a few.

Medical claims processing services.
- Processing patient claims is one of the most important healthcare activities. Hiring an external medical claims processing team to handle claims lets healthcare providers offer insurers accurate, up-to-date, and timely information. BPO companies have the appropriate technologies, networks, and resources to conduct the required tasks to work on large volumes of medical claims successfully.

HR services.
- BPO companies can efficiently manage a healthcare organization’s HR administration and benefits assistance. They have broad experience in providing more benefits packages and affordable health insurance to employees. Moreover, clinics, hospitals, and similar institutions are not required to recruit and train new workers, develop database software information, assist an internal HR department, or make employee manuals or handbooks. The external provider can deliver all these tasks at a low price.

What Are the Four Commonly Outsourced Healthcare Services?

Data Entry Services

Healthcare companies need to manage and revise large quantities of medical data regularly. They have to process information such as patient insurance, clinical records, test reports, laboratory reports and orders, prescriptions and drug inventory, nursing records and progress notes, and patient assessment forms. Industry experts say that the data-entry outsourcing market will continue to grow in the next few years. The widespread acceptance of this healthcare service fuels the growth of this industry. The rising demand for cost-effective options and the need to focus on core competencies are also the factors that drive the continued expansion.

Medical Transcription Services

One task that takes up a great deal of time and effort from healthcare professionals is transcribing their own notes. Surgeons, physicians, general practitioners, nurses, and other medical staff have to pay attention to patient care. But many of them are slowed down by paperwork and other administrative tasks, constraining their time with patients and leading to physician burnout. The latest studies have shown that the U.S. transcription market is expected to grow even more in the next couple of years. The uptrend can be attributed to organizations across the world, producing daily large quantities of data used to acquire valuable insights. As such, the demand for medical transcriptionists is here to stay.

Medical Billing Services

Healthcare companies process large volumes of medical billing and records, which are more complex than those of other sectors. They can cause errors and delays when not handled properly. Medical bills and invoices use scientific and technical codes, including the Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICS), Current Procedural Terminology (CPT), and Diagnosis Related Group (DRG). Market advisory firm Mordor Intelligence predicts that the global medical coding industry will significantly expand in the next several years. The worldwide market growth is driven by the increasing need for healthcare management systems, clinical management solutions, and electronic health records.

Claims Processing

Another commonly outsourced non-core healthcare function is processing patient insurance claims. The appropriate medical claims for patients from their insurance firms have to be efficiently managed. Maintaining accuracy and timeliness is a challenge when numerous claims are needed to be processed daily. This is among the reasons healthcare providers farm out this activity to an experienced and reliable external service provider. Subject matter experts expect the demand for claims processing services, which mainly stem from physicians’ offices and other healthcare professionals, will remain on the upward trend. They see that the number of doctor visits will further increase. This means that the volume of insurance claims from patients will also rise.

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