Health and medical care play an essential role in every community, and it’s clear that many companies and organizations invest in different technologies and interventions to create better health and medical services.
One of these many interventions is outsourcing business processes, which involve a wide range of back-end processes that patients frequently need. Hospitals, clinics, diagnostic centers, and laboratories are quickly changing into a more cost-effective and innovative way to deal with patient questions and help more patients get in touch with doctors and other medical professionals.
Outsourcing business functions in the healthcare industry offers many benefits to companies and professionals, especially when the demand for healthcare services increases.
What is healthcare outsourcing?
It is a common business practice adopted by healthcare and medical providers that involves a third-party service provider to perform clinical services even without the presence of a physical office or headquarters. Through this practice, healthcare services are delivered online by qualified professionals and healthcare workers specializing in back-office support services.
This business solution is considered the future of modern healthcare services, with the healthcare sector constantly exploring different strategies to provide each patient in need with the highest quality of care possible.
The Most Commonly Outsourced Healthcare Services
To improve patient satisfaction, it’s crucial to choose a dependable outsourcing partner. To ensure effective collaboration with a third-party healthcare provider, it’s crucial to understand their areas of expertise in patient care and healthcare delivery. Below are some of the most commonly outsourced services by healthcare companies for improved business performance and quality patient care:
1. Medical Billing
Processing medical bills amounting to hundreds, thousands, and even millions, is one of the biggest challenges that most healthcare companies have to deal with. In order to generate healthcare claims for insurance companies, it is crucial to maintain a high level of focus and accuracy. This is why medical centers hire dedicated teams that specialize in this specific business process.
With the help of a reliable outsourcing provider, navigating between patients, healthcare providers, and insurance companies is a lot easier. Healthcare outsourcing companies will be in charge of the following:
- Reviewing medical charts of patients to verify insurance coverage
- Generating medical claims and checking each for accuracy
- Submitting claims to payers (insurance companies)
- Preparing patients’ bill
They are also responsible for making the necessary deductions, which usually involve the amount covered by the insurance company and adding the outstanding patient balance.
2. Medical Coding
Coding is an integral and highly technical process that is crucial for the smooth functioning of healthcare and medical transactions. Although closely connected to medical billing, coders are expected to have excellent analytical skills and advanced knowledge of the following codes:
- Procedure codes – CPT®, HCPCS Level II, or ICD-10-PCS
- Diagnosis codes – ICD-10-CM code set
Procedure codes are used to inform the payer about the type of procedure that the healthcare provider performed. Diagnosis codes, on the other hand, explain to the payer the reason why the patient received that specific service or procedure.
3. Transcription Encoding
To ensure effective and quality healthcare delivery, healthcare professionals should provide clear and accurate transcriptions. But for free and public services, it is harder to provide hundreds and thousands of transcriptions without the risk of errors and discrepancies.
Transcriptionists, similar to professionals in billing and coding, need to have a thorough understanding of medical jargon, anatomy, and various medical and healthcare languages. This knowledge is crucial in accurately interpreting diagnoses and results. Active listening skills and attention to detail are two of the most important skills that transcription encoders should possess to perform the following:
- Listening to / recording instructions dictated by medical professionals
- Transmitting voice files and transcribing them into readable text
- Editing transcribed files
- Sending edited files to healthcare facilities
4. Receivables Management
In addition to maintaining an organized filing system for medical records, private providers should also invest in financial monitoring tools and processes. Receivables management is one of the many effective ways high-profit companies take care of their revenue and make the best financial decisions.
In fact, good receivables management helps a company have a systematic review of its cash flow, increase liquidity, and reduce bad debt. It can also enhance a company’s reputation and professional image. The receivables management outsourcing process involves the following:
- Development of a credit policy
- Follow-up correspondence to customers
- Collection of due payments
5. Insurance Claims Processing
With the rapid advancements in technology, medical practice, and healthcare management have become more convenient and accessible to patients. As a result, there is an increasing demand for healthcare and medical insurance. Why not? Insurance helps minimize healthcare costs from emergency care, integrated healthcare facilities, and laboratory services.
To improve customer experience and increase levels of satisfaction, providing relevant services such as insurance claims processing is a must. Medical outsourcing services and external service providers offer assistance to reduce administrative burdens brought on by the highly technical nature of processing insurance claims.
