Amid dwindling bottom lines and spiraling costs, the healthcare industry is accosted with a spate of challenges such as:
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Stifling Statutory regulations
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Physicians compensations not satisfactory
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Increase in the Healthcare expenses
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HIPAA regulations
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High energy costs
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Lack of adequate manpower & skill sets required for reports, analytics & implementation of disease management
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High dependence on charities & donations for medicare assistance to patients
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Loss of over USD 20 billion in write-offs due to the absence of any standard policies & procedures in billing and collections
HCL provides assistance to healthcare providers through strong compliance programs and improved technology, finance and revenue cycle efficiency and effectiveness, resulting in improved operational performance and lower costs.
HCL’s team of subject matter experts understands the challenges faced by healthcare providers. Our professionals help providers achieve growth and profitability through effective risk management in the following areas:
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Marketing Intelligence and Analytics |
Patient Access Services |
Revenue Cycle Management |
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Medical-clinical content analysis |
Pre-registration |
Payment reconciliation |
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Patient base analytics |
Insurance Verification |
Payment posting |
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Utilization and pay for performance analytics |
Scheduling |
Payment tracking |
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Benchmark reporting |
Title XIX advocacy |
Denial posting and management |
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Legal & mandatory statistics for the Regulatory Reporting |
Financial Counseling |
Refunds |
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Patient financial responsibility determination |
Provider data updates |
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POS collections |
AR analysis and follow-up |
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Patient registration |
Insurance / Self pay follow-up |
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Patient access quality assessment |
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Healthcare Payers Solution
Though it is the earnest desire of every payer to enhance the quality of services they offer, the reality today is different as each day throws up a new challenge. The payers focus on various solutions to reduce the administrative costs, enhance the efficiencies, streamline the business and manage the healthcare costs.
Some of the measures taken by the payers to face these challenges are as follows
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Fraud Reduction
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Healthcare Cost and Administration
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Continual Administrative Cost Reductions and Operational Efficiencies
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Adopting the latest Technology Platforms
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Changing Consumer and Retail Model
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Medicare Modernization Act
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Health Information Networks
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Digital Health Records
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Better Healthcare Document Management
HCL’s service offerings for the healthcare payer and provider industry reflect our deep understanding of industry business needs. We offer comprehensive healthcare BPO services out of India and the US to meet the needs of our clients in an efficient and cost effective manner.
We offer services to the healthcare payer industry including, health claims processing, claims adjudication and mailroom services.
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Policy Administration |
Claims Administration |
Financial Administration |
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Data Entry |
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Product development
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Sales and Marketing
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Rating and underwriting
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Benefits administration
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Membership
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Provider network Management
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Pricing Management
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Claims Processing
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Medical Management
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Billing
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Cash application
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Corporate financials
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Capitation
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Payables Management
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Voice Services |
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Research |
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Configuration |
