The healthcare sector is wide-spread and scattered all over the world with serviceable nature. And, the growing sector depicts that an external contractor can be better for managing healthcare services in healthcare organizations & hospitals.
Therefore, healthcare outsourcing is the latest buzzword as quality, and cost-conscious healthcare service providers prefer it to the maximal. The outsourcing companies enable healthcare administrators and staff to focus on the organization’s core service of treatment and care to the patients.
To determine why hospitals, decide on outsourcing activities, we evaluated several tasks (services) influencing the reasons to outsource:
Patient Demographic Entry
Since the pre-registration process is confusing and tiring for many patients, outsourcing is a way to ease up the process. Details such as name, date of birth, address, insurance details, and medical history are entered, as provided by the patient at the time of visit. For existing patients, the details are validated and updated, if required.
Within every organization, it is essential to maintain the record of active and discharged patients at a CRM.
Our team manages the CRM, keeps the list of services updated at every hour for the access of all physicians. The service ensures update data related to the patient whenever a doctor from any department or hospital staff needs to see it.
After submission of medical claims to the insurance company, the patient’s responsibility is checked out, and the outsourcing company is responsible for the further processes.
The service provider will keep track of all the claims and follow-up via phone, email or online is done whenever it is needed. Our BPO company takes all the steps along with the insurance company to ensure processing and recovery of payment. It will reduce the stress and help you from losing a significant portion of your income.
Follow-up with Insurance Companies
When the claims are not paid promptly or have been denied, there is limited personnel to research and determine why the claim has not been paid or denied.
The team at Fusion Business Solutions (BPO company) proactively manages the volume of insurance account’s denials follow-ups and thereby, leading to better cash flow.
Medical Billing and Coding
Creating medical bills has some standards and rules to follow, which the outsourcing company knows well. It implies that assigning this task to an outsourcing company can help to a major extent while reducing the workload for both – healthcare providers as well as insurance companies.
Medical Claim Processing
To render the best healthcare services, continuous flow of information from a clinic or healthcare organization is needed. The patient should get an in-print and online report of his/her health such as medicine prescription. Therefore, an outsourcing company can perform it well acting like the right person to do the job.
Denials are a part of A/R collection in insurance claims. And, it is difficult for a medical practitioner to handle the job. The well-trained accounts receivables executive can easily spot errors on the rejected claim and get it re-filed. The service providers at the outsourcing company will check the medical coding and help in identifying the recurring issues.
Thus, it is required to outsource the task to the team of experienced professionals who can take the pain and handle the flow of denials throughout the workflow.
ICD and CPT Coding
These ICD and CPT codes on superbills are provided for the patient from the hospital. It is then validated by the outsourcing team for preventing up-coding and down-coding, that implies all the denials.
The outsourcing team, here, are proficient in documenting the patient’s medical state, that leads to timely claim payment for a healthcare facility, ultimately saving time & boosting the organization’s cash flow.
Health Claim Transmission
The health-related claims are a part of the healthcare industry and can come from healthcare professionals and carriers. There are several types of claims that include dental, pharmacy, in-patient, and outpatient claims.
The outsourcing company like us can check the errors and rectify the false claims and sent them back to the insurance company. It is recommended to outsource the task to a company to handle medical insurance claims
The tasks such as creating a detailed and well-formatted prescription, it can be considered as outsourceable. Though one assistant shall be capable of doing it multiple or many reports can’t be created by one.
However, the job can be performed in expected quality and quantity by the trained team of a virtual assistant working in a Fusion Business Solutions (outsourcing company/BPO company). So, why not?
The outsourcing services in the healthcare industry take good care of confidentiality and data accuracy.
Here, at Fusion, we have streamed into healthcare support services that are secure, reliable, and can be customized to match up with the needs of your healthcare organization.
Contact us today! Free trial available.