Having an external provider to process your patients’ insurance claims can put your business at the top of the healthcare market. Here are the three most essential steps in insurance claims processing that your healthcare BPO partner can help you with:
- Claims adjudication
- Explanation of Benefits (EOBs)
- Claims settlement
Digital Minds BPO offers reliable insurance claims processing services at affordable rates. Enjoy top-level service quality and reduce your company’s operating costs by joining the healthcare outsourcing market now!
6. Clinical Outsourcing
Quality care and a well-structured business model make the best healthcare systems possible. For healthcare companies, research plays a huge role in keeping healthcare organizations updated with the latest innovations and trends in the healthcare sector.
Training and hiring internal staff to handle comprehensive and vital medical research and studies is expensive. Although having an in-house clinical staff can significantly increase the chances of success for your healthcare company, it is crucial to exert maximum effort to ensure a firm performance in the market. Healthcare organizations are using clinical outsourcing to save money on labor costs while enhancing patient experiences and protecting their internal resources.
How much is the current value of the healthcare outsourcing industry?
More and more healthcare organizations are considering the help of a healthcare outsourcing network to cater to the needs of patients in different healthcare settings. With this, industry experts predict a value of over $682.33 billion by 2030 at a compound annual growth rate (CAGR) of almost 10.5%.
Healthcare business process outsourcing is an excellent way for medical companies to excel in a competitive industry and use their financial resources effectively. Haven’t decided yet? Read more to learn about the key benefits of outsourcing healthcare services.
6 Benefits of Outsourcing Healthcare Services
As an ultimate modern healthcare solution, outsourcing offers a lot of benefits to health organizations, patients, and other stakeholders. Here are some of the reasons why outsourcing services is a business strategy that every healthcare provider and medical institution should prioritize:
1. Cost savings
Outsourcing healthcare services can save companies money on healthcare labor costs. This eliminates the need to hire and select new in-house staff for business processes and on-site work. Clinical laboratories can also save money on technology and equipment because they do not need as much expensive equipment.
2. Reduced errors in data entry
The daily business tasks in healthcare institutions involve a lot of data entry and processing. These processes require accuracy and high attention to detail. Since most outsourcing companies use AI to work on large amounts of data, errors will be reduced or completely avoided. The process of data entry is crucial for any business, as it lays the foundation for accurate and reliable information. Fortunately, modern technology, including AI, has revolutionized this process, allowing for the reduction and even elimination of errors.
3. Access to experienced industry professionals
When you outsource your healthcare services, you are breaking the limit that your company can access in terms of skills and manpower. Outsourcing healthcare services can give you access to the best industry professionals who have extensive experience working with medical institutions, top laboratories, and prestigious healthcare companies.
4. Enhanced patient data protection through strict HIPAA compliance
The Health Insurance Portability and Accountability Act (HIPAA) plays an important role in the protection of the privacy of patients, especially in the disclosure of personal health information, also known as protected health information. As a federal law, all healthcare organizations are required to comply with the HIPAA.
Through outsourcing, the compliance process for HIPAA will be a lot stricter, and patient data protection will be improved.
5. Effective management of administrative tasks
Back office tasks or administrative tasks support the company’s main business functions and usually help the company generate more leads and revenue. Instead of hiring in-house medical staff, you can monitor all administrative functions remotely without spending so much on office space, equipment, recruitment, and hiring.
6. Improve business scalability
Outsourcing healthcare services allows for flexible staffing based on demand, which can support business growth. Companies often outsource back-office tasks, making it more straightforward to adjust the size of each team or department. Scalability enables business owners to save more on labor and operational costs, and you can enjoy this benefit by outsourcing healthcare services.
2023 Trends in Healthcare Outsourcing Industry
We have seen a lot of advancements in healthcare facilities, improvements in laboratory tests, diagnostic imaging, and medical records management. Quick and reliable healthcare delivery has become more accessible to both private and rural hospitals, thanks to healthcare outsourcing companies.
If you’re planning to outsource your business processes to excel in the healthcare market, here are five industry trends that you should not miss:
1. Increase in AI use
The pandemic has brought many challenges to healthcare organizations and medical professionals. Having 24/7 assistance is crucial for ensuring the best health outcomes for every patient. However, this task can be exhausting even with a strong and dedicated manpower.
