What is Healthcare Outsourcing?

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Medical data entry was once the only process of the healthcare industry that was outsourced. It usually included processes such as medical transcription and medical coding and billing. But today, thanks to the rise of big data analytics, machine learning and robotic process automation, functions related to healthcare IT, clinical research and patient data security are outsourced as well. Healthcare outsourcing has evolved into a diverse and vast domain that opens up a world of possibilities for medical practices across the globe.




The driving force behind healthcare outsourcing is cost savings. Federal regulations from government bodies such as the Center for Medicare and Medicaid Services (CMS) have placed the industry in a constant state of flux. Since the passage of ‘The Affordable Care Act’ and ‘The Patient Protection Act’, hospitals and clinicians are forced to focus on the improvement and consistency of their practice, leaving them with less time and fewer resources to handle significant problems such as denied claims. 

Healthcare BPOservices have emerged as an effective solution to help medical practices cope with the changing healthcare ecosystem, especially with healthcare steadily transforming into a cost-driven initiative.

The Vital Components of Healthcare Outsourcing

Healthcare processes, especially in countries like the United States are extremely complex. The presence of numerous stakeholders in the form of payer organizations, technology vendors and pharmaceutical research firms is the reason behind it. Outsourcing non-medical components of their business process give healthcare providers the room they need to organize their approach towards care delivery. 

Healthcare BPO companies provide relief to medical practices by enabling them to focus on the clinical aspects of their business. Some of the most widely used services they provide are as follow:

Information Technology Services:  From the management of Hospital Information Systems (HIS) to network security management, healthcare BPO companies are experts in technology and business processes. They provide hospitals with the required level of technical expertise at all times. Application development, smartphone app development and the upgrading of existing systems are some of the healthcare IT services provided by these companies.

Data Analytics and Business Intelligence: Although both data analytics and business intelligence are modern business trends, they can make a significant impact on a hospital's RCM cycle. The use of these two innovative computing models helps hospitals predict demand. It also enables them to gauge patient behavior based on hospital admission and readmission rates.  

Revenue Cycle Management: Dedicated revenue cycle management services track a patient’s journey in the care process from the time of admission to the time of discharge. RCM healthcare BPO services are the most essential outsourcing services that a hospital requires. An efficient RCM process greatly reduces the rate of insurance claims denials which also happens to be a primary source of revenue bleed, for a hospital.

Data Entry and Insurance Management: Traditional services such as data entry and maintenance of the insurance status of still make up the lifeline of a hospital’s claims submission process. Any lapse in the efficiency of these processes translates into outstanding claims that affect the bottom line of medical practices.

Healthcare outsourcing can be the silver bullet that a medical practice needs to bring back stability to its financial operations. A good healthcare BPO company is essential for a hospital to stay profitable in the modern-day healthcare setting.