While many only view healthcare as an industry full of dedicated employees and patients and need, there is a completely different side to the industry. Healthcare payers and insurance companies, for example, make up a large part of what keeps the industry running day in and day out. These organizations face just as many challenges as their healthcare counterparts, but most of these challenges come in the form of attempting to recover money that has been lost in some shape or form. The issue is, many internal processes tend to hold these recovery options up. This post will detail the ways in which a third-party solutions provider can simplify this process.
Just to give an example of the type of struggle these organizations face, approximately 80% of pharmacy compliance audits uncover a potential opportunity for recovery. This means there are potentially millions of dollars just sitting on the table going unclaimed. However, the complexity of the business means it can be extremely difficult to recover as much money as possible without negatively impacting your organization’s daily operations. How can payers continue to keep their track of their audits and recovery efforts while ensuring they don’t get bogged down in the process?
The Process Of Finding The Right Partner
As mentioned previously, a much better use of a healthcare organization’s resources is focusing on their internal processes rather than recovery efforts. Through the right partnership and the right set of advanced technologies, a business process outsourcing partner can ensure the recovery of any lost capital in the most efficient manner. Even healthcare organizations with the most unique needs will be able to be assisted through these services.
A common service offered by these organizations is known as subrogation services. These services are dedicated to ensuring all healthcare costs related to medical and disability expenses in accidents or injuries are being paid by the liable party. Confidence that these expenses are being paid can help organizations reduce delays and any confusion related to these payments. Another common offering is a pharmacy audit. These audits are meant to monitor retail pharmacy operations to keep costs under control and improve the overall understanding of different fraud and abuse possibilities. These BPO providers can even stand in as an extension of a payer’s business to help improve relationships with different healthcare providers.
Choosing a capable BPO partner could be the tool your enterprise needs to cut through the red tape and get more from your recovery efforts. Best of all, this partnership can allow your staff to concentrate on fulfilling your core mission and avoid getting overwhelmed by the recovery efforts.
Hoping to find the right BPO partner for the sake of improving your organization’s internal recovery processes? For more information on the types of payment recovery services offered by Conduent, one of the leading BPO providers in the industry, be sure to take a moment to review the infographic paired alongside this post.