How does Medical Business Process Outsourcing help?

How does Medical Business Process Outsourcing help?

The pandemic that set upon the world in the first quarter of 2020 has, invariably, left behind many lessons and things to think about. One of them is the crucial role medical workers have come to play in our lives. With sedentary lifestyles, poor eating habits and limited physical activity, despite rising longevity of the human race, many people depend on the medical profession for survival and well-being.

Times like the pandemic stretch the available medical resources, with many people needing attention at the same time. We don’t have man to man cover for all human beings, do we? Apart from the fact that this is a message for us to take better care of our health, it also brings home the message of our dependence on the medical professionals, many of whom have gone beyond the call of normal duty in handling cases during this emergency.

Since we know that we have a dependency on them in a matter as critical as our health, would we not want them to be attending to the medical situations faced by the human race? 

The answer is obvious. Yes.

This is where medical business process outsourcing, or medical BPO, plays an important role. It is also referred to as healthcare business process outsourcing or healthcare BPO. Though some are of the opinion that healthcare is a wider term than medical, and includes the non-medical components of healthcare as well, medical BPO and healthcare BPO have come to be used interchangeably.

oWorkers is an established provider of data related BPO services that encompasses the medical industry as well. It is recognized as one of the three best providers globally.

 

How does medical BPO enable medical professionals to focus on their core job?

In a regulated environment, in order to be of greatest value to the largest number of beneficiaries, each person and organization has to carry out many activities and processes that may not be core to their particular profession or industry, but, in the larger scheme of things, are indispensable.

Take billing for example. The medical industry does not run on love and fresh air. It needs money. People who use the services of the industry need to pay for them either themselves or through their insurance plans. This compensates the professionals and organizations and provides them the resources to continue providing their services.

However, for billing related activities, one does not need to be a trained doctor or nurse. It can be done by a non-medical professional with perhaps knowledge of the basic operation of the organization as well as that of accounting and software applications. By engaging such professionals and outsourcing activities to them that do not require using up the limited supply of medical professionals, we free up medical professionals for their core work which is what we need them for. We enable them to focus on the patient, the reason for their existence.

Western Europe and US based clients of oWorkers routinely talk about savings of up to 80% when they outsource to oWorkers. Thus, while partnering with oWorkers clients not only gain business value, but also save on cost.

 

Other benefits of medical business process outsourcing

While the separation of the administrative requirements of providing medical services might be a core enabler, there are several others that power the two industries, the outsourcing medical and healthcare industry as well as the vendor medical BPO industry.

Access to specialists

We want access to the best medical specialists when we have a need, whether it is a coronary condition or a dental issue, don’t we? With the best advice, guidance and care, we stand the best chance of recovery.

Why should the organizations and professionals who provide the most specialized medical services to us be deprived of accessing the specialized services that they need?

What specialists do they need?

As professionals and as organizations they need to comply with the many requirements of a governed civil society. They need to pay taxes. They need to file regulatory returns. They need to maintain patient data and records. They need to hire staff for working. They need to comply with laws of the land such as minimum wages and retiral benefits. And many, many others.

Many of these activities, if outsourced, can be performed better by specialists in the respective areas.

oWorkers takes it a step further and extends the access to specialists 24×7, if the client needs it. They are equipped to provide 24×7 support from all their global delivery centers.

Cost reduction

Senior management generally focus on revenue generation and customers, and look at cost during troubled times with a view to reduce it. In the day-to-day activities of an organization, the costs incurred by the support activities do not get the same attention as the revenue and customer side activities.

Besides, the support services continue to operate on the policies that have been set up for the primary business of the organization, healthcare in this case.

Engagement of a medical business process outsourcing supplier shifts the paradigm. The supplier runs it like a business and is interested in doing it efficiently. They are free to hire resources that are more suitable, rather than relying on the hiring done by recruiters who are more geared for hiring medical professionals. They can also move the service delivery location to more cost-effective places, where possible. It is understood that some services may need to be co-located with the medical service site.

Clients from anywhere find the oWorkers pricing mechanism attractive. oWorkers offers two competing pricing methods, one where the price is based on agreed inputs, such as manhours, and the other where it is based on agreed output, such as units produced, with the client having the final choice.

Innovation and investment

Investment in innovation and improvement, generally, is directed at revenue and customer side operations, with support services keeping up as best as they are able to. This often results in inefficiencies creeping into the processes.

When a partner gets involved, what happens is that the cost of the outsourcer becomes the revenue stream of the partner. Hence, the partner is now interested in doing it better, more efficiently while keeping it growing. This brings in innovation and focus on improvement, resulting in doing more with less, with benefits being distributed across the various participants in the process, including the outsourcer.

oWorkers is an ISO (27001:2013 & 9001:2015) certified provider. It is also GDPR compliant. At the cutting edge of new technologies with the help of its partnerships with leading tech providers, oWorkers brings the most appropriate technologies into the picture for client work, that they would otherwise not have access to.

 

Medical business process outsourcing – core services

What are some of the services that healthcare BPOs are able to provide?

Medical Data Entry

Though considered to be at the bottom of the food chain, data entry, nevertheless, is important in the medical ecosystem as it is an enabler for many other processes and serves to unify information. If information of a patient is not keyed in, and keyed in correctly, many other dependent technologies will not be able to work their magic. It caters to many different elements in addition to patient information that are currently not available digitally, such as laboratory reports, surgical treatment records, .

