Would you be passive when your bills are delayed and denied frequently? It ain’t simple for a healthcare to manage medical billing simultaneously.  If you haven’t considered the productivity of healthcare BPO so far,then we would recommend to heed the below.

10 ways healthcare BPO helps hospitals:

  1. Coding and Billing
  2. Compliance Standards
  3. Systematic financial policy
  4. Maintain constant revenue flow
  5. Data analytics
  6. Concentrating on better health service
  7. Maintain low average AR days
  8. Regular follow-ups 
  9. No delay or denials
  10. Staff training.

1.Medical Billing and Coding:

  • Medical billing and coding is an important component of RCM. It involves the whole process from submitting the claims to follow-up on the denials.
  • By collaborating with healthcare BPO, it acquires less investment. Medical billers will be associated with updates on medical code changes, modifiers and subsets.
  • The bills are claimed within short period of time and faster payments are processed.
  • Instead of choosing personal staff for billing, RCM company is cost efficient with sufficient staff to claim and submit the bills in a systematic order.
  • Improve patient engagement and satisfaction rates.

2.Compliance Standards:

  • It is important to protect the patient’s information from privacy violation. 
  • Health-care BPO works together with Health-care Information Portability and Accountability Act 1966 (HIPAA).
  • Privacy breach and fraudulent laws would result in penalties and disturb hospital reputation.
  • Health-are BPO amends by the rules and regulations of HIPAA and never takes the risk of privacy violation of the patients.
  • As a health-are provider, safeguarding the privacy, security and confidentiality of Protected Health Information (PHI) of patients is very essential. 
  • RCM companies hold a strong grip by charging honestly and sticking to all the mandate protocols of HIPAA.

3.Systematic Financial Policy: 

  • In healthcare BPO, systematic financial policies are extremely essential. Therefore have to be documented and evaluated with utmost attention.
  • Healthcare providers must be aware of the financial status of their patients as it helps in depicting the unclaimed bills of patients.
  • RCM companies will have a thorough verification on the pre-authorization report submitted by the patient and evaluate any unclaimed bills.

4.Maintain Constant Revenue Flow:

  • Hospitals or healthcare providers would not find it easy to make payments feasibly and assistance for post payments which also increases the revenue is required.
  • The healthcare BPO is streamlined to submit the claims faster and receive payments without any difficulty.
  • It also maintains a constant and seamless flow of payments and promise the hospitals for a better revenue growth.
  • Every submitted claim is aimed for a post payment in smaller duration of time.
  • Errors are noticed and team would work efficiently to attain better progress.

5.Data Analytics:

  • Data analytics play a major role in the health-care industry. It optimizes healthcare provider’s time, cash flow and health information.
  • Most of the health facilities fail to capture the primary potential of data analytics.
  • They still rely on the outdated applications, inexperienced vendors and unskilled staff.
  • It’s important for a healthcare provider to use updated software technology and skilled staff to avoid inaccurate data collection.
  • Healthcare BPO helps in maintaining accurate data and efficient staff to provide better revenue cycle management to the hospital.
  • The highly developed software technology enables the RCM company to excel in whole process by supporting an equivalent to the expectations of the client.

6.Concentrating on Better Health Service: 

  • To maintain constant revenue growth, better patient care is required. As a healthcare provider, concentrating or focusing on their patients is vital.
  • Services of Healthcare BPO improves productivity and boost employee utilization.
  • Therefore, healthcare provider can spend time and effort on patients and not on the struggles to diminish the loss in hospital’s RCM.
  • Better patient-care would add value to the position and take health-care center’s reputation to next level.
  • Ensure not to delay the patient care to avoid their refusal towards your service.

7.Maintain Low Average A/R days:

  • Optimizing the claim submission process is one of the crucial ways to improve health-care revenue cycle management.
  • Lower the A/R days, faster the payments. It can maximize the targets that health-care is entitled to.
  • Maintaining low A/R days reduces denials and increases post payments.
  • A/R days should be less than 50 to maintain constant revenue flow and avoid payment delay.
  • If it exceeds 90 or 120, follow up on unpaid claims is required.
  • Days in A/R: 30 days or less for a high performing medical billing company.
  • 4045 days for an average performance and 60 days or more would result in below average medical billing company. 
  • Health-care BPO systematically maintains low A/R days and also attempt for a post payment quickly without any delay.

8.Regular Follow ups:

  • An expert RCM team is required to have regular follow up with the insurance companies.
  • All the rejected claims would keep on mounting when regular follow ups on submitted claims don’t happen.
  • When there’s a regular follow up with the insurance, identifying the gaps between submitted claims becomes easy.
  • Health-care BPO will further help you recognize different ways to improve revenue growth with frequent follow up team.
  • Considering the difference between date of service and date billed, cancellations and no- shows, denial management will push the submitted claims for a faster reimbursements.

9.No Delay or Denials:

  • The purpose of denial management is to evaluate unpaid claims and carry forward for the successful payments.
  • Preventing claims from denials ease the complications but denial management appears to be strenuous for the health-care providers.
  • Claims are often denied because of common billing errors or missing the accurate information based on patient’s coverage.
  • Healthcare BPO file corrected claims electronically with no errors. Certain tools are used to avoid denials and increase payments.
  • Medical billing specialists are involved in submitting the claims and responsible for monitoring denials from insurance companies and working towards post payments.

10.Staff training:

  • Unskilled staff is one of the most important challenges in health-care center.
  • Training the hospital staff may not save time and cost.
  • As a health-care provider, it’s not an easy task to engage with regular practice and training sessions.
  • Collaborating with the Revenue Cycle Management companies will save a lot of time and resources.
  • Health-care BPO reduces operational costs and streamlines RCM at the same time.

Hence with all these benefits from healthcare BPO, the hospitals can have a smooth flow of revenue growth and can handle the hurdles with no complications by focusing more on patient responsibility.