To solve this problem, many healthcare providers, both private and public, are using Artificial Intelligence (AI). This helps reduce backlogs and prevent staff burnout. Most healthcare BPO companies specialize in performing technical tasks which can be tedious for your in-house staff:
- Medical bills, payments, and claims processing
- Health data collection, compilation, and management
- Finance and bookkeeping
- Medical transcription and coding
BPO companies use AI solutions, including chatbots, interactive voice responses, online community hubs, video tutorials, knowledge base web pages, and automated ticketing systems.
2. Telehealth Support Expansion
Telehealth has revolutionized the way patients and medical professionals communicate, making it one of the best investments in health care. The telehealth trend is expected to continue and become more successful in the future, streamlining the communication process through the following services:
- Injury treatment
- Diagnosis
- Research and medication
- Disease treatment and medication
- Patient monitoring
Most health institutions, both private and public, use telehealth to maintain a reliable network care that benefits both the organization and its patients. Telehealth is ideal for emergency medicine and acute care hospitals with high demands and influx of patient inquiries daily.
3. Remote Patient Monitoring Assistance
Post-treatment or post-surgery monitoring is important for ensuring good patient outcomes. However, during the peak of the pandemic, patients and healthcare providers faced challenges in establishing a stable and efficient system for this.
With remote patient monitoring assistance services, BPO companies can help healthcare organizations monitor their patients’ health even without hospital visits and physical checkups. Your service provider will maintain and operate electronic health records (EHR) for you. These records will make it easy for you to access, share, and retrieve each patient’s medical files whenever you need them.
4. Digital Healthcare Experience
Clients and patients are never reluctant to embrace fast and reliable healthcare services. Healthcare outsourcing companies possess the expertise to streamline all operational aspects, ensuring a seamless experience for both businesses and their clients.
Improved business processes can result in high patient and employee satisfaction rates, which are vital to every company’s success. A medical company can benefit from the following services that healthcare BPO firms offer:
- Appointment setting and checkup scheduling
- Claims request filing
- Communication with medical professionals
- Health benefits and insurance coverage monitoring and processing
- Payments processing
5. Staff Shortages
One of the negative areas of the healthcare industry is that staff shortage is a worrying yet manageable problem that most hospitals and healthcare facilities encounter. Regular training and hiring of new medical staff result in substantial expenditure on healthcare labor costs, which can negatively affect plans for the company’s expansion.
Outsourcing healthcare services is a practical and cost-effective solution for hospitals to handle the increasing demand for healthcare. It helps them manage the influx of patients and emergency cases that require immediate attention. BPO companies provide hospitals with 24/7 access to skilled workers, so owners, administrators, and patients don’t need to worry about a lack of in-house employees.
Frequently Asked Questions
Who can avail of healthcare outsourcing services?
Healthcare outsourcing services work best for hospitals and medical professionals. However, diagnostic centers, laboratories, and even health insurance companies can also benefit from this.
How much does it cost to outsource healthcare services?
The cost will depend on the type of service that you would like to outsource. For example, medical billing could cost you between $20,000 to $45,000 monthly if your business collects $500,000 a month in revenue. Other factors that may affect outsourcing costs include the following:
- Number of staff
- Duration of contract
- Type of payment
- Size of the company
- Location
Contact your chosen service provider today and request for a quote to start your healthcare outsourcing journey ASAP.
What specific things should you look for in a healthcare BPO?
Before signing a contract and selecting a healthcare outsourcing partner, there are important factors to consider. This can be a daunting task, but here are some of the things that you should look for in a healthcare outsourcing partner:
- Advanced automation and analytics
- Excellent collaboration initiatives
- Process maturity and design thinking
- Referencability of processes
- Scalability and adaptability for market changes and demands
- Transparency and absence of hidden costs
Witness great growth in your business by outsourcing your healthcare services with us.
Here at Digital Minds BPO, we can help you provide superb quality patient care regardless of your company’s size and location. We have the skills and knowledge to handle claims processing, data entry, and medical billing services. Our team is globally competitive and will provide your patients with the best experience at affordable rates.
Contact us now and take that massive step toward a more modernized and efficient healthcare service for you and your patients. We look forward to seeing you build your dreams!
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