Healthcare and Outsourcing

By Sandip Sen

Healthcare is not a field that can afford to broach any compromises on quality of customer care. As a healthcare provider, you need to take strategic business steps in the near-term to better manage your revenue streams and operating costs. Customer care does not need to suffer as a result of this strategy and can be turned over to experienced vendors.

Outsourcing is a strategic, cost-effective solution to manage costs while providing high levels of customer care. Deciding to outsource and choosing a business process outsourcing (BPO) vendor can be daunting tasks. Businesses are under pressure to find an outsourcer with extraordinarily high quality standards. While a vendor may cut on unnecessary costs, be wise to ensure your vendor doesn’t cut corners on the elements most important to you and your patients. Approach the relationship as a partnership rather than a vendor-client engagement. Here are a few critical attributes to look out for while choosing a responsible BPO partner:


The foot soldiers in customer care are the call center agents. They need to be surrounded by support such as training, quality assurance, and feedback. Start with training. Are your call center associates licensed to provide the right level of care? A good BPO partner should be able to hire call center agents with relevant skills and experience.

But how does it accomplish this quickly and efficiently? One solution is to hire professionally licensed associates with existing home-state licenses. One healthcare client reported that hiring licensed agents saved them $1,000 to $1,500 per person in billing time and training costs because agents did not have to be trained for the licensing examination. This procedure also keeps you out of the unpredictable and time-consuming licensing process.

Your BPO partner should look for highly qualified candidates with a background in the healthcare industry, experience in customer service, and a record of accomplishment in previous jobs. Once hired through a stringent selection process, experience shows that well-qualified agents usually exceed clients’ expectations. Licensed, well-trained, and high-caliber performers put your BPO partner in position to meet the key performance indicators you set.


Retaining associates is an essential task of outsourcing – ideally, the BPO partner would keep its employee retention rate high by using employee incentive programs and setting the right job expectations among employees. Successful BPO partners have run daily incentive programs based on performance metrics or attendance to boost employee retention.


Agents are on the front lines, so it is important for a responsive BPO partner to encourage feedback from agents, as well as their supervisors. Such feedback is important to detect customer issues at a grass roots level.

Compliance and Certification

All BPO partners need to be compliant with the healthcare regulations that their clients follow. The outsourcing industry has certain certifications, and those possessing them tend to have more rigorous measures of performance quality. SAS70 (Statement on Auditing Standards (SAS) No. 70, Service Organizations), developed by the American Institute of Certified Public Accountants, is widely recognized because it represents that a service organization has conducted an in-depth audit of their control objectives and control activities, which often include controls over information technology and related processes. A responsible BPO partner should also have Payment Card Industry (PCI) and International Standards Organization (ISO) certifications, such as ISO 9001:2008.

Real-Time Adherence

BPO partners deploy real-time adherence technology that enables their clients to track differences between agent schedules and current agent activities in real-time. The automatic call distributor that supplies agents with calls also monitors their activities and enables supervisors to track the status of each agent. This technology has grown to become a client requirement because it affords visibility into the BPO partner’s operations process.

Emergency Support

Expect a BPO partner to keep their agent schedules flexible enough to provide emergency support during times of call-volume spikes, such as during open enrollment periods or in the wake of natural disasters. A good partner should be able to induce real-time changes to agent schedules to derive all the support it can out of the existing employee reservoir. Just as healthcare facilities staff up during peak periods, a BPO partner should also staff accordingly.


A BPO partner should proactively align its own schedule with the clients’, considering the seasonality and unpredictability of the healthcare business. As traffic ramps up for season peaks, the seasoned agents will return to the client campaign in time for the peak, reducing time spent in hiring and training employees.


A BPO partner’s capability amounts to the quality of its resources. As a member of the healthcare industry, search for an outsourcer that recruits agents quickly and effectively, providing the highest level of performance quality. The vendor should also be able to structure the schedules of their agents to meet client requirements. Make the relationship between a healthcare client and a BPO partner one of flexibility and understanding in order to provide the best experience for your patients.

Sandip Sen is president (Americas) and chief marketing officer with Aegis Global Communications.

[From the February/March 2011 issue of AnswerStat magazine]