All about healthcare BPO (services, trends, top companies)

by Andy Nguyen
healthcare bpo

Want to learn about the healthcare BPO industry and how it can help your company?

Today, tons of healthcare organizations are turning to business process outsourcing to manage their day-to-day activities.


With lower costs and increased efficiency, it’s the perfect solution for any healthcare company looking to step things up.

In this article, we’ll cover everything you need to know about healthcare BPO to help your company benefit from it.

This article contains:

(Click on the links to jump to a specific section)

What is healthcare BPO?

Healthcare business process outsourcing is an activity where a healthcare provider contracts its non-core activities to an external party. Rather than doing the work themselves, the healthcare company hires a third-party firm to perform the job for them.

While companies usually outsource their activities to dedicated outsourcing firms, some choose to outsource to freelancers directly.

Why do businesses do this?

Outsourcing non-core work lets healthcare facilities and hospitals focus on their core competencies. Outsourcing services like medical billing and marketing services help healthcare providers solely focus on what they do best — treating their patients effectively.

Where can you outsource to?

Generally, people view outsourcing as contracting work to a third-party in a foreign country. For example, many companies outsource medical billing services to third-parties in countries like India to save costs.

However, you can also outsource these jobs to providers within your own country (but you probably won’t save as much money by doing so).

Three common healthcare BPO services

The healthcare BPO sector handles a variety of activities ranging from data entry to medical claims processing services.

Here’s a closer look at some key healthcare provider services that you can outsource:

1. Medical coding and billing

Hospitals and healthcare professionals process tons of medical records everyday. However, unlike other industries where coding and billing is a fairly straightforward activity, medical coding and billing can be complicated.

You need to be familiar with various scientific codes that are used in medical bills and records like:

  • ICD (International Classification of Disease)
  • CPT (Current Procedural Terminology)
  • HCPCS (Healthcare Common Procedure Coding System)

That’s why you need specially trained staff to deal with these records. Without the right knowledge and expertise, you will face significant delays and errors in processing your patient bills and records.

To prevent any coding and billing hiccups, why not outsource the job to an expert service provider?

As they’re professionals, they’re already well-equipped with the necessary resources to do the job accurately and efficiently. This lets you focus on tasks that really matter to your company, like medical research, patient treatment and care.

2. Claims processing

Processing patient claims is a critical healthcare activity. Your patients need to have accurate medical claims for their insurance companies, right?

But when there are hundreds of claims to be processed every day, how do you maintain accuracy on every single one?

To ensure that your patient claims are in check — why not outsource it to a service provider?

They have skilled workforces and technologies to process large volumes of medical claims seamlessly. Also, as this is all that they’ll be focusing on, you won’t have to worry about distractions clouding the accuracy of the claims.

3. Data entry services

In addition to treating their patients, healthcare providers have to process and update large volumes of medical data everyday.

They need to manage data like:

  • Tests and lab reports.
  • Prescriptions and drug inventory.
  • Patient insurance details
  • Other hospital records.

Outsourcing your data entry activities will help you free up time and resources for your other core healthcare activities. While data entry is usually the safest activity to outsource as it’s relatively simple, remember to only outsource it to a proven healthcare BPO.


Medical data entry can be far more technical than most other fields and you need a professional to handle it for you.

outsource healthcare

Three reasons to outsource your healthcare activities

A 2019 case study of current market trends in the healthcare system showed that the global healthcare BPO market would reach USD 449,623.8 million at a 12.3% CAGR in the forecast period till 2023.

In other words, the healthcare BPO industry is going to grow exponentially over the next few years.

But why is the healthcare industry looking to outsource so much now?

What caused this?

Here are three key reasons why:

1. Helps you focus on your core competencies

One of the primary benefits of outsourcing is that it lets companies focus on their core activities.

Healthcare BPO lets healthcare companies outsource:

  • Managing bills.
  • Processing claims.
  • Logging data entry.
  • Resolving patient disputes.

As they no longer have to manage that themselves, they have more time and resources to focus solely on patient care. This helps them improve their customer experience, which will increase their reputation — helping them get more customers in the long run.

Also, in the case of billing disputes, patients can directly engage with the staff of the service provider. As you don’t have to deal with this yourself, you can solely focus on your core competencies.

2. You get access to specialists at a lower cost

Most companies outsource their non-core activities to reduce their business expenses.

For example, many healthcare companies outsource activities to countries like the Philippines.


With talented workers at lower wage rates, you can save costs without compromising on quality!

Also, as these are trained professionals, you won’t have to worry about any mix-ups happening.

3. Improves patient experience

As healthcare BPO allows companies to focus on providing better patient care, patients also benefit from it.

As your staff is no longer managing tons of different activities, they’ll be able to dedicate more time to patient care.

Think about it.

Your staff is no longer overburdened with processing claims and entering bills. They can simply focus on attending to your patients and giving them what they need!

Three things to look for in a healthcare BPO partner

There are tons of BPO companies to choose from.

So how do you choose the right one?

To help narrow down your options, only look at healthcare BPO partners who have:

1. HIPAA compliance

Any healthcare BPO firm you would work with must be 100% HIPAA compliant.

Why does it matter?

As the healthcare sector is mostly digitized, there are tons of privacy concerns over patient data.

The Health Insurance Portability and Accountability Act (HIPAA) regulates how companies handle patient data. Any medical company or health practitioner violating this law can face serious criminal charges with fines up to $50,000 per violation.

To be HIPAA compliant, BPO companies must have strict security measures in place to protect patient data. Hiring a service provider that’s HIPAA compliant will ensure that your patient’s information never gets into the wrong hands.

