Healthcare BPO companies are third-party support providers who primarily look after the business aspects of medical practices. By outsourcing non-core tasks to a BPO, healthcare providers can focus more on the core aspects of their business. Over the years, the importance of healthcare BPO providers has increased by leaps and bounds as they assist medical practices in keeping their cash register ringing. As a result, the scope of the services sought from them too has increased. Some of the important healthcare support services a BPO provides include:
Medical Coding Services
Renowned healthcare BPO’s provide medical practices with coding services that adhere to the alphanumerical coding standards such as CPT, ICD, etc. They make it easier for medical practices to access professional coders who stay up-to-date with the coding regulations. Thus, the medical coding services offered by the healthcare BPO’s help prevent claim denials.
Medical Billing Services
This is one of the healthcare support services that help maintain steady financial health for medical practices. It involves keeping track of the healthcare provider’s clinical collections starting from the first step of registration of the patient. Medical billing ensures that patient payments reach the healthcare provider without delay.
Denial Management Services
Claims get denied due to inaccurate coding, incomplete patient information and other errors in the data filled into the claim. Sometimes they also get denied due to late submission to the insurance provider or a mistake from the insurer’s side. In this service, the billers and coders find the issue, resolve and resubmit the claim to the insurance provider. Thus, denial management is one of the healthcare support services that prevent delays in receiving patient payments.
Insurance Verification Services
The patient’s insurance information collected during the patient’s first visit to the healthcare center could change over time. The patient could have changed their insurance plan or switched to a different insurance provider. This is why it is important to double-check the patient’s insurance information on every single medical visit that the patient makes. Hence, this type of healthcare support services helps medical practices avoid claim denials due to inaccurate patient insurance information.
Medical Claims Processing Services
In this type of healthcare support services, the healthcare BPO takes up the task of filling in the medical and insurance information of the patient into the claim. The billers verify the information by checking patient insurance eligibility and accuracy of the data received. Then they proceed to translate it into alphanumerical codes and submit the claim to the insurance provider. Finally, they follow-up with the patients and the insurance provider till the claim is settled.
Medical Record Indexing Services
All the information regarding the patient medical information, financial transactions, physician orders, explanation of benefits, insurance bills, claims etc. are comprised in a medical record. The process of filling in all this information into the electronic medical records is called medical record indexing. This is one of the healthcare support services that help maintain real-time reports and monitor the entire tenure of time spent by the patient with the healthcare provider.
Revenue Cycle Management Services
This kind of healthcare support services are inclusive of all the steps of medical billing and coding to reach the final outcome of gaining complete reimbursements and maintaining medical records. This process starts from the step of patient registration and lasts until the patient’s payment is reimbursed to the healthcare provider. If a medical practice prefers to outsource its entire financial process to a third-party provider, it can utilize the RCM services.
Established healthcare BPO’s provide several other specialized support services such as teleradiology services or disease-specific billing services. As the healthcare support services, provided by them take off a major chunk of the burden that otherwise has to be borne by medical practices, the role of healthcare BPOs are expected to grow with time.