In today’s competitive world, businesses need to find ways to streamline their operations. To do this, most modern healthcare agencies turn to healthcare business process outsourcing (BPO) providers.
A BPO’s cost-saving services can increase your company’s efficiency. This lets you optimize your operations. As a result, you’re able to focus more on patient care.
Let’s explore how healthcare administration outsourcing elevates healthcare companies to the next level.
On this page
Key Takeaways
There are various types of Healthcare Administration Outsourcing services.
Using a trusted Healthcare BPO improves efficiency and reduces cost.
Working with a Healthcare BPO lets you focus on improving patient and healthcare services.
Key Healthcare Provider Services that BPOs Offer
Healthcare companies handle many administrative duties. Healthcare outsourcing companies exist to take these tasks off your hands.
There are many healthcare administration outsourcing services you can choose from. Doing this will let you focus more on the quality of your healthcare services.
Here are some of the key services you can avail of through healthcare outsourcing.
Medical Coding and Billing
It’s common for healthcare pros to process hundreds of medical records per week. However, medical coding and billing can be complex. It involves converting patient diagnoses and procedures into alphanumeric codes.
Industry reports state that error rates of in-house coding are 5% to 15%. This can be even higher in some cases. Here are some factors that affect error rates:
- insufficient training
- technological challenges
- changing coding guidelines
That’s why having the proper training and expertise is crucial.
Healthcare BPO teams are proficient. They’re able to assign the proper codes in records and billings.
This is because it’s their core competency. These outsourced teams have extensive medical backgrounds. They’ve also received training for proper coding.
Healthcare BPOs also train their staff in various coding systems. These include:
- International Classification of Diseases (ICD)
- Healthcare Common Procedure Coding System (HCPCS)
- Current Procedural Terminology (CPT)
They also aid their coders in getting their Certified Professional Coder (CPC) certification. Staying certified keeps their coding skills up-to-date. It also ensures they follow the current coding guidelines.
Outsourcing your coding and medical billing tasks to a healthcare BPO is a win-win move. It lowers the risk of coding errors and delayed payments. At the same time, it brings down your administrative costs.
Claims Processing
Healthcare providers submit their patient’s documents to insurance companies. These documents must be complete and accurate. This is a bare minimum for their medical claims to be approved.
Claims processing is a crucial healthcare activity. Large volumes of claims need to be processed every day. This can be tedious and cumbersome for an in-house team. It can affect the accuracy of some patient claims.
You can outsource to a third-party to handle the patient claims processing of your company. Not only is it more practical, but it also guarantees efficiency.
Having a reliable outsourced staff on this task will maintain the accuracy of your medical claims processing services.
Patient Intake
Healthcare providers process hundreds of patient and medical data daily. These include the patient’s insurance details, hospital records, and more.
It’s best to use a healthcare BPO for these tasks. This will streamline all your data entry duties. Outsourced teams use electronic systems, online platforms, or call centers to collect and process the required data.
Patient intake is a commonly outsourced task of healthcare BPOs. A reliable healthcare BPO can guarantee the following benefits:
- Proper handling of high volumes of patients
- Shorter wait times
- Proper compliance with legal and privacy regulations
Health Insurance Portability and Accountability Act (HIPAA)
The HIPAA is a U.S. Federal Law that safeguards the security, privacy, and confidentiality of patients’ health information. Its provisions guarantee that patient’s have rights to privacy, access, and control of their health information.
Authorization
Another common task for healthcare BPOs is insurance pre-authorization for patients. This service is called healthcare authorization. Performing this will reduce the chances of a patient getting denied insurance coverage.
Authorization involves the collection of key medical information. Once collected, it will be sent to the insurance company. The goal is to seek approval from the insurance company before patient care is rendered.
The outsourced staff are responsible for following up on requests for info. They will also address the queries from the insurance company. If the request is denied, the BPO team can assist in making an appeal.
