DST Health Solutions' BPO Services Help Health Plans and Physician Group Practices Thrive

In Healthcare Informatics magazine, DST Health Solutions' clients addressed common questions about business process outsourcing (BPO) and provided real-world examples of how health plans and physician practices benefit from successful BPO relationships.

Helping Physicians in Fast-Paced ER World
With BPO, physicians are free to focus on their core competencies. When HCA contracted with Greater Houston Emergency Physicians (GHEP) to ensure excellent patient care, DST Health Solutions' BPO services alleviated part of the administrative burden on GHEP physicians. HCA handles scheduling, quality and risk management, practice development, payroll, provider processing, recruiting, and marketing. HCA outsources billing and collections to DST Health Solutions.

GHEP's improved operational efficiencies include fewer than 60 days in "revenue outstanding." The industry norm ranges from 90 to 110 days.

Health Plan Doubles Size, Enhances Services
Another organization that experienced strong results using DST Health Solutions' BPO services was Pinehurst, N.C.-based FirstCarolinaCare. FirstCarolinaCare focused on business development and client, member, and provider services, while outsourcing claims processing, member and provider maintenance, and portions of medical management administration.

FirstCarolinaCare achieved tremendous gains in efficiency over five years. The accuracy of claims processing is 98% or higher; 90 percent of all claims are paid in fewer than 14 days; and enrollments are processed within 48 hours.

Intuitive system helps new employees
The result? Since the acquisitions, BCBSTX has hired approximately 270 additional employees, and new hires are quickly learning to navigate these easy-to-use screens. Kathleen Leifker, manager of HMO operations development, says, "The Health Solutions team is very helpful. They are like one of the family here. We can always rely on them to help us and answer any questions we have."

Choosing the Right BPO Provider
One thing both organizations share is the need to adequately evaluate their BPO provider and identify service levels for the outsourcing agreement. Organizations considering outsourcing should evaluate many attributes including the outsourcing provider's financial stability, track record, quality assurance plan, and service-level reporting capabilities.

For more about DST Health Solutions, contact us at inforequests@dsthealthsolutions.com.