6 Factors to Consider while Choosing a Healthcare BPO

6 Factors to Consider while Choosing a Healthcare BPO

Susan Collins
Susan Collins
November 23, 2023
Last updated on:

November 23, 2023


Read time: 5 mins

A Healthcare BPO partnership is a strategic practice where organizations delegate specific non-core functions or processes to external service providers. These functions encompass critical areas such as medical billing, coding, claims processing, revenue cycle management, and medical transcription, among others. The driving force behind healthcare BPOs is the pursuit of operational efficiency, cost reduction, and unwavering compliance with the intricate web of healthcare regulations. Often, healthcare organizations find it difficult and daunting to effectively handle voluminous administrative and core functionalities. Therefore, they look for the best healthcare BPO partners to focus on their core mission of delivering quality patient care improving overall patient satisfaction.

However, choosing reliable and efficient healthcare BPO partners is another daunting task for healthcare practices. This is because a vendor's capability needs to be evaluated in terms of expertise, experience, reputation, scalability and a host of other equally important factors.  

This blog aims to be a comprehensive guide on healthcare BPO selection. It also aims to empower practices to make informed decisions when delegating key healthcare functions.

According to a report by the markets and markets the global healthcare BPO market is poised to reach $468.5 billion by 2026. 

Choosing the Right Healthcare Partner: Key Factors

Here are the key factors healthcare practices should consider during healthcare BPO selection: 

1. Expertise in Healthcare

Intricate processes and stringent regulatory requirements characterize the healthcare sector. Hence, the BPO partner should possess comprehensive experience and understanding of the specific nuances. This includes a deep knowledge of medical billing, coding, revenue cycle management, and other specialized tasks integral to healthcare operations.

To gauge a BPO partner's expertise in these fields, it's essential to review their track record, client references, etc. Their past performance and the success stories with other healthcare clients also serve as reliable indicators of their proficiency. 

2. Technology & Infrastructure

The technology and infrastructure employed by healthcare BPO providers play a key role in a successful and long-term partnership. 

When evaluating a BPO provider, it's essential to ensure they are equipped with up-to-date systems and platforms. These technologies should be compatible and seamlessly integrated with the practice's healthcare systems.

For instance, one particular requirement should be efficient data sharing and connectivity are vital. It facilitates the smooth exchange of critical information between the practice and the BPO partner. This not only improves the efficiency of operations but also ensures that data is readily available when needed. Like this there are other aspects related to technology that need to be given due consideration.

3. Scalability and Flexibility

When selecting a healthcare BPO partner, it's imperative to consider the growth and changing needs of a healthcare practice. They should look for a BPO provider that demonstrates the ability to scale their services in alignment with evolving requirements. It ensures that when a healthcare practice expands or adapts to industry changes, the BPO partner can seamlessly accommodate these shifts.

Likewise, providers must look for a flexible partner. This means they should customize their services to meet the specific needs of their clients. For instance, there might be a change in workflow, in response to a sudden regulatory requirement. The partner must be adept and responsive enough to take this change in their stride. Likewise, there might be a sudden security challenge to be addressed. A flexible partner will rise to meet the new challenge by implementing and adapting the latest data security measures.

Healthcare BPO vs Inhouse System
Image 1 - Healthcare BPO vs Inhouse System

4. Communication and Support

The effectiveness of a BPO partnership is as good as the robustness of the communication system in place. Therefore, when evaluating a healthcare BPO provider, healthcare Practices should begin by inquiring about the available communication channels. Sometimes, a particular mode of communication may not be the preferred mode of communication for the vendor. But, to meet your needs, the vendor must adapt to your preferred communication mode. This is critical because it helps to tackle firefighting developments more efficiently.  

5. Regulatory Compliance and Data Security

Compliance with healthcare regulations, particularly the Health Insurance Portability and Accountability Act (HIPAA), is an absolute necessity during healthcare BPO selection. HIPAA establishes stringent guidelines for the protection of patient data. To safeguard patient data and maintain strict compliance, the BPO partner must have a robust framework - comprehensive security protocols, encryption measures, access controls, and a data protection culture. More than this, they need to be committed to this framework. And ensuring that the vendor is willing to walk the talk is where the challenge lies. 

Your first parameter should be to look for certifications such as ISO 27001,HIPAA, GDPR etc. These certifications demonstrate the provider's commitment to data security. Have a closer look at their history of data breaches and security protocols. Similarly, analyze their encryption and access control measures. The vendor's employee training and data handling practices such as disaster recovery plans can also throw good light into their commitment to data security. 

Healthcare BPO Market Overview
Image 2 - Healthcare BPO Market Overview

6. Quality Assurance and Performance Metrics

Understanding how a BPO partner maintains quality control is vital in ensuring the delivery of top-notch services. Therefore, to make an informed choice, practices should inquire about their quality assurance processes. A reputable healthcare BPO provider will have a well-defined framework to maintain quality levels.  Some key features of the framework will include regular internal audits, assessing performance in terms of well-defined metrics, and adherence to industry standards.

At a basic level, check for the quality control process the vendor has in place. Do the documents go through an efficient document retention and retrieval process? Does it ensure that patient records and information are readily available when required. For healthcare practices it is essential to assess the above aspects to keep quality of service at the peak. Also, it is essential to check for established processes for reporting and tracking errors and implementing corrective actions. These measures address errors in patient data promptly, preventing their recurrence and enhancing data quality. 


The strategic healthcare BPO selection wields the power to revolutionize the very core of healthcare services. Far from being a transactional engagement, it marks the inception of a transformative partnership poised to optimize operations, curtail costs, and propel patient care to unprecedented heights. 

Adhering to a well-established methodology of choosing partners guarantees that the chosen partner seamlessly integrates with your healthcare organization's vision, principles, and competencies. 

At Invensis, we offer invaluable support to healthcare practices by shouldering non-core administrative functions and allowing them to emphasize their core mission of delivering high-quality patient care. The hallmark of our service lies in working hand-in-hand with your team and ensuring we are always in sync with your inhouse team. This makes us a partner who doubles up as an extension to your team. Contact us if you want to transform healthcare delivery. We ensure excellence, and innovation with our revenue cycle management services.

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