Everything You Need To Know About the Healthcare BPO Process

Digital capabilities, growing consumer expectations, and emerging technologies are prompting medical providers to move from traditional care and support models and offer innovative services. Find out how Healthcare BPO creates the opportunity to support these initiatives.
Healthcare Process in BPO - featured Image

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Digital capabilities, growing consumer expectations, and emerging technologies are prompting medical providers to move from traditional care and support models and to offer service in innovative ways.

Modern patients demand technology-powered healthcare solutions. They expect to book and manage bookings online, receive virtual care, and easily access medical records digitally. Providing a patient experience of this magnitude is challenging for an organization without ample resources and advanced technology.

Healthcare BPO is the solution for companies looking to enhance their patients’ experience.

Read on to learn more about the healthcare process in BPO and how it helps.

What Is Healthcare BPO?

What is healthcare BPO meaning. Short definition

Healthcare business process outsourcing (BPO) involves hiring an external contractor to handle non-clinical or non-core activities of a healthcare organization. Hospitals, clinics, and other medical facilities outsource work instead of performing the tasks in-house.

The healthcare process in BPO enables healthcare organizations to focus on their core competencies. Delegating services to a third party allows medical providers to concentrate on treating patients.

Typically, companies outsource to third-party vendors in foreign countries to save on costs. However, hospitals can contract healthcare BPO services within their country. Directly hiring freelancers is also an option for managing tedious activities such as medical coding and billing.

How Does BPO Help to Manage Healthcare Processes?

The healthcare process in BPO is similar to how medical providers serve patients. Third-party vendors process healthcare information and share medical records with patients using digital channels such as email, chat, or phone calls.

The scope of service is limited because healthcare BPO lacks the physical representation of a hospital or office. Medical BPO services support healthcare providers, insurance carriers, and government agencies but do not replace them because medical BPO services cannot examine, diagnose, or treat patients.

Healthcare outsourcing involves all tasks related to the medical industry but not medical care itself. The most common services are transcription, coding, and billing, but some providers also handle lead generation and insurance processing.

A reputable medical outsourcing provider like Unity Communications prioritizes work efficiency, data security, and information accuracy. Your healthcare outsourcing vendor should guarantee flexible pricing along with the following:

  • Hiring only skilled talent with proven experience in healthcare support services;
  • Ensuring a better customer and patient experience using talent technology, analytics, and extensive business knowledge; and
  • Quality, comprehensive in-house monitoring to ensure agents meet quality standards.

Healthcare Processes You Can Outsource

Healthcare Processes You Can Outsource

The healthcare BPO industry manages various functions, from medical claims processing to data entry services. Here’s a closer look at key services to outsource.

Medical Coding and Billing

Healthcare providers and professionals process numerous medical records every day. Unlike other industries where encoding is straightforward, medical coding is complicated.

Medical coders and billers must be familiar with numeric and alphanumeric codes used in health records, such as the:

  • Healthcare Common Procedure Coding System (HCPCS)
  • International Classification of Diseases (ICD)
  • Current Procedural Terminology (CPT)

Hospitals and clinics need specially trained coders to handle medical records. Without the right expertise and knowledge, healthcare providers will face significant errors in insurance claims and delays in processing those claims to achieve optimum reimbursement.

Prevent coding and billing hiccups by outsourcing these functions to a third-party service provider. Healthcare BPO companies have more resources to perform the tasks efficiently and accurately. Outsourcing reduces coding errors, expediting the revenue cycle.

Claims Processing

Creating and submitting medical claims to insurance companies are vital healthcare processes in BPO because these are how healthcare practitioners are paid for their services. Delays in processing those claims result in delays in reimbursing medical professionals for their services.

When you have thousands of claims to process in a day, how will you maintain the accuracy of each one?

Outsource claims processing to ensure that your claims are handled appropriately. Healthcare BPO providers have skilled professionals and advanced technologies to process large volumes of insurance claims efficiently.

Data Entry

Healthcare providers process and encode large amounts of data daily for patient care. They handle data such as:

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

Outsourcing data entry tasks frees some of your time and resources for other critical medical activities.

Outsource data management services only to a trustworthy healthcare BPO company. Medical data entry is more technical than other data entry services in different fields; hence, you need professionals to handle it.


Telehealth solutions have increased in popularity in recent years. During the pandemic, people stayed at home; even going to a hospital was risky. As a result, telehealth became an acceptable alternative to in-office visits for providing basic healthcare services.

Telehealth will remain relevant because many healthcare customers prefer this alternative. More than half of millennials and Gen Zs said they would continue to use telehealth due to its convenience.

Outsourcing this function allows doctors and other medical practitioners to focus on inpatients while your remote staff manages basic medical concerns.

Medical Transcription

One activity that wastes healthcare providers’ time and effort is transcription. Physicians, surgeons, and general practitioners must pay attention to patient care, but admin duties and paperwork slow them down. The results are often delays and physician burnout.

Reports show that the transcription market in the U.S. will continue to grow in the future. This trend is due to companies across the globe producing large amounts of data. Hence, the demand for medical transcription is here to stay.

Human Resources (HR)

BPO companies seamlessly manage a medical organization’s HR administration. They have extensive knowledge of providing benefit packages and managing employee recruitment.

Additionally, service providers handle hiring and training. They develop employee databases and create employee handbooks or manuals. An outside vendor provides these services at a fraction of the cost.

Payroll Management

Medical professionals see delegating payment management services to BPO vendors as effective and efficient because handling payroll in-house is expensive.

For instance, an external service provider has the latest payroll tools that expedite the salary process. The result is accurate and timely compensation delivery to the medical company’s employees.

Benefits of Outsourcing Healthcare Processes

Focus on patient care - Asian nurse with a happy older patient

Now that you know the healthcare process in BPO, let’s examine how your organization can benefit from outsourcing the processes. Here are the key advantages of healthcare BPO.

Focus on Patient Care

As you strive to deliver excellent patient care and support, time-consuming and non-core activities are the last thing you want to worry about.

Hiring a BPO company to manage repetitive tasks and admin duties on your behalf lets you focus on treatment and offer patients the care they deserve.

Maintain Compliance

Healthcare facilities handle tons of sensitive data, including medical records and financial information. As a result, the medical industry is highly regulated, and strict compliance is a must. Non-compliant organizations can be liable for costly fines ranging from $100 to more than $50,000 per violation.

Partnering with a BPO provider proficient in medical standards and regulations and providing services to secure patients’ data helps you remain compliant.

Reduce Overhead

With increasing revenue targets and shrinking budgets, medical organizations must find ways to save money. Outsourcing cuts overhead and labor expenses by 70%.

Access to low-cost infrastructure and resources through BPO offers significant savings for hospitals, medical institutions, and clinics and boosts profitability.

The Bottom Line

Medical business process outsourcing offers much-needed help to healthcare providers looking to overcome challenges, remain compliant, and be agile in today’s changing consumer landscape.

Many healthcare BPO providers are available in the market. Choose a vendor with a proven track record and experience in your industry.

If you’re in the market for a medical BPO partner, Unity Communications can help. Our healthcare outsourcing, partnered with our managed services portfolio, will equip you with the resources and expertise needed to excel in your industry.

Get in touch with us now to learn how we can support you.

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Allie Delos Santos is an experienced content writer who graduated cum laude with a degree in mass communications. She specializes in writing blog posts and feature articles. Her passion is making drab blog articles sparkle. Allie is an avid reader—with a strong interest in magical realism and contemporary fiction. When she is not working, she enjoys yoga and cooking.
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Allie Delos Santos

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