Healthcare Outsourcing: Specialized Functions in Healthcare Outsourcing Connext

Healthcare outsourcing is the practice of healthcare organizations assigning services, to a third-party provider that offers healthcare support.

Healthcare Outsourcing Specialized Functions in Healthcare Outsourcing medical appointment consultation doctor in hospital

Benefits of Outsourcing Healthcare

Outsourcing Healthcare services is a cost-effective solution that can help practices provide quality patient care. How does healthcare outsourcing help save costs?

There are plenty of benefits to healthcare outsourcing. Healthcare outsourcing is a great way to save on costs such as hiring costs and overhead, which help guarantee the company’s revenues.

With healthcare outsourcing, you can assign various specialized functions to an experienced healthcare support team. Overall, these healthcare specialists significantly help improve healthcare operations, increase efficiency and reduce errors in processing.

Specialized Functions in Healthcare Outsourcing

Medical Billing and Coding

Accounting and collections are not the specialty of healthcare practitioners yet are equally important in day-to-day operations.

If your practice needs help improving the accounting and collections process, healthcare outsourcing, particularly outsourcing medical billing and coding, is a great way to start.

Outsourcing medical billing and coding lets you work with Medical Billing Specialists who can be assigned to tasks such as provide correct posting for all credit cards/checks and cash payments and provide A/R month end closing among others. The tasks can also extend to participating in all quality assessment activities and assist to collect and analyze all information and recommend required improvements to all processes.

Medical coding is also important in the medical billing process. These codes are subject to changes or updates in the system. Proper entry of codes is needed to ensure proper documentation and collection.

Common causes of billing errors are incorrect entry of these medical codes, another cause is incorrect codes used result in higher payment amount for the services rendered. Healthcare outsourcing is a great way to avoid these kinds of errors in medical coding and make sure the patient is billed properly.

Insurance Verification

One specialized service in Healthcare outsourcing is to assign the process of reviewing and checking a patient’s insurance plan’s coverage and regularly updating and monitoring of the patient’s basic information and electronic medical records.

Healthcare outsourcing providers verify and review a patient’s insurance claims on a daily basis for accuracy.

Medical Transcription

Through healthcare outsourcing you can also work with staff with attention to detail and active listening skills to provide effective and accurate record transcription for patients and doctors’ records.

Medical Transcriptionists provide documentation support by transcribing medical reports, doctors’ notes, patient data. They provide effective and accurate patient record transcription, verify data entered from the claim form is accurate and complete to enable the claim to be processed correctly and accurately. They can also virtually scribe for surgeons, review notes for completion and fax completed these completed notes.

Telehealth Services

The use of cloud computing, analytics, smart medical devices, enable practices to provide telehealth services.

In April 2020, overall telehealth utilization for office visits and outpatient care was 78 times higher than in February 2020. (McKinsey)

Telehealth services can be provided by outsourced staff with specializations to help practices improve their healthcare operations.

For example, by outsourcing healthcare services to Virtual Optometrists and Virtual Nurses, practices assign functions to well-trained professionals who are able to give the best care with little supervision. They work with a variety of patients and can conduct patient assessments and virtual check-ins prior to each scheduled visit onsite, patient intakes and reviewing of previous records, and brief patients prior to the procedure.

They can be asked to answer all basic medical questions and issues about the procedure apart from cost, as well as calls calling patients to verify information, calling MD offices, assigning faxes and sending receipt of referrals, answering calls from patients about refills. They also assist with taking calls from other optometrists about basic pre/ post op care. Their duty includes tasks like creating and maintaining accurate patient records, administering medication and monitoring for side effects, recording vital signs, and reporting symptoms and changes in patient conditions.

This ensures the recovery of patients and dramatically improves the turnaround time and wait times.

Inbound and Outbound Customer Service Support

Through Healthcare Outsourcing, you get to work with Inbound and Outbound Customer Service specialists who can be primarily tasked to assist patients in preferred communication channels such as calls, emails, messaging and walk through patients on the terms of service, insurance coverage, and payment options.

They also assist patients on their scheduled appointments or treatments and consultations. They maintain the customer database and talk to and reach out to patients on their claims status and records, incoming appointment requests and status, and confirm, cancel or reschedule appointment requests.

Inbound and Outbound Customer Service specialists have excellent interpersonal skills, active listening and customer-care with focus on quality, problem solving, and analyzing information, and documentation skills.

Medical Compliance

Medical billing involves researching and resolving pre-processing errors and edits to ensure that claims are filed timely, accurate and timely processing of claim appeals means compliance with the various payor requirements, and meet requirements of local, state, and federal regulations.

The Health Insurance Portability and Accountability Act is compliance specific to U.S. Medical and Healthcare transactions. The Health Insurance Portability and Accountability Act (HIPAA) Compliance is a standard set by the HIPAA for protecting patient data. Companies that handle sensitive patient data and information need to be HIPAA compliant and have operating and network controls in place.

Healthcare outsourcing providers are required to provide proper operating controls to effectively protect the interests, confidentiality and data of clients.

Connext Global Solutions is a business process outsourcing company that provides fully customized outsourcing solutions for healthcare organizations looking to improve healthcare operations.

Connext Global Solutions offers custom healthcare outsourcing solutions. Here is a list of common roles with their accompanying tasks that you can delegate to a Healthcare outsourcing and staffing solutions provider like Connext Global Solutions:

- - Medical Coding Specialist
- - Medical Billing Specialist
- - Eligibility Verification Specialist
- - Prior Authorization Specialist
- - Virtual Nurse
- - Virtual Optometrist
- - Patient Care Coordinator
- - Patient Scheduler
- Medical Claims Appeals Specialist