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Business

A brief overview of Healthcare BPO Services

The worldwide healthcare BPO market will surpass a half-trillion-dollar threshold in less than five years. International healthcare BPO is predicted to reach over $470 billion by 2026 from roughly $296 billion in 2021, with a compound annual growth rate of about to the most 9.6%, according to a recent report by India-based market research firm Markets and Markets.

A Rise in Healthcare BPO Outsourcing

 

According to the Markets and Markets research, the Patient Protection and Affordable Care Act (PPACA), better known as Obamacare, and the need to rein in rising healthcare costs are the two key drivers of the industry. Providers and payers turn to outsourcing their business operations to nations with competitive labor rates in order to reduce operational costs. The majority of the countries that outsource their non-core functions to outside companies are from the North American and European continents.

According to the survey, the COVID-19 pandemic has significantly contributed to the rise in outsourcing medical services. In addition, the pandemic has forced healthcare facilities to create a highly networked environment where all clinical operations are linked internally and are coordinated with the other healthcare units.

Using Healthcare BPO services to handle non-core but crucial activities like patient interaction, claims management, and RCM allows healthcare providers to create a well-coordinated environment. As a result, they can better serve the patients by concentrating on their core strengths with the help of outsourcing. Revenue cycle management is the non-core activity that is growing the fastest and has the most market share. In 2021, it controlled close to 71 percent of the market.

What Is Outsourcing in Healthcare?

Healthcare outsourcing is a business activity in which a healthcare institution subcontracts out the management of its auxiliary operations to a third-party service provider. While some healthcare organizations use independent vendors to complete the work, the majority of them use call centers or other service providers who specialize in healthcare outsourcing.

BPO is the outsourcing of business processes, including information technology, to a different vendor. Its main duty is to oversee these procedures on the client’s behalf using quantifiable performance indicators.

Outpatient clinics, specialized offices, and clinics assisted living facilities, labs and diagnostics clinics, dental offices, nursing homes, orthodontist offices, health centers, and hospitals are all included in the healthcare sector.

To focus on what they do best—provide effective and efficient healthcare services for patients—the majority of companies in the healthcare industry choose to outsource their non-core functions. BPO businesses excel at handling non-medical procedures, computer and information technology, and accountancy, to mention a few. Healthcare organizations can devote all of their time and resources to patient care in this way.

The human resources, claims, revenue cycles, supply chain, team member training, IT functions, and finance and accounting of healthcare facilities manages by healthcare BPO services and other outsourcing firms.

What Services Are Commonly Outsourced by Hospitals?

Healthcare firms’ fundamental competencies include accurately identifying illnesses and giving patients the care they need. Non-core activities are crucial to the overall operations of healthcare firms and account for a sizable portion of operating costs. However, they might be delegated to BPO firms or other external service providers to cut costs and boost output.

Nine non-core business procedures that BPO organizations frequently engages :

  • IT functions:

    using IT systems to acquire patient databases, manage electronic health data, enhance coding and billing methods, and manage electronic billing and payment systems.

  • HR

    – Recruiting and hiring, onboarding, managing staff, improving patient satisfaction, understanding government laws, and legal compliance, choosing compensation and benefits, and managing shifts and pay schedules are all aspects of human resources (HR).

  • Customer relationship management:

    refers to the standards, protocols, and practices that healthcare organizations follow while communicating with patients and other stakeholders. The strategy aims to provide clients with accurate information, worthwhile support, beneficial insights, etc.

  • Patient management:

    refers to a set of guidelines that healthcare professionals must adhere to meet patients’ evolving needs. In addition to the treatment of diseases, this guideline uses to strengthen and maintain patient relationships.

  • Employee training:

    consists of giving employees the knowledge, tools, and programs they need to execute their jobs more effectively. In order to achieve specific goals and objectives, a healthcare service must invest heavily in staff training. Personal care aides, dental assistants, nurses, nursing assistants, physical therapists, paramedics, pharmacists, and surgeons typically receive coaching and training.

  • Finance and accounting:

    controlling and managing finances, budgeting, internal accounting, bookkeeping, and economic auditing trends that influence the operations and resources of healthcare services.

  • RCM:

    Healthcare organizations use revenue cycle management to manage their finances and use medical billing software to track patient care services like payment, registration, and appointment scheduling.

  • Claims management:

    involves processing, organizing, and filing medical claims for patient diagnoses, procedures, and prescription drugs. Patients are able to comprehend the cost of the operation as well as the goods or services they obtained in terms of medicine.

  • Supply chain management:

    refers to the necessary resources that a firm should convey to its clients. The healthcare industry’s supply chain is considers a dispersed and complicated system that includes acquiring resources, managing supplies, and supplying the patient, medical staff, and healthcare professionals with the necessary goods and services.

What Are the Three Healthcare Services That Are Frequently Outsourced?

Data Entry Services

Large amounts of medical data must be manage and update on a regular basis by healthcare organizations. Patient insurance, clinical records, test results, laboratory reports are just a few of the documents they must process.

According to industry analysts, the market for outsourcing data entry will expand over the coming years. This industry is expanding as a result of the growing adoption of this healthcare service. In addition, the necessity to concentrate on core expertise. And the increasing need for affordable solutions are other factors that are driving the continuous expansion.

Billing for Medical services

Medical billing and records, which are more complex than those in other industries, processes in massive amounts. When not managed correctly, they might result in mistakes and delays. Scientific and technical codes, such as those from the Healthcare Common Procedure Coding System (HCPCS), the International Classification of Diseases (ICS), the Current Procedural Terminology (CPT), and Diagnosis Related Group, are uses on medical bills and invoices (DRG).

According to market research company Mordor Intelligence, the worldwide medical coding market will grow dramatically over the coming years. In addition, the demand for clinical management tools, electronic health records, and healthcare management systems is growing. Which is fueling the global market expansion.

The upswing aids by the growing use of cloud technologies that improve billing and coding effectiveness. The demand for medical coding increased as well as the technical infrastructure in the healthcare industry developed.

Claims Processing

Patients’ insurance claims processing is another non-core healthcare activity that outsource to Medical BPO companies. Patients’ insurance companies’ appropriate medical claims must be efficiently take care. Maintaining accuracy can be difficult when several claims must be processed each day. This is one of the explanations given by healthcare professionals for outsourcing this task to a reputable external service provider.

Experts in the field predict that demand for claims processing services, which drives by healthcare providers’ offices. And also other healthcare providers, will continue to rise. They predict that the number of medical visits will rise even more. As a result, there will be an increase in the number of patient insurance claims.

Final Thoughts

Without a question, working with healthcare BPO services companies can help you save time, money. Improvement will happen in client section by outsourcing some services to outside vendors, giving you, as a healthcare provider. The chance to leave a long-lasting positive impression on your target market.

Among the many services that BPO businesses may give to the healthcare sector are helping you offer. And maintain high-quality patient care, utilizing the most recent systems and technologies related to healthcare and streamlining medical billing. They practically have everything you require to increase productivity and client loyalty, which will increase sales and income.

Whatever the case, it will take time to select the right BPO partner to assist you in achieving your objectives. Before working with a healthcare BPO company, you must conduct extensive background checks on them. Stay in frequent communication with them, and prepare your strategy carefully.

 

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