Outsourcing health insurance claims processing has become a strategic move for many insurance consulting firms in the U.S. This approach not only streamlines the reimbursement process but also offers significant cost savings, improved efficiency, and the ability to scale operations rapidly.
By partnering with an experienced provider like Big Outsource, firms can leverage the skills of Filipino talent, known for their exceptional quality and dedication, to enhance their claims processing functions.
Let’s explore the benefits of outsourcing health insurance claims processing and how Big Outsource plays a pivotal role in this transformation.
Health Insurance Claims Processing Issues in the U.S. & Current State of the Insurance Market
The shocking truth in the U.S. insurance claims processing is that it is the second most costly aspect of healthcare in the United States. A black hole of waste, errors, and even fraud absorbs billions of dollars, raising the cost of healthcare and making it more difficult for everyone to access.
According to studies, claims processing cost $210 billion in 2009, ranking the second largest source of “wasted” healthcare dollars in the United States. In 2019, the figure had risen to an estimated $265 billion.
Consider this: a maze of regulations, billing codes, and coverage policies that even experienced professionals struggle to understand. With piles of paperwork, outmoded systems, and the constant threat of fraud, it’s no surprise that claims are lost, delayed, or wrongfully denied.
Here is where outsourcing companies like Big Outsource can help. You now have an ally to help address the challenges faced in US health insurance claims processing. They can offer solutions that range from cost reduction to improved efficiency and accuracy.
The Benefits of Outsourcing Health Insurance Claims Processing
Outsourcing can effectively address challenges with US health insurance claims processing, with solutions ranging from cost savings to enhanced efficiency and accuracy:
Cost Efficiency
Outsourcing claims processing to locations with lower labor costs, such as the Philippines, can help healthcare providers and insurers save administrative costs. This allows them to devote resources more effectively to patient care and innovation.
Big Outsource provides significant cost savings by basing its operations in the Philippines, where labor costs are significantly lower than in the United States. This enables you to cut administrative costs and manage resources more effectively.
Access to Expertise and Scalability
Outsourcing gives you access to a professional workforce specializing in medical coding, billing, and claims processing. This experience, combined with the ability to scale operations up or down as needed, ensures that claims are processed efficiently, particularly during peak periods.
Our staff comprises highly skilled experts with considerable experience in medical coding, billing, and claims processing. They keep up with the latest legislation and coding guidelines, ensuring correctness and compliance. Our scalable solutions enable you to change the number of staff you need based on changing claim volumes, ensuring efficient handling even during peak periods.
Technology Adoption
Outsourcing partners regularly invest in cutting-edge technologies, such as automation, artificial intelligence, and machine learning, to streamline claims processing. This can result in shorter turnaround times, fewer errors, and more accurate fraud detection.
Big Outsource leverages cutting-edge technology such as automation, AI, and machine learning to accelerate claims processing, leading to shorter turnaround times, fewer errors, and better fraud detection.
Focus on Core Skills
Outsourcing claims processing allows healthcare providers and insurers to free up internal resources to focus on their key competencies, such as patient care, research, and development.
We have a pool of specialists focusing on their specialized skills, such as patient care, research, and development.
Improved Accuracy and Compliance.
Specialized outsourcing companies follow tight quality control techniques and are up to speed on the latest standards and coding requirements. This reduces errors, ensures compliance, and minimizes claim denials. Our stringent quality control systems and commitment to industry best practices reduce errors and maintain compliance, resulting in fewer claim denials and better revenue cycle management.
Guaranteed 24/7 Operations
Outsourcing enables round-the-clock claims processing, resulting in reduced turnaround times and increased patient satisfaction. Our 24/7 operations ensure faster turnaround times and higher patient satisfaction.
Data Security and Privacy
To protect sensitive patient information, reputable outsourcing organizations have strong data security and privacy policies in place. We value data security and privacy, following strict policies and industry standards to safeguard sensitive patient information.
Claims Processing Services that Big Outsource Offers
In the intricate landscape of healthcare billing, efficient and accurate claims processing is paramount for healthcare providers to receive timely and proper reimbursement. Here are some services you can offload:
- Medical Coding: Correct medical coding is necessary for accurate bills and reimbursement. Big Outsource has extensive experience in data entry outsourcing and has a pool of very skilled coders with the relevant medical knowledge needed to ensure that all claims are coded properly and reduce denials and rejections as much as possible.
- Billing: Our billing services make it easier to send reports to insurance companies, which cuts down on wait times and raises the chance of getting paid on time.
- Eligibility Verification: Making sure a patient is eligible for services before they are given can help avoid delays and rejections that aren’t necessary. Big Outsource does a good job of making sure that all of the services provided are covered by the patient’s insurance plan by checking their qualifications.
- Payer Contracting: It can be hard to understand and take a lot of time to deal with payer contracts. Our experienced teams help negotiate and manage client contracts to get better terms and make the claims process go more smoothly.
- Denial Management: Dealing with claims that are turned down is an important part of getting reimbursed. Big Outsource’s denial management services focus on finding out why claims are being denied, fixing the problems, and quickly submitting claims to get paid.
Streamlining Health Insurance Claims Processing with Big Outsource
Big Outsource provides a full range of health insurance claims handling services that are meant to make administrative tasks easier and speed up the revenue cycle. With our skills and experience, we make every step of the process easier, from making sure that medical codes are correct to figuring out complicated insurance contracts.
With our services, healthcare providers can focus on giving great care to their patients while knowing that their claims are being processed by our specialty services. Correcting issues, and resubmitting claims promptly to secure payments.
Outsourcing health insurance claims processing offers a strategic advantage for U.S. insurance consulting firms looking to streamline operations, reduce costs, and enhance service quality.
Schedule a consultation with Big Outsource so you can tap into the exceptional talent pool in the Philippines, benefiting from our expertise, commitment to excellence, and cost-effective solutions.
With Big Outsource, you can be confident that your claims processing needs are in capable hands, allowing you to focus on growing your business.
