Written by Ezra Samarista
Phoenix is the fifth largest city in the U.S., complete with a bustling medical scene. Efficient administrative duties are essential for many healthcare organizations. Thus, these institutions rely on healthcare business process outsourcing (BPO) to delegate such tasks.
By hiring virtual assistants in Phoenix to handle tedious administrative operations, healthcare practices can use their time and resources to provide quality patient care.
But how exactly does outsourced administrative support streamline healthcare processes for Phoenix-based organizations?
Continue reading to learn more.
What Is the Importance of Medical Administrative Work in Phoenix?
Medical administrative work is the backbone of any well-functioning healthcare practice in Phoenix. While this function might not directly involve patient care, it covers a variety of responsibilities that help improve patient experience and institutional safety. Some of these tasks include the following:
- Recordkeeping and documentation
- Appointment scheduling
- Budget and spending management
- Insurance claims processing and billing
- Regulatory compliance
- Staff training
- Patient communication
The capital city of Arizona is becoming a national leader in the healthcare industry. The Greater Phoenix Economic Council (GPEC) forecasts an additional 90,000 healthcare jobs within the next decade.
As the city’s reputation as a medical hub grows, it must maintain high-quality clinical services and administrative operations standards. Thus, more Phoenix facilities partner with healthcare BPO providers because they can help streamline processes while solving various challenges.
Benefits of Outsourcing Healthcare Administrative Support for Healthcare
Outsourcing is a business practice where facilities hire third-party service providers to handle specific job functions. The healthcare process in BPO typically covers non-medical responsibilities such as the administrative tasks mentioned above.
Grand View Research predicts that the healthcare BPO market will grow at a compound annual growth rate (CAGR) of 13.6% for the next seven years. The institution forecasts a total market revenue of $4.6 billion by 2030. This increase can be attributed to the benefits that come with BPO services for healthcare.
Here are four ways medical service providers and organizations benefit from outsourcing:
Third-party professionals undergo screening to ensure their expertise in their respective fields. They receive continuous training to develop their talent and contributions. Healthcare BPO providers ensure workers have the necessary certifications, including the following:
- Certified Medical Administrative Assistant (CMAA)
- Certified Medical Biller and Coder (CMBC)
- Certified Professional Coder (CPC)
- Registered Health Information Technician (RHIT)
- Registered Health Information Administrator (RHIA)
These certifications signify the outsourced support staff’s prompt, optimal, and accurate work ethic. Well-trained staff can minimize administrative bottlenecks and reduce patient wait time.
Outsourcing administrative support functions, such as data entry, appointment scheduling, and billing, increases your healthcare practice’s efficiency and productivity.
Higher costs and budget cuts in the healthcare industry have become inevitable. According to the Centers for Medicare and Medicaid Services (CMS), national health spending is expected to reach an average of $6.8 trillion by 2030.
Fortunately, outsourcing administrative services can significantly reduce overhead and labor expenses. Outsourcing lets healthcare organizations scale their operations up or down as needed, which is especially beneficial during fluctuations in patient volume.
Outsourcing also lets healthcare practices reduce expenses for training staff and maintaining equipment and software. This approach allows organizations to allocate their budget to enhance patient care.
Medical facilities are highly regulated due to the sensitive data they handle, such as medical records, personal data, and financial information. Healthcare organizations in Phoenix follow a variety of regulations, such as the following:
- Arizona Medical Practice Act (AMPA)
- Arizona Hospital Licensing Act (AHLA)
- Arizona Nursing Home Licensing Act (ANHLA)
- Arizona Health Care Cost Containment System (AHCCCS) Requirements
- Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Emergency Medical Treatment and Labor Act (EMTALA)
- False Claims Act (FCA)
Violating these regulations, even by accident, can cause extreme financial damage to healthcare providers, with fines ranging from $100 to more than $50,000 per violation.
Relying on third-party experts knowledgeable in medical standards and regulations is best for ensuring compliance and data protection.
Increased Focus on Patient Care
Quality patient care is extremely important for healthcare facilities, especially in medical hubs such as Phoenix. They must keep up with the latest innovations and the increasing volume of patients to live up to their reputation.
However, Arizona has been facing one of the worst medical staff shortages in the U.S. since the pandemic. In addition to the burnout the global crisis caused, healthcare workers were also underpaid. These factors left them feeling undervalued.
As a result, many healthcare staff resigned, which might have forced medical specialists to handle administrative tasks and duties outside their line of work. This overwork led to lower-quality patient care.
Outsourcing takes administrative tasks off their plate. Thus, clinicians can redirect their time and energy toward what they do best—providing premium medical treatment.
The benefits of outsourcing administrative support for healthcare extend beyond operational productivity and cost savings. This strategy allows for the benefits below:
- Shortened patient wait time
- Improved financial experience for patients
- Enhanced patient data security
- Reinforced medical care
- Increased overall patient satisfaction
Commonly Outsourced Healthcare Administrative Support
Outsourced administrative support covers many essential healthcare procedures. Below, we list the four most common healthcare BPO services in the Phoenix medical field.
Healthcare Information Technology (IT)
Efficient healthcare IT is the key to successful medical practices, which is why it is one of the most outsourced services in Phoenix.
This process utilizes computer systems, software, and networks to improve the delivery and quality of medical services. It achieves this goal by streamlining the following tasks:
- Data storage
- Dara sharing
- Data analysis
- Appointment scheduling
- Medical billing
Healthcare IT provides clinicians with quick access to medical records and tools to help them make more informed decisions. It also helps improve patient satisfaction by offering easy methods to manage their medical information.
