Healthcare BPO Guide: What to Know Before You Start

In a study conducted at over 500 hospitals, 90% of executives are exploring healthcare BPO.

Given the industry’s demands, leveraging third-party providers for support is a more strategic approach. In fact, a large majority of medical establishments have already outsourced some of their operations, a shift driven by factors such as cost efficiency and improved patient care.

The decision to utilize BPO in healthcare is a challenging move for the organization. This article is meant to make things easier for you. We’ll help you evaluate your position and guide you on how to move forward.

The medical field is a battlefield. Professionals must juggle delivering exceptional patient care while managing administrative and clinical responsibilities. This forces a choice between spending more time with patients or providing accurate data when it shouldn’t be the case.

Paperwork is a crucial component of any business, particularly in the healthcare industry. However, it’s time-consuming, which can also be detrimental to the time clinicians could use to care for their patients.

This is the burden that healthcare BPO services can ease. Instead of the organization shouldering the administrative weight, outsourcing companies function within these operations.

Businesses opt to outsource for various reasons. Contrary to popular belief, you don’t have to outsource simply because you’re a little packed. While it’s strategic, there can be instances when it does more harm than good.

What should you look into to make a decision?

Hire if your workload is steady, justifying full-time staffing. Outsource if your workload volume can fluctuate, as outsourcing gives you more freedom over your staffing.

Hire if the long-term costs, such as salary, benefits, and training, are low or justifiable. Outsource to the Philippines if you want to reduce your overhead costs and cut on recruitment costs.

Hire if the skills and experience needed are core competencies, critical to patient care. Outsource if the gap falls on non-clinical talent.

Do you need the team immediately? Hire if you have both time and resources to build and train the team. Outsource if you need the skills immediately.

Hire if you want to have more control over handling sensitive data and compliance. Outsource if you can fully trust your outsourcing partner with its compliance and strong SLAs.

Healthcare BPO services encompass a wide range of functions, primarily focused on financial, administrative, and some operational aspects of the business.

These processes help organizations streamline operations to improve patient care, making things more effective and efficient. Here are some of the most common healthcare services you can outsource and the respective tasks involved:

• Managing patient billing
• Submitting claims
• Following up on denials
• Ensuring compliance with regulations

• Patient registration
• Information verification
• Insurance processing

• Initial claim intake
• Documents validation
• Settlement
• Reporting

• Managing care plans
• Conducting follow-ups on treatments
• Tracking documentation for billing purposes

• Patient Communication
• Appointment Setting
• Feedback Collection

• Medical Billing
• Customer Service
• Appointment Scheduling
• Live Chat
• Complaints and Inquiry Assistance

• Converting audio into written medical information
• Formatting and checking accuracy in reports

• Data entry
• Report generation
• Medical coding
• Patient scheduling
• Claims processing

• Recruitment
• Onboarding
• Payroll
• Benefits administration
• Compliance

• Software development
• Cybersecurity
• System configuration
• Infrastructure maintenance

Outsourcing in the healthcare space provides organizations with several benefits, primarily by significantly improving cost reduction and operations.

If you’re considering outsourcing, here are some advantages you can enjoy:

Relieving administrative burdens gives your clinicians the space to practice efficiently and in a patient-centric manner. This fosters a more positive work environment that isn’t only less stressful for the professionals but also more satisfactory for the patients, resulting in lower turnover rates and happier patients.

Reduced costs are among the most evident and common reasons why BPO in healthcare exists. This cost efficiency leads to financial sustainability and stability, as you begin to optimize your operations through specialized expertise without increasing costs. The increased profitability brings in long-term stability without compromising financial health.

Outsourcing enables you to exert more supervision and control over your operations, performance, and finances. By leveraging third-party teams, you can divide and conquer responsibilities, streamlining processes while still retaining control.

Hospitals are constantly under pressure to provide exceptional care while struggling with a swarm of documents to accomplish. While your clinicians are heroes in their own ways, they can’t do everything. Outsourcing allows them more space to breathe and time to nurture patients on a deeper, more compassionate level.

Healthcare BPO services are handled by experts in their departments. This means you’re assured of the quality and knowledge provided for your services and patients, regardless of the support you need.

Outsourcing is strategic, but it isn’t always dandy and peaceful. Healthcare BPO can be complex and multifaceted, especially since it involves sensitive medical data.

While there are exciting benefits, healthcare outsourcing also presents risks, primarily in terms of data security and loss of control.

Outsourcing means letting a third-party company handle your operations, which can be concerning for medical care.

When you have less control over where to source employees and who to hire, the quality of your service can be compromised, which in turn impacts your patients.

Granting another company access to sensitive medical information raises significant concerns. This can put your organization and patients at risk of threats and security breaches.

Outsourcing, especially from another country, can create operational coordination challenges. This can make it difficult for you to provide seamless care to your patients.

When you rely on an external provider, you may experience issues in monitoring the performance of your outsourced team. This can lead to loss of expertise and misalignment of service standards.

With the wrong outsourcing partner, the freedom and ease from administrative tasks can harm your operational integrity.

Fortunately, some key pointers will help you make this critical decision. It’s relatively easy to spot a good healthcare outsourcing company. You need to check the following:

This is a no-brainer. You should only outsource your healthcare services to a company with adequate experience in healthcare BPO. This reassures you of the quality of their services and the metrics they keep to ensure they maintain their service levels.

Partners with healthcare experience know and understand medical terminology, payer-provider dynamics, HIPAA compliance, and workflows.

Your BPO partner should comply with HIPAA, GDPR, and HITECH. They should also be transparent and confident about their data protection practices and breach response plans.

The Philippines has numerous companies that you can trust when it comes to data privacy and security. You can partner with companies like Logix BPO, Teleperformance, and Accenture.

Your outsourced partner should be able to easily connect to your EHR systems or management systems. This is vital to make sure your operations can run smoothly with their external assistance.

Your outsourced partner should be able to easily connect to your EHR systems or management systems. This is vital to make sure your operations can run smoothly with their external assistance.

The ideal healthcare BPO partner should align with your standards and requirements. You can check this through their KPIs, sample results, and tools they use to track performance. Checking these ensures they can offer transparent and adequate SLAs that match what you need.

By now, you should have made your decision about which path to take. If you want to work with trained experts in various fields without overspending or sacrificing service quality, outsourcing is the right choice.

At Logix BPO, we’ll enhance your operations by hiring a team that understands the healthcare industry and its challenges. We consistently strive to deliver exceptional services to our partners, ensuring their healthcare operations remain successful and effective.

Are you ready to accelerate with the perfect team?