How Healthcare Business Process Outsourcing Impacts Providers

How Healthcare Business Process Outsourcing Impacts Providers

If we ever needed a reminder that our health is precious, the Covid-19 outbreak in 2020 has provided it to us. Catching us unawares, it initially spread rapidly across populations, putting unforeseen burden on healthcare facilities around the world, whether it was hospitals, or doctors, or medicines or supplies of medical oxygen, or even ambulances all of which, at most times, are limited, especially doctors. Most jurisdictions have an elaborate study and qualification plan for medical professionals and a limited number of seats. Hence, at the best of times, doctors are in great demand. While the demand increases at times like the Covid-19 outbreak, the unfortunate impact is that many people do not get the medical attention they require.

Whether it is doctors or any other medical resource, human or product, it needs to be handled with care and all efforts made to widen the reach and coverage of every single unit. Healthcare business process outsourcing has played a key role in taking away from medical professionals and services many of the tasks that do not need a medical professional to perform, freeing them up for tasks that cannot be performed by anyone else, viz. providing medical care and attention to people in need of it.

Healthcare is an expansive ecosystem. Not only does it contain caregiving units like hospitals and medical professionals, there are many extended units as well such as pharmaceutical companies that produce medicines and medical insurance companies that insure people against medical situations.

Delivering any service, or running any type of organization, generates a fair amount of administrative work. It is the way it is; the nature of the beast in a way. The administrative ‘overheads’ are either a result of the competitive landscape that providers operate in, or a result of regulatory requirements set up usually for the protection of some less privileged constituents. A hospital, for example, needs resources such as nursing staff. The effort required in finding them, hiring them, negotiating salaries, assigning duties can be considered to be an administrative task. It is required because in our world, everyone has choices. These resources may also be able to choose between different organizations. Government regulation may cover maintenance of records so that in the event of a complaint or issue that crops up reference can be made to them. There could also be a need to pay taxes and pay salaries in line with minimum wage guidelines set up by the government.

oWorkers, in the short period of eight years it has been in existence, has carved out a space for itself in providing data based BPO services to clients from around the world. It is clear on its area of focus and has even earned accolades for it. In fact, it has been identified as one of the top three BPO service providers in its area of work.

 

Healthcare business process outsourcing services

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

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.”

Apart from the significant role it plays in the communication between hospitals and insurers and closing the loop by facilitating a decision on the claim, medical coding is also critical to generating population health analytics and maintaining information related to disease and treatment.

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.

Medical Billing and Collections

Revenue is the fuel that enables an organization to run and billing is the process through which it is generated. Managing the revenue cycle is an important element of any commercial activity, which is what medical billing does in the healthcare sector.

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. Healthcare 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.

Indexation of records

In any field of work, indexation is an activity the primary purpose of which is to store records in a manner which lends them to easy retrieval in future as and when the need might arise.

Healthcare is no different. If anything, there is greater relevance of these records as they pertain to the health of individuals which is personal as well as critical. Hence, indexing of medical records is another critical activity.

The records are of a wide variety, such as patient demographics, laboratory reports, physician prescriptions and diagnosis, clinical history, charts, insurance information, etc. 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.

Data Entry

Though considered to be at the bottom of the food chain, data entry, nevertheless, is important in the healthcare space as it facilitates many processes. It starts with keying in relevant patient information at the first point of contact and goes on to cover many other aspects, such as digitization of information that comes in from many other systems, such as laboratory reports.

There are also specific types of data entry services such as transcription services, sometimes placed in a category all by itself, that convert manual or handwritten information into a digital record, such as the prescription handwritten by a physician.

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.

Claims Processing                  

As medical insurance expands to cover more people, accurate processing becomes more important. This is a task that requires comprehensive knowledge about medical processes as well as the fine print of medical policies. Claims being paid in excess of entitlement lead to needless financial burden for the insurer while claims being denied unjustly can lead to protracted litigation.

