How Healthcare Call Center Services Helps Hospitals with Revenue Cycle Management

The Healthcare industry is customer-centric, and the hospitals and small facilities are accountable for treating patients with care and saving lives. However, other than medical facilities, a healthcare system must also have impeccable financial policies and management systems to stay financially strong. That is where revenue cycle management comes into action. Like most organizations, hospitals and medical institutions also outsource most of their services to keep their in-house staff free from non-core jobs. The commonly outsourced activities that a healthcare BPO undertakes are emergency call support, virtual reception support, tele-pharmacy services, appointment booking, physicians’ referrals service, and medical billing. Medical coding and billing are highly specialized services that most call centers don’t offer. But with an increasing demand for outsourced revenue cycle management services, more and more healthcare BPO companies are hiring medical coders and medical terminologists.

What is RCM or healthcare revenue cycle management?

As, healthcare revenue cycle management or RCM is the process of managing financial processes of a hospital or large healthcare systems by taking care of functions like payments, pharmacy billing, claim processing and profit generation. It follows a systematic approach of identifying, managing and collecting service charges from patients, vendors and associates with pending invoices.

The continuous inflow of cash helps hospitals run smoothly with seamless administration and deliver superior treatments to patients. Healthcare RCM mainly focuses on collection of bills.

Through the next sections, we will explore how can a medical call center help hospitals and clinics with Revenue Cycle Management or RCM.

What is the role of Healthcare Call Center Services in Claims Processing?

A critical activity in healthcare is patient claim processing. Patients who have medical insurance must provide proper claims for their medical coverage from insurance companies. However, with hundreds of claims pending every day, it is hard to maintain correctness on every single claim. To ensure proper and faster insurance claims, you can outsource claim processing to a healthcare BPO service provider.

With the necessary resources and workforce, the specialized teams can process large volumes of healthcare claims. You have the least to worry about cloudy claims. The faster the claims process, the faster the revenue comes in.

What is the role of Healthcare BPO in Medical Billing and Coding?

Keeping medical records updated is a herculean task. Every day, hospitals have to process hundreds of medical records. In healthcare sector, medical billing and coding is not a straightforward activity, unlike other sectors. There are complicated and minute details to be considered. Dedicating a team of medical staff for billing and coding is a cumbersome job as hiring and training new joiners eats up a lot of time and investments. Most in-house staff are assigned to look after the needs of the patients. This is why you need dedicated processes with specially trained staff for medical billing and coding. Otherwise, delays and errors can hinder your revenue cycle management.

To prevent such hiccups, healthcare BPO companies are there. The COVID-19 crisis has increased the demand for medical billing outsourcing because hospitals, clinics and medical institutions were running short of internal staff.

Professional Healthcare call centers are equipped with the necessary software, employees and permits to handle the job efficiently. In the meanwhile, the in-house staff can focus on core operations, medical research and patient care.

What is the Role of Medical Call Center in Data Processing?

Apart from providing treatment to patients, healthcare givers have to handle medical data processing and updating in large volumes. Managing the job every day becomes tedious for any healthcare organization. There are data like:

• Firstly, tests and lab reports
• Secondly, prescription and drug inventory
• Thirdly, patient medical insurance claim papers
• Finally, Additional hospital records

And, outsourcing data entry and data processing activities to a call center helps hospitals to manage internal resources better. It is usually the safest function to outsource because the process is simple. But it would help if you chose only an experienced healthcare BPO provider.

What is The Role of Medical BPO in Meeting Compliance Standards?

It is crucial to protect patients’ sensitive information from confidentiality violations. Medical call center works closely with the hospitals or clinics to ensure Healthcare Information Portability and Accountability Act is always met.

Why is HIPAA crucial to patients?

although, HIPAA is crucial to patients because it makes sure that healthcare givers, healthcare programs and schemes, medical insurance companies, and related service providers are accountable for any privacy breach. They have to pay penalties if someone leaks a patient’s details. HIPAA complaint is multiple-layer protection that imbibes trust among patients and their family members.

As your outsourcing partner, it is the duty of the BPO to amend the rules of HIPAA and never do anything that puts patients’ or hospitals’ information at stake.

Revenue cycle management becomes easy when it allows all mandates, and HIPAA compliance is met.

What is The Role of Healthcare Call Center in Maintaining Constant Revenue Flow?

At last, for hospitals and clinics, maintaining a constant inflow of revenue is not an easy task. The healthcare BPO streamlines the process and submits error-free claims, looks after pending invoices, and collects payments on time; promising revenue growth for hospitals.

Conclusion

Concluding, Healthcare revenue cycle management continues to evolve and keep pace with rapid changes to the healthcare ecosystem, such as new technology development, value-based care, and global pandemic. Healthcare providers should always be aware of their revenue cycle status to provide best care to patients and receive proper reimbursement for services. Hiring a healthcare BPO service provider helps in achieving this goal.