While patient care lies at the crux of healthcare it comprises of multiple components which are essential in delivering the ultimate service to the patient. In other words, healthcare is a composite of various functions where patient-provider encounter is thought to be the key driver. Upstream and downstream of this significant event are multiple processes which determine whether a provider will get paid for his service and thus determine whether the cycle will repeat.

In the US getting paid for a rendered service is usually a lengthy process for a provider. Besides, the process itself has evolved to become complex which needs to be handled meticulously in order to ensure accurate and timely payment. The provider usually knows little or nothing about this process and this is where healthcare professionals other than providers step in.

Let us state the example of the process of Medical Coding for instance. Medical Coding is assigning alphanumeric codes to diseases, conditions and services rendered which is how insurances accept medical claims. This function is a science in itself. On an average it takes at least 2 years for a person to become a certified coder and the book of codes (ICD, CPT, etc.) gets reviewed every year. Now, when there are experts who can handle this tricky affair with ease is it worth bothering the providers and taking their time away from providing patient care. Also, there is a severe dearth of qualified medical coders within the US which is where countries such as India step in. Many developing nations like India churn out thousands of medically qualified individuals every year who require minimal training and can deliver with the same quality. Besides, these individuals are already primed with the global trends so it is just a matter of time to get their knowledge updated and at a comparatively reasonable cost. Also, the labor arbitrage and the availability of primed, technically sound individuals greatly favors the outsourcing of the accessory functions in order to meet the eventual goal of providing Class A patient care.

Thus, it is beneficial for practices to relegate the accessory tasks to experts who spend hours laboring over the claims filing process and ensuring that the providers get paid on time. By ensuring that the upstream and downstream processes are carefully monitored and executed the provider is available to do what he does best…..provide the best care there is for his patients. At the end of the day isn’t that what we all want.