Improving Your Organization’s Payment Recovery Efforts


Healthcare continues to be one of the most complicated industries to navigate through. Healthcare payers in particular, namely health insurance companies and plan providers, face countless challenges when attempting to recover money. Most of these companies struggle from inefficient internal processes that result in countless dollars being lost every day.

For example, recent research indicates 80% of all pharmacy compliance audits will bring some form of opportunity potential to light. Meaning some organizations could potentially be missing out on millions of unclaimed dollars. Recovering this money often comes at the complexity of negatively impacting your organization’s day-to-day operations. More and more payers are struggling to find ways to keep track of all of their audits and recovery efforts. What can they do to simplify their efforts while remaining efficient in the process?

How A Partner Can Help

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.

A common service offered by these organizations is known as subrogation services. These services are dedicated to ensuring all healthcare costs related to medical and disability expenses in accidents or injuries are being paid by the liable party. Confidence that these expenses are being paid can help organizations reduce delays and any confusion related to these payments. Another common offering is a pharmacy audit. These audits are meant to monitor retail pharmacy operations to keep costs under control and improve the overall understanding of different fraud and abuse possibilities. These BPO providers can even stand in as an extension of a payer’s business to help improve relationships with different healthcare providers.

Selecting the right BPO partner for you organization can be a challenge. However, with a sound partnership comes the best recovery efforts. Which means your staff can continue concentrating on their responsibilities rather than becoming distracted with recovery efforts.

Conduent continues to serve as a leader in BPO services, particularly those catered to healthcare practices. For more information on how Conduent can improve your payment recovery process and other internal processes,  be sure to check out the infographic accompanying this post.

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