BPO Webinar Q & A

BPO Webinar Q&A

From Solving Your Key Operational Challenges through BPO Outsourcing

Q: Are there size constraints when outsourcing BPO services, i.e., is a plan too small or too large?
A: No size constraints.  We can do these things for all health plans.

Q: Are you located in the U.S., or do you offshore all services?
A: Large onshore presence.  We also have a nearshore and offshore presence.

Q: How can US-based located BPO services compete with offshore providers?
A: While off-shore resources can sometimes appear to be a less expensive option initially, there can be challenges with off-shore that need to be considered when performing a comprehensive assessment. 

Some common challenges around offshore outsourcing services are:

  • Significant time zone differences
  • Cultural and language barriers
  • Quality control issues
  • Security and IP concerns
  • Compliance issues with regards to some state and federal plans
  • Day to day operational challenges that arise from a workforce that does not have in-depth knowledge of the US Healthcare market

Often when all administrative and market costs (rework, late payment interest, audit complications, connectively issues, etc.) are taken into consideration, keeping tasks onshore can make very good business sense.

There is no question that offshoring resources can prove to be a much less expensive solution; however, less expensive does not ensure accurate, timely SLA (service level agreement) adherence. Experience consistently demonstrates the costs to offshore are considerable. Once offshored, faulty production can lead to lost revenue and penalties. Further, reversing an offshoring decision is equally costly. Before offshoring, be certain total costs are controlled without jeopardizing SLAs.

Q: How do you help the health plan ensure productivity and quality minimum standards?
A: Catalyst has a proven track record of exceeding production and quality standards for our clients; we attach Service Level Agreements (SLA) to all our BPO engagements to ensure our clients achieve a superior BPO outcome.

An example of some of the claim SLAs we align are:

  • Financial Accuracy of 99.0% or better
  • Payment Accuracy of 98.0% or better
  • Procedural Accuracy of 95.0% or better
  • 0% of clean claims paid within 30-day
  • 0% of clean claims paid within 90-days
  • We adapt our SLAs to the client’s business plan to alleviate any member or provider abrasion.

Catalyst’s BPO Services

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