Posts Tagged ‘Healthcare OutSourcing’
Thursday, April 5th, 2012
Medical Services by Sun Knowledge
Medical answering services are an important service which most medical related companies use in some form or the other. The important services in this line of healthcare outsourcing specialization which medical community avail of range from simple telephone answering services to managing referrals, resources and reminders.
How Sun Knowledge can help you??
Sun Knowledge is experienced with social service support programs that integrate medical and user communities. Our call centers provide programs for suicide hotlines, mental health and hygiene services, emergency response, dispatch services, etc etc…. We are confident that we can provide excellent service and respect to clients related to medical answering services.
Benefits of working with us:
- We provide and host a toll free number that can be used according to your needs.
- We provide subsequent callers with health education resources via mail.
- We direct callers to their appropriate Managed Care Organization for appointment information.
Call us now to explore our extra ordinary services.
Tuesday, February 1st, 2011
For ages, insurance companies and politicians have vehemently proclaimed that the US healthcare system is perhaps the best of its kind in the whole world. However, as its fatal flaws unfolded, the unfaltering faith of 42 million Americans in the entire system was badly shaken. There are scores of Americans, who are without proper health insurance. This gives vent to the fact that the American healthcare system may not be entirely invincible, infallible, as claimed by the healthcare pundits and political bigwigs. Astronomical healthcare costs, coupled with lack of access, pose a major threat to the US government. People are slowly coming to terms with this hard reality. Instead of taking the bull by its horns and addressing the problem head-on, the US government has been either shoving it under the carpet or proposing short-term, patch-work solution.
According to the comparative studies, conducted on the healthcare systems of various countries, the determinants of a good healthcare system are essentially its responsiveness and the extent to which it guarantees good health and financial protection to everyone. A sound, stable and unprejudiced healthcare system will, therefore, ensure:
i) Optimal good-health and an even distribution of the same across every population groups
ii) Even distribution of financing healthcare amongst all Americans, irrespective of class, creed, gender, race, age and color
iii) Tremendous, overall responsiveness and a fair distribution of the same in the society
The US healthcare, off late, falls short of everything that makes a sound, cost-effective, reasonably user-friendly and accessible healthcare system. Owing to the consistently rising costs of medical technology and prescription drugs, US boasts of the most expensive healthcare in the world. Moreover, the shift from not-for-profit providers to for-profit providers has triggered an abrupt rise in healthcare costs by a whopping percentage. The administrative costs at for-profit hospitals also attribute to the phenomenal healthcare spending. A large chunk of uninsured American population has also added to the woes, necessitating expensive healthcare.
US is the world’s only developed, industrialized country that does not promise universal healthcare coverage to all its citizens. Although quite a few employers take pains to insure their employees and the Government specifically offers insurance coverage to senior citizens (Medicare), the military as well as the unprivileged and disabled, a vast majority of the population still remains uninsured, wallowing in the woes, inflicted by this apparent “non-system”.
Lack of insurance coverage can pose a serious threat to a particular segment of the American population that does not have any access to the basic amenities of life, let alone a decent healthcare system. This shambolic system creates a gnawing gap in the coverage, which is hard to seal. As insurance rates go up, employers cannot help but stop their insurance benefits altogether and those who do not, are compelled to raise premiums and deductibles.
The US healthcare reform is indisputably a welcome relief, in these uncertain times. It will make healthcare accessible to millions of Americans, who have been regularly putting their health on hold because they cannot afford basic treatment or even the co-payment of a routine physical. The healthcare bill is believed to benefit more than 95% of legal American citizens. Even, those who have lost their jobs to recession and unfavorable times, will be able to make the best use of their coverage.
Giving unprecedented, uninhibited access to healthcare also beckons one pressing problem that all Americans have to brace for, whether they want to be covered or not. The dark clouds of recession have lifted from the face of America, with the nation successfully and bravely riding out tough times. However, it will be a “hard slog” for politicians to recover the money, lost during the credit crunch, in order to finance their health insurance scheme. This may lead the Government to consider increasing the tax of the US citizens in general and even, many businesses. As a result, people, who are not covered, can wind up paying more taxes than the ones, who are insured.
Wednesday, December 1st, 2010
Whatever business one is associated with- be it information technology or insurance or health care- one can now easily and seamlessly gauge where one’s business stands and what curative measures one must adopt in order to whip it back into shape and make it grow. The market is thankfully swamped with numerous sophisticated tools that comprehensively and expeditiously perform health check-ups of businesses and help them hit the ground running again. Broadly speaking, a company’s business health boils down to its consumer base, working capital and IT systems.
In order to boost the sales of any product, it is essential for business owners to penetrate the awareness of their target customers, substantially gaining their trust and credibility. An effective, streamlined and integrated marketing action-plan can significantly bolster the brand reputation of any organization. In this age of globalization and IT, business owners are increasingly falling back upon smart, nimble web-marketing tools including search engine optimization, email marketing and Facebook as well Twitter market in order to build brand reputation and rope in prospective clients. However, for both smaller and bigger business organizations, conventional and age-old marketing tactics, including advertisement with renowned publications and distribution of marketing flyers as well as brochures, work just fine.