A specific type of company, known as the Third Party Administrator (TPA) has emerged that handles healthcare related insurance claims processing. In a strange twist, 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.

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.

 

Why healthcare business process outsourcing makes sense

The arguments in favor of engaging BPO providers in relevant healthcare processes are:

Focus on patients

In a competitive world, one needs to ensure that one’s core constituencies are kept engaged and happy at all times. From an organizational perspective, they are the reason for its existence, despite the many other pulls and pressures on time and resources.

This is exactly what is enabled by the outsourcing of healthcare processes that are not centered around the core constituent – the person in need of healthcare services. By letting them manage the processes that may be called supporting, but often take a lion’s share of resources and time, healthcare providers put themselves back in a position to do what they were meant to do originally, focus on the patient.

Pure play BPO providers, like oWorkers, are equipped to provide 24×7 support, if required by clients, leveraging available resources much more than what most companies are used to.

Specialists can do it better

The large umbrella of healthcare services contains many smaller services, some of which could be considered as mini-industries in their own right. Activities like claims processing and medical coding require qualified personnel and are specialized activities by themselves. As such, the benefits and limitations that apply to specialists are applicable to these processes too.

The upside is clearly the ability and intent to do it in the best possible manner, as it is a revenue generating activity for the partner. Besides, they also have the intent, desire and capacity to invest in improvements, as they perhaps do the specialized activity for multiple clients and are, hence, able to take advantage of larger volumes.

The popularity of oWorkers with jobseekers helps us provide short-term resources at short notice, like a hundred extra within 48 hours. This ends up being a huge saving for clients who would, otherwise, have to hire and retain resources for the entire year, just to handle a few days of unexpected peak volumes.

Cost saving

Though it should not be seen as the main reason for outsourcing, it certainly helps that healthcare business process outsourcing can lead to a healthier looking income statement.

One of the main areas for cost saving is human resources. Healthcare workers, being specialists in a field that is needed, tend to be available at a certain price point. BPO operators, who source workers from other talent pools, perhaps with fewer educational qualifications and lesser experience, have a resource cost lower than healthcare companies. Even after adding the operator’s margins, this translates to lower costs for the outsourcer.

There are other savings too, such as infrastructure and premises. BPO operators do not have a need to operate out of expensive downtown real estate.

oWorkers has earned accolades from clients for its unique pricing model. It offers clients a choice between output-based and input-based pricing. Clients choose the one they find suitable. Clients routinely mention saving almost 80% of pre-outsourcing cost after engaging oWorkers for healthcare work.

 

Challenges with healthcare business process outsourcing

Confidentiality of information

Client data is confidential. Added to tat is the sensitivity of dealing with medical data and history of patients registered with the healthcare provider. The data being compromised at the hands of partners with weak processes remains a possibility.

oWorkers operates out of ISO (27001:2013 & 9001:2015) certified facilities and protocols for ensuring the safety of all data pertaining to clients, whether medical or staff. We are also GDPR compliant, as we operate out of the Eurozone.

Focus moves from the patient

While one of the benefits of outsourcing is that it enables the provider to focus on its core constituent, the patient, some of the outsourced processes could actually work against this principle.

When outsourced to a partner who is driven by process efficiency and not by patients, it is possible that they get ignored, even in the exceptional situations when they need some non-standard support.

Being led by an experienced team of managers with over 20 years of hands-on experience in the industry helps oWorkers navigate such issues and ensure that human sensitivities are not forgotten and that a ‘no’ does not become the convenient response.

 

Final Word

Like many other types of outsourcing, healthcare business process outsourcing looks set to stay as it adds value in many different ways to its clients.

oWorkers works for several large players in the space. We hope you will be one of them soon.

Our work enables us to employ people from less advantageous backgrounds and communities in all the locations we operate from and give them an entry ticket to the global digital economy. Your work will enable us to do the same for a few more.

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