A Breakdown Of Payment Recovery Solutions Used By Healthcare Organizations

When considering the healthcare spectrum, it’s true that both employees and healthcare professionals struggle. What most people don’t consider is the fact that the other side of that spectrum is also struggling. The organizations that support these healthcare practices, such as healthcare payers and insurance providers, also face some serious challenges. One of their main struggles comes in the form of recovering money. Whether this be related to poorly coordinated internal processes or just an inability to recover certain money, organizations are losing out on a lot of capital. This post will detail the ways in which third-party solutions providers can help your organization get the most out of its payment recovery options.

This is an industry-wide problem, as nearly 4 in every 5 pharmaceutical compliance audits will find generous amounts of money capable of being recovered. For some organizations, upwards of millions of dollars can be recovered with the right strategy. However, it can be difficult for organizations to balance both internal processes and these recovery efforts effectively. Meaning in order to recover all of the lost capital, they’ll likely need to find a business process outsourcing partner to work with.

Customized Solutions Available From A Partnership

Organizations should consider ways in which they can limit their own resources being used to solve these tasks. This is usually accomplished through a business process outsourcing partnership. These organizations use advanced technology in connection with their proprietary techniques to help recover lost money while remaining as cost-effective as possible. No matter the needs of an organization, these partnerships and accompanying services will prove to solve any organization’s woes.

For example, subrogation services ensure that applicable healthcare costs linked to medical and disability expenses related to accidents and injuries are being paid by the proper liable party. This can help cut down on delays and confusion that typically result in such instances. Additionally, a properly managed pharmacy audit can monitor retail pharmacy operations. This not only ensures costs are contained, but also provides comprehensive oversight and deterrence 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.

For organizations with the inability to recover this capital on their own, choosing the right BPO provider can make all the difference. To learn more about the types of services these providers offer related to payment recovery, be sure to take a moment to review the infographic coupled alongside this post. Within it, you’ll find more information on the ways Conduent can help simplify this process for your organization.

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