A reliable healthcare BPO handling authorization tasks guarantee the following benefits:
- Higher rates of approval
- Minimized reimbursement delays
- Cost saving
Healthcare QA
Healthcare quality assurance (QA) is crucial for healthcare companies. QA assesses the quality of your processes, services, and systems. It ensures that you’re at par with your established standards and requirements.
Hiring a healthcare BPO for QA services will help enhance your operations. Their outsourced team will conduct assessments on your operations. They also give insights on how to improve your processes.
Their feedback is helpful in streamlining your healthcare organization. And they can be beneficial in improving your quality of care. Plus, QA ensures you are in proper compliance with healthcare industry standards.
Benefits of Healthcare Administration Outsourcing
Cost Effectiveness for Healthcare Companies
Assigning non-core duties to a healthcare outsourcing service provider saves you money. This is mainly due to the lower rates for offshore manpower.
Hiring in-house staff means you have to invest in infrastructure and equipment. BPOs on the other hand, take care of this for you.
This lets your company cut up to 40% of expenses. This allows you to relocate this cost savings to other areas such as:
- Marketing and sales
- Hiring quality clinicians
- Improving patient care
Elevates Patient and Healthcare Services
A huge benefit of outsourcing is it helps improve your quality of patient care. Healthcare BPOs free you from taxing non-core duties. This lets you focus more on enhancing core healthcare activities like:
- Developing personalized treatment plans
- Direct interaction with patients
- Conducting thorough examinations
Your increased attention to patient care ensures more accurate patient diagnoses. This leads to better treatment outcomes for patients. The result is a higher overall quality of care and patient satisfaction.
Compliance with Healthcare Industry Regulations
A trusted healthcare BPO ensures that you’re compliant with healthcare regulations. As we know, the healthcare sector deals with sensitive patient data.
This is why outsourced staff should be well-versed with HIPAA rules and regulations. They will help guarantee that your company follows all guidelines. This mitigates the risk of any costly errors.
Keep in mind that you should evaluate a healthcare BPO’s HIPAA compliance. First, review their operation’s privacy and security policies. This includes assessing their physical and technical safeguards. This ensures their electronic protected health information (ePHI) compliance.
You can also verify their employees’ knowledge on HIPAA rules and regulations. Lastly, you should present a business associate agreement (BAA) to the healthcare BPO. They should not have any problem signing it. If they do, then it’s likely they are not HIPAA compliant.
Streamlined Workflow for Healthcare Organizations
Outsourcing admin work creates a leaner internal operation. All admin tasks are now the domain of your BPO partner. This includes everything from revenue cycle management to compliance. Your onshore org is now centered around growth and patient treatment.
Final Thoughts
Using healthcare BPO services streamlines your operations and lowers costs. It improves compliance. Most importantly, it allows you to focus on your core competencies. This improves patient care and the overall patient experience.
However, not all healthcare outsourcing companies are created equally. It’s important that you partner with a proven healthcare BPO. Do your due diligence. See what’s available in the healthcare outsourcing market.
Frequently Asked Questions
Healthcare BPOs cover various administrative tasks. These include medical coding, billing, claims processing, patient intake, insurance pre-authorization, and healthcare QA.
One benefit is that it frees you from the taxing administrative duties. This lets you direct your attention towards better patient care. Another is that non-core tasks are efficiently handled. This is because the BPO is focused only on those duties.
Lastly, outsourced partners stay up-to-date with healthcare industry regulations. This ensures your company remains compliant with them.
Hiring a healthcare BPO team will help you save money. Offshore talent is available at lower costs than onshore staff. It eliminates the need to build additional infrastructure to support administrative duties.
Sources
Analysis: Health insurance claim denials are on the rise, to the detriment of patients. (2023). Retrieved 22 June 2023, from https://www.pbs.org/newshour/health/analysis-health-insurance-claim-denials-are-on-the-rise-to-the-detriment-of-patients
Claims Denials and Appeals in ACA Marketplace Plans in 2021. (2023). Retrieved 22 June 2023, from https://www.kff.org/private-insurance/issue-brief/claims-denials-and-appeals-in-aca-marketplace-plans/
