What Is Healthcare BPO?

What is Healthcare BPO

Every business pursues ways to outsource some of its services and reduce costs without sacrificing quality. Well, healthcare facilities are also keeping up with the trend. But what is healthcare BPO?

Outsourcing healthcare-related services might seem impossible because of the industry’s nature. While patient care can’t be outsourced, many administrative responsibilities can. Let us introduce you to healthcare outsourcing and its benefits, from customer care to billing, coding, and IT support.

What Is Healthcare BPO?

Healthcare BPO is short for healthcare business process outsourcing. It is defined as an activity when the healthcare facility contracts with a third party billing provider, like us, to do some of their activities. We, as contractors, can be hired to handle the organization’s non-core and non-clinical functions.

In simple terms, healthcare BPO is when some of the in-house tasks of healthcare organizations are outsourced. Some facilities that take advantage of the outsourcing process are hospitals, clinics, nursing homes, allied health professionals, hospices, addiction clinics, community health centers, etc.

Importance of Healthcare BPO

To fully understand the healthcare process in BPO, we feel obligated to dive deeper into its importance. Healthcare BPO is an opportunity for organizations to focus on their core activities and look for ways to offer better care while not worrying about administrative work. But what is healthcare process in BPO?

For instance, if you hire a specialized outsourcing firm, you won’t have to worry about things such as medical billing, coding, IT services, customer care, claims processing, data entry, support, drawing up reports, etc. 

Not having to micromanage such departments will leave your organization more time to tackle more serious challenges. For example, the 10 million shortfall of healthcare workers by 2030.

Benefits of Healthcare BPO

BPO in the healthcare industry has several benefits. All of them contribute to a better overall operation of your healthcare organization. The advantages of outsourcing some of your healthcare tasks include:

  • Cost reduction and increased profitability because of the high ROI.
  • High accuracy levels and reduced error risks because you will hire a skilled workforce.
  • Increased efficiency because your organization can focus on core competencies and patient care.
  • Reduced staff acquisition and training costs.
  • Access to the latest technologies without the high costs.
  • Better time management.
  • Faster processing times.
  • Possibility to handle greater work volume.
  • Guaranteed regulatory compliance, etc.

Key Services Offered in Healthcare BPO

The value of the global healthcare BPO market was estimated at $391.32 billion in 2023. The predictions are that it will hit a compound annual growth rate of 9.20% by 2032. 

So, what is healthcare account in BPO, and what are the most commonly demanded services for outsourcing that contribute to the industry’s market size? The key services offered by healthcare BPO companies, such as CLICKVISION BPO, are the following:

  • Medical coding and billing
  • Claims processing
  • Data management and medical data entry services
  • IT services
  • Customer service and support

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Medical coding and billing

Medical coding and billing are important parts of the reimbursement cycle. They assure healthcare providers receive payments for their services, whether it is from an insurance company or the patient itself.

The job of a medical coder is to assign codes according to the treatment and services the patient got in your healthcare facility. In simple words, the medical coders look at the patients’ injury, diagnosis and medical procedure and translate them into numeric or alphanumeric codes.

On the other hand, medical billing is the process of taking the codes from the medical coder and creating a claim for the insurance company. A claim is a bill that needs to be paid. The claim can be created either by using a form or special software. 

It is also the biller’s job to determine the amount the patient owes to the healthcare organization. The last step in the medical coding and billing process is to send the claim to the insurance for evaluation.

Coding and billing for insurance claims within a healthcare BPO is significantly important. It focuses on the accurate and efficient processing that leads to financial stability and compliance.

Claims processing

Claims processing includes complex tasks that assist you as a healthcare provider in receiving medical service payments. Some of the most important activities in claims processing are:

  • Gathering and patient information
  • Adding data points into databases
  • Filing paperwork

Data management and data entry services

One of healthcare facilities’ many obligations is keeping a record of all patient appointments, diagnoses, and treatments. All states have special regulations that require healthcare organizations to retain records for a certain amount of time. Generally, the retention period is typically between five and ten years.

These types of services focus on implementing strategies to digitize access to information and manage healthcare records. All information, such as clinical records, insurance claim documents, medical history, lab test results, medical charts, doctor notes and much more, must be handled properly.

IT services

Another popular healthcare outsourcing option is IT services. It includes hiring an independent third-party organization to handle IT processes and technologies such as:

  • Electronic health record systems
  • Medical billing and coding software
  • Telemedicine and remote patient monitoring solutions
  • IT Infrastructure management
  • Cybersecurity and data protection services

Due to the technological complexity, many healthcare organizations prefer to outsource their IT services instead of investing in an in-house sector. Outsourcing IT services is beneficial for cost optimization, ensuring regulatory compliance, enhancing data security, and offering flexibility and scalability.

Customer service and support

What is healthcare account in call center? BPO can assist in managing call center operations. Trained employees can answer patient questions, schedule appointments, bill inquiries, and update patient information according to HIPAA regulations. They can also route patients to the appropriate person in the organizations and much more.

Customer service and support

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What is healthcare BPO? Understanding its benefits can open broad possibilities for improving your healthcare organization’s efficiency, service qualities and customer satisfaction. Feel free to contact us if you want to use our unique solutions in navigating the complex landscape of modern healthcare management.

With a strong background in the marketing industry and healthcare leadership roles, Filip is responsible for CLICKVISIONBPO's sales strategies and onboarding new clients. With a passion for sharing insights gained from his experience, he also shares valuable knowledge through industry related articles.

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