Healthcare BPO: The role of outsourcing in the Health & Medical Industry

What is Healthcare BPO?

Healthcare BPO refers to an outsourced business activity or process that provides administrative or other support to medical institutions, staff, and organizations. Coding, billing services, transcription, and other similar tasks are frequently outsourced.

It’s safe to assume that healthcare organizations, from insurers to pharmaceutical firms, aren’t exactly known for being customer-focused. With the growing demand for healthcare services, businesses must ensure that patients and customers have a better experience. The current status of a healthcare emergency, coupled with an aging population, necessitates a review of healthcare brands’ operating capacities.

A significant change would be to provide exceptional customer service and to use digital-first touchpoints. An important part of that will be moving away from the negative emotions of worry and fear that come with illness and starting to introduce seamless patient-doctor and customer interactions – moving from sick-care to proactive healthcare experiences.

Predicting issues and resolving them before they become a problem for the patient-customer has become the norm today. In the field of healthcare, customer service has come a long way. However, based on its low popularity, it appears that there is still much room for improvement. This is where healthcare business process outsourcing comes into play.

Types of Healthcare BPO Services

The healthcare BPO industry covers a wide range of tasks, from data input to medical claims processing. You can outsource the following critical healthcare provider services to a healthcare business process outsourcing partner:

Medical Coding And Billing

Every day, hospitals and healthcare professionals process massive amounts of medical records. In contrast to other businesses where coding and billing is a relatively simple task, medical coding and billing can be challenging.

These facilities have medical personnel that is more qualified to meet the demands of patients. That is why dealing with these records necessitates the use of professionally qualified personnel. You will encounter severe delays and inaccuracies in processing your patient invoices and records if you do not have the necessary knowledge and skills.

Healthcare outsourcing comes into play to avoid coding and billing mishaps.

Healthcare business process outsourcing teams, as experts, are well-equipped with the resources needed to complete the work effectively and efficiently. This allows you to concentrate on things that are important to your company, such as medical research, patient treatment, and care.

Claims Processing

Processing patient claims is an important aspect of healthcare. Patients must submit accurate medical claims to their insurance carriers. However, when there are hundreds of claims to be processed every day, it is critical to preserve accuracy on each and every one of them. It’s a good idea to outsource claims processing to a third-party service provider to keep patient claims under control.

Specialized teams are assigned to process huge volumes of medical claims with enough resources and manpower. Furthermore, because this is all they would be focusing on, you won’t have to worry about distractions clouding the veracity of the claims.

Data Processing Services

Every day, in addition to treating patients, healthcare providers must process and update massive amounts of medical data.

Managing and processing data is a time-consuming task in and of itself, but healthcare institutions must deal with massive amounts of data, for example:

  • Tests and lab reports
  • Prescriptions and drug inventory
  • Patient insurance details
  • Other hospital records

Outsourcing data entry tasks allows you to free up time and resources for your other important healthcare activities. While data entry is typically the safest task to outsource due to its simplicity, remember to only outsource it to a reputable healthcare BPO.

Importance of Outsourcing for the healthcare industry

For many years, outsourcing was not thought to be practicable in the healthcare sector, yet the proper BPO partner can dependably improve day-to-day company operations. Not only that, but outsourcing certain back office and patient experience components of the job allows for improved commercial growth while simultaneously providing outstanding medical treatment.

Outsourcing in the healthcare industry benefits both the patients and the personnel in multiple ways. Consider the following advantages:

Focus on patients

You have more time to focus on providing your patients with the high-quality care they deserve when you outsource time-consuming tasks to a third-party service provider. Reduce your workload when it comes to redundant tasks and administrative responsibilities, and your team will be able to improve the patient experience.


This isn’t the most compelling reason to outsource, but it can’t hurt. Save money and cut operational costs by outsourcing instead of hiring and training in-house employees. The money you save by outsourcing can then be used to improve your healthcare company.

Grow your offerings

When you outsource specific jobs, you free up time and energy to focus on providing great care and increasing your services. You will most likely have more time and financial resources to implement additional specializations or services in your firm if you outsource.

Avoid costly mistakes

Healthcare is a sensitive industry. You have access to patient records, medical information, and other sensitive data. Furthermore, health insurance portability and accountability standards and regulations might be difficult to manage. The right BPO partner will guarantee that your firm follows all requirements, is up to date on new rules and laws, and can even assist you in avoiding costly billing concerns.

Access to industry experts

When you partner with the proper BPO company, you add value to your existing team and organization. Outsourcing can provide you with access to people that have been professionally trained to handle various types of data, as well as saving you time and money on hiring and training assistance for your on-site employees.

