Why Outsourcing is a Viable Solution for the U.S. Healthcare Sector

by | Published on Jul 31, 2023 | Specialty Billing, Specialty Coding

Benefits of Outsourcing for the Healthcare Sector
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The United States healthcare system boasts cutting-edge technology and remarkable medical advancements, making it one of the most superior in the world. Nevertheless, over the past two decades, the healthcare industry has experienced significant upheavals, presenting substantial challenges. Addressing issues such as soaring costs and limited access to care necessitates a multifaceted approach for effective solutions. In this context, medical billing outsourcing has emerged as a practical strategy for hospitals and medical practices to maintain financial stability and adapt to the dynamic landscape of the healthcare industry more efficiently.

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How Healthcare Business Process Outsourcing (BPO) makes the Difference

The rapid advancement of digital capabilities, coupled with ever-increasing consumer expectations and emerging technologies, is compelling medical providers to embrace innovative approaches beyond traditional care and support models. Today, most healthcare providers outsource non-core tasks to companies that have the right technology, innovation and flexibility to handle them.

In the modern era, patients have come to expect technology-driven healthcare solutions. They demand the convenience of online appointment bookings, the flexibility of virtual care, and seamless access to their medical records digitally. However, meeting these expectations can pose challenges for organizations with limited resources and outdated technology.

Fortunately, healthcare business process outsourcing (BPO) presents a practical solution for companies aiming to enhance the patient experience. Outsourcing can ensure many benefits:

  • Expertise and Accuracy
  • Time and Cost Savings
  • Fast turnaround
  • Scalability
  • Data security and compliance
  • Focus on patient care and improved outcomes

By leveraging the support of an external vendor, organizations can elevate their services, stay ahead in the ever-changing healthcare landscape, and provide patients with the cutting-edge solutions they desire.

Top Areas for Healthcare Outsourcing

Equipped with advanced technology, outsourcing companies are supporting healthcare providers in key areas such as:

  • Medical billing and coding: Medical billing is complex due to the extensive use of various code sets, including Current Procedural Terminology (CPT), International Classification of Diseases (ICD), and Healthcare Common Procedure Coding System (HCPCS). Accurate coding is essential for billing insurance companies and other payers correctly. The process requires attention to detail, adherence to specific guidelines, and constant updates to accommodate changes in medical practices and regulations. Different insurance companies may have specific coding requirements, and technology integration adds another layer of complexity. Proper medical billing is crucial for ensuring timely and accurate reimbursement, compliance, and financial stability for healthcare providers.
  • Patient appointment scheduling: Healthcare providers often need to manage a large number of patients with limited appointment slots available. Balancing patient demands with available time slots can be challenging, leading to scheduling conflicts and wait times. Outsourcing the task allows healthcare facilities to efficiently manage appointment booking and rescheduling, reducing wait times and ensuring timely responses to patient inquiries. A streamlined scheduling process enhances patient satisfaction, results in more efficient resource allocation, and improves the overall experience. It ultimately leads to a more successful and patient-centered practice.
  • Insurance eligibility verification and authorization: Verifying patient eligibility before services are provided is crucial for healthcare to receive reimbursement for their services. It requires navigating through a multitude of complex insurance policies. Moreover, patient insurance information can change frequently due to updates in coverage or changes in insurance providers. Ensuring up-to-date and accurate data can be time-consuming. Partnering with a reliable medical billing company can ensure efficient insurance eligibility verification and authorization, which is vital for maximizing revenue, reducing claim denials, and delivering timely and effective patient care.
  • Medical transcription and management of electronic health record (EHR) systems: Professional outsourcing companies employ skilled and experienced medical transcriptionists, ensuring accurate and high-quality EHR documentation. Outsourcing medical transcription streamlines the documentation processes, reduces costs, and enhances overall workflow and productivity for healthcare providers.
  • Clinical data entry: Precise and timely clinical data entry allows providers to make more informed decisions about a patient’s care. In healthcare, even the smallest data entry error can have devastating consequences. Outsourcing the task can ensure that both healthcare providers have access to good quality patient data. Expert data entry specialists minimize errors and ensure data accuracy, leading to improved data quality and reliability.
  • Medical document scanning, storage and retrieval solutions: Poor records management can lead to medication errors, missed diagnoses, treatment lapses and even potentially life-threatening events. Accurately scanned digital records help reduce medication errors, prevent unnecessary investigations, and improve communication and interaction among healthcare providers, patients, and others involved in their care. Outsourcing medical document scanning ensures that healthcare organizations have accurate, easily retrievable, and secure digital records, facilitating smoother operations and improved patient care.
  • Medical forms processing: Medical forms processing involves the digital conversion and management of various medical forms, such as patient intake forms, insurance claims, medical history records, and consent forms. This process typically includes data entry, validation, and organization of information into electronic formats, making it easily accessible and searchable. Outsourcing companies can ensure efficient and accurate medical forms processing, helping healthcare providers streamline document management and make data-driven decisions for better patient outcomes.

Get the Right Support

Today’s medical outsourcing companies are technologically advanced. These companies invest in cutting-edge technologies and software to provide efficient and innovative solutions to healthcare providers. They employ professionals who are highly trained, experienced, and knowledgeable in their respective domains. Their certified medical coders are skilled in accurately assigning medical codes to diagnoses, procedures, and services, ensuring proper billing and claims processing. They also have medical billing professionals who are experts in claim submission, payment posting, and handling insurance denials to optimize revenue cycle management. With the right support, healthcare organizations can enhance service delivery, stay ahead in the ever-changing healthcare landscape, and provide patients with the cutting-edge solutions they desire.

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Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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