2. Proven healthcare expertise

Healthcare BPO firms differ from other BPO companies.

Unlike regular BPO firms, healthcare BPO companies have to go through rigorous rounds of training to ensure that they know what they’re doing. They should know medical codes, have department-specific knowledge and follow government laws and regulations.

Before deciding on a healthcare BPO provider, you need to verify their expertise by:

  • Comprehensively analyzing them just as you would when hiring employees.
  • Checking online reviews, ratings and getting referrals from industry peers.
  • Checking if they have an excellent track record that balances professionalism and cost.

Remember, if a service provider has had success in this field before, chances are, they can help you find success too.

3. Performance monitoring measures

Healthcare activities like claims management and billing are incredibly important and need your complete focus. If you’re distracted while performing them, you’ll make mistakes — leading to tons of patient issues.

But when your healthcare BPO partner is thousands of miles away, it’s hard for you to know if they’re focused on their work, right?

You don’t know:

  • How productive they are.
  • If they pass idle-time as work hours.
  • If they’re only working on your tasks during their work hours.
  • If your tasks actually took that long to complete.

While you should ideally look for a BPO partner that has some monitoring procedures built-in, that’s not always possible.

Luckily, there’s a solution to this.

Just use performance monitoring software like Time Doctor.

What’s Time Doctor?

Time Doctor is a powerful performance tracking tool that’s used by PwC and KPMG.

It lets you:

  • Monitor the working hours of your outsourced staff.
  • Track the time they spend on your activities.
  • Identify poor-time usage and hold the provider accountable.
  • Prevent your outsourced staff from getting sidetracked with other activities.

time doctor

Here’s a closer look at how Time Doctor helps you:

1. Accurate project records

The tool accurately tracks the hours your outsourced healthcare team spends on projects to help you identify who’s worked on each task and for how long.

Time Doctor’s Projects Report gives you a detailed breakdown of hours spent on each task. As these reports are accurate to a second, you can use it as a reliable record to pay your service provider on an hourly basis.

time doctor projects report

2. Ensure that your outsourced staff is actively working

You can’t have your outsourced team pass off idle hours as hours worked, right?

Fortunately, Time Doctor has a built-in inactivity tracker.

It tracks idle time by monitoring keyboard and mouse movements. If an employee is inactive for three minutes, the tool auto-displays a pop-up, asking them if they’re still working. If there is no response to this alert, the tool automatically puts them on a break.

This way, they can only log active hours as hours spent on your project.

Note – Time Doctor does not track which keys were pressed for privacy reasons. It simply determines if any keys were pressed or not.

time doctor distraction management

3. Monitor their web and app usage

Worried that your outsourced staff is visiting non-work related sites during work hours?

With Time Doctor, that’s not an issue.

Whenever they access an unproductive site during work hours, the app displays a pop-up asking them if they’re still working or not. This nudge is usually enough to get them back to work.

time doctor nudge

With Time Doctor’s Web and App Usage Report, you’ll also know which websites and apps were used by each employee and how long they spent there.

web and app use report

4. Instantly integrate with workplace software

Time Doctor seamlessly integrates with tons of workplace tools to help you streamline your healthcare activities. You can connect it to your communication software, payment apps and help desk tools for added flexibility.

time doctor integrations and addons

Here’s a complete list of Time Doctor’s integrations.

The top five global healthcare BPO providers

Here’s a list of the top five healthcare BPO providers to help you get started:

1. Accenture


Accenture is a global leader in providing cost-effective healthcare services. It offers medical and administration services in more than 45 countries, including India, the Philippines and the United States.

Key healthcare BPO services:

  • Medical billing and account services.
  • Claims processing.
  • Medicare services.
  • Pharmacy benefits management.
  • Cash flow improvement analytics.

2. Invensis


With over 16 years of experience, Invensis offers global services for healthcare BPO and patient support. The company is HIPAA compliant and is also ISO 9001 and 27001 certified.

Key healthcare BPO services:

  • Medical coding and billing.
  • Claims processing.
  • Data entry services.
  • Revenue cycle management (RCM).
  • Payment posting and charge entry services.

3. WNS Global Services

WNS Global Services

WNS provides an array of healthcare services that cater to the needs of companies across the world. They also offer technology solutions to increase healthcare providers’ market shares.

Key healthcare BPO services:

  • Medical transcription.
  • Medical coding and charge preparation.
  • Follow-ups and payer services.
  • Medical equipment supply chain.
  • Patient care management.

4. Cognizant


A US multinational corporation, Cognizant provides cutting-edge healthcare services and outsourcing solutions.

Key healthcare BPO services:

  • Health intelligence and analytics.
  • Clinical services and data integration.
  • Revenue cycle management.
  • Patient care and administration systems.
  • Help desk services.

5. Octopus Tech Solutions


Octopus Tech is a leading Indian BPO service provider with clients in Australia, Europe and the US. It offers services and solutions that streamline healthcare provider management.

Key healthcare BPO services:

  • Insurance claim processing.
  • Billing and collection services.
  • Medical transcriptions.
  • Pharmaceutical services.
  • Doctor on-call services.


Healthcare BPO outsourcing can help you save time and money while giving your patients the care they deserve.

However, this isn’t something you can do overnight.

Carefully identify the activities you want to outsource and evaluate your healthcare BPO partner before getting started. Once you do, you’ll have no trouble finding a setup that works for your business!

Have any more questions and concerns about healthcare BPO? Let us know in the comments below.

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