In today’s fast-paced and ever-evolving healthcare industry, healthcare providers often find themselves balancing quality patient care with managing complex administrative and support functions. Healthcare process outsourcing emerges as a strategic solution for clinics, hospitals, and healthcare systems in countries like the United States and Australia looking to streamline operations, reduce overhead costs, and focus on patient-centric care. But what is it exactly, and what benefits can you get from it?
What Is Healthcare Process Outsourcing?
Healthcare Process Outsourcing (HPO) refers to the practice where healthcare facilities, such as hospitals and clinics, contract out various non-core services to external companies. These services range from medical billing and coding and claims processing to patient scheduling and healthcare analytics.
The primary objective is to improve efficiency, reduce operational costs, and allow healthcare professionals to focus more on patient care rather than administrative tasks.
7 Commonly Outsourced Healthcare BPO Services
Let’s delve into these top seven outsourced healthcare business processes and their advantages for facilities like yours.
- Medical Coding and Billing
Converting healthcare diagnoses, procedures, and medical services into universal medical alphanumeric codes is crucial in running every healthcare facility efficiently. It ensures that your healthcare providers are reimbursed for their services, payments are processed promptly, and, most importantly, you’re able to sustain your operations.
However, handling medical coding and billing in-house can be challenging, primarily due to the industry’s stringent regulatory compliance standards. More importantly, accuracy is crucial because coding errors can lead to claim rejections or denials.
Leveraging healthcare business process outsourcing can lead to enhanced accuracy in coding. With the knowledge and resources of expert coding and billing companies, you can mitigate the risk of errors and maximize reimbursements from insurance companies.
- Claims Processing and Management
Along with your medical coding and billing tasks, claims processing and management form the backbone of your revenue cycle management and play a critical role in maintaining your facility’s financial viability. However, as with any process, handling it in-house presents several challenges:
- Complexity and Regulatory Compliance – With thousands of codes for different medical procedures and diagnoses plus continuous updates and revisions, maintaining accuracy can be daunting.
- The Need for Specialized Staff – For your in-house claims processing to be effective, you need to personally hire a team of specialized staff well-versed in medical coding, billing regulations, and insurance guidelines.
- Cash Flow and Revenue Delays – Errors in claims can lead to rejections or denials, which can significantly delay revenue. This ultimately translates to disrupted cash flow and additional resources diverted to managing resubmissions and appeals.
With their dedicated expertise, healthcare process outsourcing experts like AHM Outsourcing can help you optimize your revenue cycle by reducing the number of denied claims and shortening the timeframe for reimbursements. The resulting improvements in financial performance can allow you to reinvest in your infrastructure or expand your services.
- Medical Record Transcription
Transcribing voice-recorded reports as dictated by physicians and other healthcare professionals into text format is essential in creating accurate and accessible patient records.
One of the biggest challenges in medical record transcription is maintaining high accuracy. As medical records are complex and filled with medical terminology, abbreviations, and patient information that must be transcribed verbatim, avoiding errors is crucial to prevent misdiagnosis or inappropriate treatment.
On the bright side, healthcare BPO service providers are staffed with skilled medical transcriptionists. Working with them gives you access to a large pool of experienced transcriptionists and the flexibility to scale your staff according to your needs.
- Medical Record Retrieval
Medical record retrieval encompasses the collection, organization, and management of patients’ healthcare information. These records may include treatment histories, diagnostic test reports, prescriptions, and notes from healthcare professionals, and they may be retrieved for purposes such as medical audits, research, continuity of care, and legal evidence.
One of the biggest challenges when handling medical record retrieval in-house is staying compliant with stringent healthcare regulations and privacy laws. Healthcare facilities must ensure that all retrieval processes preserve patient confidentiality while maintaining data integrity.
Maintaining up-to-date technology for secure and efficient record handling can also be a significant burden for healthcare facilities, as this requires ongoing investments in software and hardware solutions.
Fortunately, outsourcing to medical record retrieval experts helps healthcare facilities ensure that their process complies with healthcare regulations and standards, thus reducing legal risks. It can also be more cost-effective than maintaining an in-house team, as it eliminates the need for specialized training for additional staff and the technological investments required.
