As COVID-19 continues to surge, the healthcare industry remains battling more and more challenges. One of the challenges that must be dealt with on behalf of healthcare payers — such as health insurance companies and other plan providers — is recovering money. In many cases, inefficient or poorly coordinated internal processes could mean funds are slipping through these payers’ fingers every day.
To provide some context, just about 80% of pharmacy compliance audits uncover some form of potential opportunity for recovery. In some instances, millions of dollars are waiting to be claimed. Understanding the difficulty of this process makes it easier to consider just how difficult it is to recover as much money as possible without negatively impacting an organization’s daily operations. In what way 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 Right Partner For The Job
Many healthcare payers have realized that devoting their own resources to these time-consuming tasks can only make the situation worse. Which is why many companies in the healthcare sector instead went the route of hiring a reliable business process outsourcing (BPO) partner. With the help of their advanced technology and proven techniques, the right BPO provider can ensure that their clients recover their money in the most efficient and cost-effective manner possible. With several services available to their disposal, these businesses can hire these partners for a whole suite of services that ease the burden.
One of the major categories of these services are known as subrogation services. Subrogation services can ensure that the healthcare costs linked to medical and disability expenses related to accidents and injuries are being paid by the proper liable party. When these types of situations are handled by an outsourced party, internal delays and confusion can be reduced. Retail pharmacy operations also benefit from these service providers, as pharmacy audits can help identify which costs should be contained, while simultaneously offering a comprehensive oversight and defense against fraud and abuse. In some cases, a BPO provider can even act as an extension of the payer’s business office to maximize overpayment recoveries and strengthen relationships with healthcare providers.
Selecting the right BPO partner can be exactly what your organization needs to aid in its recovery efforts. When lifting the burden of these efforts off your organization, more attention can be placed on things like the organization’s core mission and prioritizing a healthy life balance for staff. For more information on how Conduent, a leading BPO provider specializing in payment recovery, can aid your organization, take a moment to review the infographic coupled alongside this post.