Sunday, October 7, 2007

BPO companies to look into healthcare


Indian software services BPO companies are setting their sights on the healthcare outsourcing market. Hospitals and large physician groups in the US outsource activities such as patient records, handling claims, medical policies for the government and third party administrators TPAs, so that hospitals do not have to bear these overheads.

Indian BPOs, which earlier forayed into the healthcare segment through medical transcription, which involved necessary documentation to satisfy regulatory and insurance provider requirements, are now looking at high end outsourcing contracts.

Recently, companies like Wipro, Firstsource and Apollo Health Street, the BPO arm of the Apollo Group, have acquired companies in the US to grab a lucrative share of the healthcare market.

Healthcare outsourcing deals cost US Dollar30 to 60 per hour, which is three times more than normal BPO work, Canaan Partners Alok Mittal said.

Apart from the higher dollar billing rates, the size of the healthcare outsourcing market is also huge. The size of the US hospital care market is around US Dollar700 billion and administrative costs are estimated to be around 14 per cent or US Dollar100 billion, Ananda Mukerji, managing director, Firstsource, said.

Sensing this market potential, Indian companies are positioning themselves as an end to end service provider Our Infocrossing acquisition would enable us to bring in expertise in health plan and payer management segments, Suresh Vaswani, president, Wipro technologies, said.

Explaining the strategy behind Indian companies acquisition spree, an analyst from a leading brokerage house said earlier Indian players used to get sub contracts from hospitals and TPAs, whereas now can get these contracts directly through acquisitions in the segment.

Another area of business that Indian companies are eying along with the BPO part is the infotech business, which could give them more predictability in generating future revenues.

This acquisition in the US comes with a significant IT business, Apollo Health Street, managing director, Sangita Reddy said.

Friday, September 28, 2007

TOP TEN BPO ADVISORS


1. Morgan Chambers

http://www.morganchambers.com

2. NeoIT

http://www.neoit.com

3. TPI

http://www.tpi.net

4. Equaterra

http://www.equaterra.com

5. Alsbridge

http://www.alsbridge.com

6. Everest Group

http://www.everestgrp.com

7. Pace Harmon

http://www.paceharmon.com

8. Ovum Orbys.com

http://www.orbys.com

9. Quantum Plus

http://www.quantumplus.co.uk

10. Marakon Associates

http://www.marakon.com

source :black book of outsourcing

Top Healthcare Payors List - U.S

healthcare Association

HBMA
Healthcare Billing & Management Association (HBMA)
Founded in 1993, the Healthcare Billing & Management Association (HBMA) is the only trade association representing third-party medical billers. HBMA members process physician and other provider claims integral to the health care delivery system.
RBMA
Radiology Business Management Association (RBMA)
The Radiology Business Management Association (RBMA), founded in 1968, is the only radiology-specific business organization in existence today. RBMA is dedicated to providing managers with information, resources, education and networking to run a successful radiology business.
HFMA
HFMA is the nation's leading membership organization for healthcare financial management executives and leaders. It is a respected thought leader on top trends and issues facing the healthcare industry.

Sunday, September 16, 2007

BPO Agreement

How to Draft an Outsourcing Agreement, BPO Agreement, KPO Agreement?

Outsourcing is the contracting out of a company's non-core, non-revenue producing activities to specialists. It differs from contracting in that outsourcing is a strategic management tool that involves the restructuring of an organization around what it does best - its core competencies.

Two common types of outsourcing are Information Technology (IT) outsourcing and Business Process Outsourcing (BPO). BPO includes outsourcing related to accounting, human resources, benefits, payroll, and finance functions and activities. Knowledge Process outsourcing (KPO) includes outsourcing related to legal, paralegal, and other highly skilled activities.

A good outsourcing agreement is one which provides a comprehensive road map of the duties and obligations of both the parties - outsourcer and service provider. It minimizes complications when a dispute arise. However, many a times people neglect to pay attention while drafting an outsourcing agreement.

Before finalizing an outsourcing agreement, the terms should be thoroughly discussed and negotiated to avoid any misunderstanding at a later stage. Lawyers from all applicable jurisdictions must be consulted before finalizing any outsourcing agreement.

Before signing an Outsourcing Agreement the following must be properly addressed:

  • Duties and obligations of Outsourcer
  • Duties and obligations of service provider
  • Security and confidentiality
  • Legal compliance
  • Fees and payment terms
  • Proprietary rights
  • Auditing rights
  • Applicable law to outsourcing agreement
  • Term of the Agreement
  • Events of Defaults and Addressing
  • Dispute Resolution Mechanism
  • Time limits
  • Location of Arbitration
  • Number of Arbitrators
  • Interim measures/Provisional Remedies
  • Privacy Agreement
  • Non-compete Agreement
  • Confidentiality Agreement
  • Rules Applicable
  • Appeal & Enforcement
  • Be aware of local peculiarities

Every outsourcing agreement should be modified as applicable under different circumstances. One brush should not paint all the painting. Offshore outsourcing is a legal minefield and many companies are not aware of the problems it causes. Of the 18 areas in a standard contract 15 need to be changed if the outsourcing provider is abroad.

Healthcare Bpo Solution

  • Revenue cycle management
  • Medical coding
  • Medical billing
  • Accounts receivables management
  • Claims and payroll processing
  • Teleradiology
  • Remote diagnosis (Sleep study, ECG interpretation)
  • Electronic medical records (EMR)
  • Healthcare data analytics

Introduction to healthcare BPO

Introduction

  • As healthcare provider organizations wrestle with improving revenues while providing high-quality care, there has been a lot of conversation about Business Process Outsourcing (BPO) and Revenue Cycle Management (RCM) – with emphasis on back-end billing

  • By taking a more holistic front to back-office approach, a true BPO solution can bring significant value to an organization by reducing administrative costs, increasing collection levels and dramatically lowering its percentage of aged receivables

Facts & Figures

  • The net spending of US healthcare industry in outsourcing was US$ 29.5 billion in 2003-04
  • In the first half of 2006 alone, the US healthcare industry accounted for 7.2% of the total outsourcing market value without restructuring, compared to 3.4% in all of 2005 and 1.6% in all of 2004
  • However, the Indian service providers accounted for only US$ 225 million worth of offshore outsourcing contracts during 2005-06
  • Claims processing and revenue cycle management are the major processes outsourced from US

The Problem

  • Growing demand for affordable healthcare at a time when medical costs are increasing
  • Increasing operating back-office costs and human resources
  • Complying with HIPAA standards (Automate entire provider services) and Pay-For-Performance initiatives etc
  • Chronic shortage of nurses, physicians, radiologists and other specialized staffing
  • Financial strain of providing healthcare services to some 44 million uninsured citizens

Friday, June 22, 2007

Hi Guys,This is yogesh from Chennai, India. I've been in this Industry for some time now and thought of having an open channel of communication with people in the same industry. With this idea in mind, have created this blog titled Healthcare KPO to enable people from different parts of the world, who are involved in a similar industry, to share their views, thoughts and knowledge about this field.Hope to have all your support...Thanks,Yogesh