Outsourcing IT support helps healthcare organizations access expertise they might not have in-house, reduce costs by automating tasks, and improve overall IT system reliability and efficiency.
Medical Coding and Billing
Medical coding is a complex healthcare process. It requires specially trained experts with comprehensive knowledge of the different numeric and alphanumeric codes used in the billing process, such as the following:
- Healthcare Common Procedure Coding System (HCPS)
- International Classification of Diseases (ICD)
- Current Procedural Terminology (CPT)
By outsourcing this administrative support task, healthcare providers can easily avoid delays and errors in billing, saving them time and money. As mentioned above, these third-party professionals have the resources, skills, and experience to perform coding tasks to a high standard.
Processing medical insurance claims is a tiresome undertaking. Typically, the procedure is lengthy, and the wait time for adjudication takes even longer. Claims processing involves the following steps:
- Submission: The insured patient or healthcare provider submits a claim to the insurance company.
- Registration: The insurance company registers the claim and assigns it a unique identifier.
- Triage: The insurance company triages the claim to determine its priority. Claims involving emergency care or severe medical conditions take higher priority.
- Review: The insurance company reviews the claim to confirm it is complete and accurate. It might also contact the healthcare provider to request additional information.
- Adjudication: The insurance company adjudicates whether the policy and the amount of reimbursement owed to the insured cover the claim.
- Payment: The insurance company pays the insured patient or healthcare provider.
Considering the number of patients healthcare organizations cater to daily, keeping up with these processes can overwhelm daily operations.
Thus, most facilities outsource claims processing. Aside from reduced costs and increased efficiency, this approach also lessens the risk of fraud while improving compliance.
Medical Answering Services
Urgency is vital in any healthcare practice, but medical professionals can’t always take calls. This gap is why medical answering services are popular among the outsourced administrative support functions available for Phoenix-based healthcare organizations.
According to the United States Census Bureau, the city has an estimated 42.7% Hispanic and Latino population. Therefore, it’s beneficial for Phoenix-based medical facilities to outsource these services to English- and Spanish-speaking countries such as Mexico.
With a bilingual team to cover medical answering tasks, ensuring clear communication between patients and medical professionals is much easier.
Fortunately, some Phoenix-based BPO firms, such as Unity Communications, have operations in Mexico. Clients can enjoy these benefits when they partner with us for their healthcare outsourcing needs.
Challenges Faced by Healthcare Administrators in Phoenix
Like the rest of the industry, Phoenix-based healthcare organizations face challenges with in-house administrative management. As service demand increases with the city’s growing popularity as a healthcare and biomedical hub, so do administrative work and issues.
Here are the common problems they encounter:
- Widespread staff shortage: The healthcare industry needs more qualified healthcare workers, including nurses, physicians, and administrators. Medical organizations might find recruiting new talent and retaining their top-performing staff challenging.
- High patient volume: With the city’s reputation, many people visit or relocate to the area for premium medical aid, increasing the demand for healthcare services. This increase in patient volume, paired with the decrease in the workforce, is a combination that hurts patients and organizations.
- Long and irregular working hours: A medical professional’s duties can be stressful. Staff shortages and high service demands also lead to longer operating hours. Working overtime and irregular shifts can lead to burnout among clinicians, decreasing productivity while increasing errors and even resignations.
- Limited budget: Increasing operating expenses, rising staff costs, and inadequate reimbursement rates are among the most significant financial challenges facing healthcare administrators today. They must find a workaround to manage these restraints while providing accessible and affordable healthcare.
These challenges can be easily solved by outsourcing additional staff. Hiring third-party providers is less expensive than employing an in-house team. Phoenix hospitals can hire more support staff to accommodate higher patient volumes, leading to more stable working hours and fewer cases of burnout.
How to Start Outsourcing Administrative Support for Phoenix Healthcare
From setting definitive agreements to ensuring clear communications, healthcare BPO necessitates give-and-take. To ensure the success of your healthcare process outsourcing endeavors, you must start by finding the right partner.
Here are some steps to get you started:
1. Assess Your Healthcare Facility’s Needs
Outsourcing requires careful planning and research of Phoenix’s unique healthcare landscape and the challenges specific to the area. So identify the tasks and processes you think can benefit from outsourcing.
Determining how long you intend to employ a BPO team is also essential. This information can help you set more precise expectations, specifications, and requirements.
2. Identify Your Pay Rates
Before contacting a BPO firm, determine whether you are willing to pay hourly or project rates for your third-party support team. Fixed billing helps you stay on budget.
However, with the seasonal demand fluctuations in Phoenix’s healthcare scene, you might want to consider hourly pricing. This model can save you labor costs during low-volume periods.
3. Research Local Providers
Explore the medical BPO landscape in Phoenix. Communicating with a firm in the same vicinity is easier since your point of contact is more familiar with your conditions and the challenges facing Phoenix healthcare organizations.
Make a list of providers you think match your needs. Then, compare factors that might affect your choice of BPO firm, such as reputation, track record, and available services.
4. Communicate Your Needs Clearly
When contacting healthcare BPO firms, be straightforward with your terms, timelines, rates, and expectations. Do not be afraid to go into details to avoid misunderstandings, which can be costly if left unaddressed.
Efficient administrative operations are the key to enhanced patient care and experience. Honing these processes is essential with the constant development of Phoenix’s healthcare scene.
Healthcare process outsourcing offers comprehensive solutions for facilities, from healthcare IT and billing to claims processing and multilingual customer service. Ultimately, it is a great way to overcome the increasing challenges in the field.
Let’s connect if you want to outsource administrative support for your healthcare facility in Phoenix. Our experience in healthcare process outsourcing and pool of professionals can help you keep up with the increasing service demands in the city.