Handwritten prescriptions of doctors are also covered by this service, though, as a manual transcription service, it exists as an independent service as well, with physician handwritten prescriptions, forming a significant chunk of the work.

oWorkers, with its multi-cultural and multi-ethnic teams, is equipped to support clients in over 20 global languages. Whatever be the language of the original script, we will help you convert it to a common standard and system. The doctor does not need to speak English.

Indexation of medical records

There are different requirements for the maintenance of different types of records. Most business and financial records need to be available for a defined period, generally not exceeding ten years in most jurisdictions.

Healthcare records, however, are generally required for much longer. A patient’s history as a child may have a bearing on the discovery and treatment of a tumor that has developed in late life. This places a premium on the storage and retrievability of medical records over a long period.

Apart from patient history, the records could be of a wide variety, such as prescriptions and diagnosis at various stages, lab reports, insurance related data, charts, clinical history, etc.

This is where indexation services offered by a medical business process outsourcing partner help us in storing and retrieving historical data. While familiarity with the medical domain is required, no training or qualification is.

There are many methods of indexation, such as by record type, by Medical Record Number (MRN) and Social Security Number (SSN), to name a few. With detailed knowledge of plans, processes and methods, the trained staff of oWorkers is able to deliver superior outcomes.

Medical Coding

According to the American Academy of Professional Coders, “Medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The diagnosis and procedure codes are taken from medical record documentation, such as transcription of physician’s notes, laboratory and radiologic results, etc.”

Medical coding is a critical activity for generating population health analytics and maintaining information related to disease and treatment, leading to creation of management and intervention strategies for improved outcomes.

It also plays a significant role in the communication between hospitals and insurers and facilitates the process of reaching a decision on the claim.

Being a preferred employer enables oWorkers to access a wide variety of skills and resources that enable handling of even tasks that might require greater knowledge, such as coding. In any case, going beyond the skills that candidates come with, the dedicated training team of oWorkers ensures they are equipped to handle client work before being assigned to one.

Processing of medical insurance claims

Medical insurance, starting with the developed nations, has gradually expanded to cover larger populations around the world, including populous Asian nations like China and India. It is, effectively, a universal process today.

The importance of accurate processing in such a scenario cannot be overstated. Denial of justified claims leads to needless hardship for the claimant, and possible litigation expenses and awards to be borne by the insurer down the road, while paying more than the justified amount places needless burden on the insurer.

The criticality of this process is such that a whole new breed of companies has emerged to handle it. This type of company is known as a Third Party Administrator (TPA) and handles healthcare related insurance claims processing. They act as the interface between patients and insurers. It is not uncommon to find the helpdesks of TPAs set up in hospitals to aid patients in their claims. In a strange twist and possibly a sign of the times, occasionally, two patients might have different insurers but the same TPA.

Working with employed staff, as oWorkers does, unlike some of our competitors who choose to work with freelancers and contractors, has advantages. All our delivery centers are registered as local companies and pay social and local taxes. We get a satisfaction score in excess of 4.6 on a scale of 5 on platforms like Glassdoor, both from existing as well as past employees.

Medical Billing and Collections

While they are rendering a much-needed service, it must be recognized that most medical service providers are private, for-profit enterprises. They need to watch their bottomline just like any other business corporation.

Billing being the process through which much of their revenue is generated, they need to watch it closely and ensure that the processes are efficient. Managing the revenue cycle is an important element of any commercial activity, which is what medical billing does for medical service providers.

The added complexity in healthcare arises from the fact that in many cases the payment is made by a party other than the party receiving the service, in other words, the insurer, with whom the service recipient has a separate arrangement. Medical business process outsourcing enables this service to be handled with the attention that it needs, helping release money for the operation of the client’s services.

The ability to tap into deep candidate pools gives oWorkers the additional flexibility of hiring short-term resources. This is occasionally required when a client project experiences an unexpected or unexplained peak in volumes. oWorkers can hire almost a hundred extra resources within 48 hours. This is a huge benefit to clients who may otherwise either need to retain extra idle resources, or forego the additional volumes when they materialize.

 

Medical business process outsourcing – Support Services

As we have discussed earlier in the article, every organization, whether an aircraft manufacturer or bank, a movie maker or a hospital, operating in a managed environment has to mandatorily fulfil many requirements of governance that are designed for the greater good of society. Not only that, by virtue of its existence as a part of a competitive free market, it also has to adapt to the constantly changing landscape and adapt the best practices of the time, or be left behind.

When provided in the context of a medical service, these are also bundled under the umbrella medical BPO term though they could as well be clubbed with their respective functional BPO as well.

These services could include:

Accounts Receivables

Though it might be considered as a part of medical billing, managing accounts receivables is a distinct activity and a part of the larger umbrella of outsourcing of finance and accounts processes. It leads to better, faster revenue realization for the commercial entity.

With 85% of our clients being technology companies, and our strong ties with many technology providers, oWorkers is able to deploy the latest technologies for client projects, be it a core service or a support service such as accounts receivables.

Human Resources

Human resource process outsourcing, or HRO, comprises another critical set of processes that need to be handled by any organization that exists and seeks to deliver some product or service.

From resource hiring, to managing compensation and benefits, salary negotiation, appraisals and feedback, increments and promotions based on evaluation, compliance with regulatory requirements, are all a part of HRO, in one way or another.

With our stringent hiring processes that focus on language and mathematical ability, along with EQ and IQ tests, oWorkers has been able to hire the right people for the right roles. Our HR skills are available for the benefit of our clients as well.

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