Healthcare BPO and a Growing Need for Assistance in Healthcare

Until recently, the only way to see a doctor was to walk right up to their door. Consumers now frequently self-diagnose, look for local providers online, and review provider websites and ratings. Although some patients immediately pick up the phone to call the provider’s appointment line, many others begin their search online via the provider’s appointment engine, the patient’s online medical portal, or even a mobile app.

For today’s varied points of patient engagement, healthcare service organizations will need to raise their performance standards (mobile, text, email, etc.).

However, for an industry that hasn’t always been on the front edge of customer service trends, healthcare providers will find it challenging to close this gap.

The idea is to observe how patients behave. Many healthcare providers adopted an informed and empowered approach, presenting substantial amounts of information on websites to educate consumers and encourage them to use self-service choices. However, this was only partially successful. This deluge of information only makes it more difficult for customers who don’t understand how healthcare systems work to rapidly focus on the proper doctors and services.

Instead, even tech-savvy customers are resorting to customer support for rapid guidance and scheduling, bypassing overburdened online resources. The problem is that healthcare providers who were educating and empowering patients didn’t think about how they’d handle enormous amounts of customer support demands that weren’t self-service.

There are three essential customer service qualities that consumers prefer based on these consumer behaviors, by collaborating on the implementation of this strategy, as well as complementing and disseminating existing customer service plans. Providers of healthcare can strive for a better balance between self-service and supported service.

One consistent experience across all customer service channels

Having to deal with healthcare issues is difficult enough. When each customer support channel provides a different experience, it calls into doubt the brand’s professionalism and service, raises dissatisfaction, and erodes loyalty.

Despite the fact that more customers are starting their interactions online today, many patients end up switching to a different channel to continue their interaction. Frequently, the experience of channel hopping leads to greater complication and disillusionment.

According to Accenture Global Customer Pulse data, 72 percent of customers are dissatisfied with the uneven service they receive across different contact channels within the same organization.

The top two complaints are having to repeat information and being unable to reach a live person on the phone. These inconsistencies are usually the result of a strategy that allows different channels to be owned and handled by various entities inside the company. This method creates communication gaps that are felt directly by customers and cost healthcare providers more than they anticipate.

Proactive notifications and engagement with patients

Another strategy for the customer service team to make patients feel empowered is to provide them with information in the format they choose, even before they need it.

Touchpoints are a great way for healthcare practitioners to communicate with patients via their preferred channel, whether it’s email, SMS, web, text, or voice. Notifications can be used to confirm scheduled appointments, file deadlines, provide request status updates, or just transmit information that a consumer may be interested in before a patient asks for it.

Healthcare practitioners must anticipate the response to each notice before sending it.

Will patients have any other questions? Will they be willing to reschedule the appointment? Perhaps they’ll want to speak with a live agent?

Healthcare providers can insert helpful content and links into messages to get more information, connect with an agent, reschedule appointments, and so on by anticipating this next step in the communication process. Patients will have easy access to additional resources, and the brand’s overall perception will improve as a result.


Provide meaningful interactions

To enhance patient experience, healthcare providers should comprehend the complete patient journey, including touch points and channel transitions. This understanding guides the creation of customer-centric journeys and the technology needed to enable them.

Virtual queuing, for example, can lay the groundwork for a seamless journey.

Customers’ information is gathered from each touchpoint using a data feed. After the data has been gathered, it is organized into a customer interaction repository, which provides a single point of access to all relevant data. It’s critical to be able to track and view the customer journey in order to anticipate the next request. This allows healthcare providers to send notifications to patients that they will find useful, as well as links to other resources they may find useful.

Agents benefit from having this data at their fingertips since it provides context information prior to a live engagement with a patient. Agents may get right into the problem with this information and promptly resolve it. It also lowers the number of calls received by the contact center without compromising service quality.


Healthcare providers can leave a positive, long-lasting impression by providing excellent customer service. A negative one, on the other hand, allows customers to share their negative experiences with others, potentially harming a company’s reputation. Providers can give customers peace of mind and create memorable experiences that drive customer loyalty, customer and agent satisfaction, and a positive perception of the brand by understanding the customer’s journey, anticipating the communication process, and leveraging new technologies.

Healthcare BPO can help you save time and money while still providing the best possible care to your patients. This, however, is not something that can be accomplished in a single day. Before you begin, carefully identify the activities you want to outsource and assess your healthcare Business Process Outsourcing partner.

Consider outsourcing if you want to take your healthcare organization to the next level while increasing patient satisfaction and lowering costs. You’ll have no trouble finding a setup that works for your company once you’ve done that!