- Healthcare Information Management (HIM)
Healthcare Information Management encompasses collecting, storing, analyzing, and protecting digital and traditional medical information vital to providing quality patient care.
While this already sounds overwhelming on its own, adherence to regulatory requirements such as the Health Insurance Portability and Accountability Act (HIPAA) and other privacy laws adds layers of complexity to HIM.
Healthcare process outsourcing offers a strategic solution to this challenge. Companies specializing in medical business process outsourcing implement robust security measures and stay abreast of changing regulations to help you stay compliant. Best of all, they deliver process improvements and efficiencies that in-house teams may not have the capacity to develop or support.
- Patient Scheduling and Registration
As a healthcare provider, it’s part of your duty to ensure a seamless flow of patient care from the moment an individual decides to seek medical attention until their treatment is complete. However, handling patient scheduling and registration in-house often entails coordinating multiple schedules.
However, with patients needing to be matched with the appropriate specialist and healthcare professionals having varying availability, managing a conflict-free schedule can quickly become overwhelming. What’s worse is that any efficiencies can lead to long wait times, consequently impacting the patient experience negatively.
Entrusting this task to a healthcare BPO services provider can allow your medical staff to dedicate more time and energy to improving patient outcomes while specialized outsourcing partners handle your scheduling and registration tasks, no matter the volume.
With their trained staff and advanced scheduling software, they bring expertise in handling patient data, supporting your operational efficiency, and enhancing the patient experience you deliver.
- Healthcare Analytics and Data Processing
Using your data and related business insights systematically is crucial in healthcare-related decision-making. Your ability to analyze vast amounts of data enables you to streamline your operations, improve patient care, and maximize opportunities to reduce the cost of healthcare.
The good news is that you can effectively process healthcare data without investing in expensive analytics software or specialized personnel yourself. Enlisting healthcare BPO services lets you work with companies already equipped with modern infrastructure, a secure environment, and professionals specializing in healthcare analytics and data processing.
Leveraging the experience, technology, and specialized skill sets of external services can help you improve your operations, patient care, and overall efficiency.
Benefits and Advantages of Using Healthcare Business Process Outsourcing
It’s normal to have concerns and reservations about medical business process outsourcing. After all, you are sending essential tasks to a third-party provider and must learn to work well with them moving forward.
On the bright side, you stand to gain plenty of benefits like the following with the right partner:
- Cost Reduction Without Compromising Quality
Medical business process outsourcing companies leverage strategic staffing solutions and specialized expertise to deliver services at a reduced cost. With this, sending non-core healthcare tasks like billing, coding, and claims management to them can help you reduce your costs while maintaining or even improving patient care quality.
- Focus on Core Medical Services
Having external specialists take care of your administrative tasks allows your medical staff to focus on patient care and, ultimately, improve patient outcomes and patient satisfaction.
- Access to Professional Expertise
When you partner with healthcare BPO companies, you work with remote staff with the experience and specialized knowledge to handle your needs and ensure compliance with the latest industry regulations. This significantly reduces the burden of training and development on your staff.
- Improved Compliance and Risk Management
Professional medical BPO service providers can help you navigate complex healthcare regulations and ensure all your processes adhere to healthcare laws and regulations.
- Scalability and Flexibility for Growth
Outsourced teams can quickly adjust to the changing needs of your healthcare facility, especially during peak periods. Whether you need to scale up to handle increased demand or introduce new services, providers like AHM Outsourcing offer the scalability and flexibility you need without the typical overheads associated with expansion.
Grow Your Healthcare Facility and Optimize Patient Care With AHM Outsourcing
With the right outsourcing strategy and partner, contracting out your non-core tasks to external companies can bring exciting benefits, such as reduced operational costs, improved efficiency and accuracy, and more time to focus on patient care. Whether you delegate the meticulous nuances of medical billing or the advanced analysis of healthcare data, outsourcing can lead your medical facility toward a more efficient, patient-centered future.
If you’re a healthcare provider looking to streamline your operations and improve patient care, look no further than AHM Outsourcing. Our top-notch virtual employees stand ready to support your team so you can focus on caring for your patients. Contact us today to discuss your requirements.