Working capital is crucial to the management of funds in any organization, as it reflects its ability to pay its debts or short-term liabilities on time. Successful and timely achievement of an organization’s long-term and short-term goals essentially reflects its sound business health and calls for effective working capital management. Poor liquidity or working capital can spell disaster on the health of a business, making it increasingly difficult for it to cope with its day-to-day expenses. Hence, it is of utmost importance to monitor and hold a vigil on an organization’s amount of working capital, including its accounts receivables and payables. Moreover, every organization must make a conscious effort to keep its working capital ratio as low as possible in order to maximize its profitability margins. A business owner must stay abreast of the latest trends of the target market and strictly avoid tying funds in fixed assets and stocks that are an anachronism now.
Due to absence of hindsight, business owners often miserably fail to judge the enormity of risks, associated with their businesses, hampering their growth in the process. Lack of smart action-plans to ward such risks off also contributes to the failure of businesses. This holds true for most SMEs (small and medium enterprises) that comprise the lion’s share of private sector enterprises in almost all the countries of the world. Failure to access modern, easy-to-use online tools accounts for the collapse of most of the businesses. What business owners do not realize is that they are just one click away from solving problems that need to be addressed immediately. There are certain integrated online tools such as Google Analytics, Omniture that can perfectly identify the reasons behind the sudden shift in traffic across the web. Web tools, including Alexa can work to the advantage of a company, giving it valuable information about its position in terms of web-traffic, traffic detail pages, related link pages and what people are primarily searching on the web. Alexa site audit, like webmaster tools, can crawl and analyze websites, giving in-depth visibility to search engines and insights into optimization, monetization and overall health status of business websites.
A business will jeopardize its own growth, if it loses sight of its consumer base. That is where a good PR campaign comes in handy. A business can flourish only when it accurately gauges the expectations and demands of its consumers. PR can do its tricks in different ways. Apart from traditional advertising, sales letters and face-to-face selling, well-executed PR tools can include press releases, guest columns, media interviews, workshops, seminars and public speaking engagements, which are highly instrumental in promoting and bettering the health of businesses.
Last but not the least, a small yet significant component of business health is Information Technology that handles all kinds of data, eventually paving the way for information. Infact, IT and business intelligence work hand in hand in order to accomplish all data related tasks that an organization is assigned with. IT is crucial to all the processes associated with Business Intelligence applications that primarily collect, preserve and extensively analyse business data. Infact, mission-critical BI applications can expertly churn out insightful information about new revenue generation opportunities from crude data they have at their disposal and target network expenditures at the most lucrative service areas. BI tools significantly slash unnecessary expenditures that business organizations stumble upon, improving their profitability margins and operational efficiency. BI is also effective in keeping a track of the performance levels of people across the entire organization, right from finance and HR to sales.
Tuesday, November 16th, 2010
A chief information officer spearheads the operational activities in relation to Information Technology within a healthcare setting. Infact, a healthcare CIO has to take in stride all the challenges that the Information Technology unit of a health care organization encounters on a routine basis- right from supervising and structuring data entry and analysis and laying down the rules and regulations for effective handling of data to working in conjunction with vendors and contractors to develop and enhance IT tools, crafting the IT budget and collaborating with other bigwigs of the organization for its greater good.
However, these days, the responsibility of a healthcare CIO is much more than just overseeing and controlling the IT operations for a particular organization. In some organizations, the onus of managing its supply-chain and group purchasing is usually on the health care information officer. The role of a CIO is gradually evolving and expanding with more and more information officers foraying into areas related to biomedical engineering, imaging equipment management, performance evaluation process redesign etc.
Ideally, a healthcare CIO is a multi-tasker, adeptly juggling his priorities and delivering top-notch results within compressed timelines. He is also a multidimensional communicator, who is vocal about the issues and concerns of his immediate team, effectively explaining the broader strategic agendas to them at the same time. Organizational culture and individual background are also equally responsible for the changes that are creeping into the role of a healthcare CIO.
A chief information officer must be a peoples’ person, blending effortlessly with his team, as he steps into the role of a manager. He also has to have hands-on experience in both health care as well as business administration. He should be adept at crafting comprehensive training programs for the in-house IT professionals, while seamlessly handling and maintaining production levels, personnel records and other relevant documentation. A healthcare CIO has to shoulder the responsibility of managing even the minutest and most mundane aspects of a multifaceted IT program that includes but is not limited to teleconferencing, office automation, internet and imaging.
In larger hospital or health care set-ups, a chief information officer takes several subordinates under his wing. They ensure the effective and efficient functioning of the IT programs under the tutelage and strict supervision of their seasoned healthcare CIO, who primarily acts as a liaison between the top management and other departmental managers. Though the global spending on health care IT has fallen for the last couple of years, the health IT industry is certainly looking up. Despite financial crunch, they are much better-off, career-wise, at the moment because of the difficult compromises they made, during recession. Some health care IT projects faced inordinate delays, but things are back to normal for health care CIOs with a variety of stimulus incentives in place.
Wednesday, October 27th, 2010
Image Data Entry entails translation of scanned images to a desired format. Primarily of two types- online and offline, it usually comes in form of huge volumes of work. In case of an Image Data Entry project, after getting specific requirements from the consumers via fax and emails, the service providers process their requests, sending the images in their coveted formats. However, attention has to be paid to the quality of images and confidentiality of data has to be rigorously maintained.
Image Data Entry services are usually executed by highly skilled and competent professionals. When the project is still at its nascent stage, two or three professionals, simultaneously working at two terminals, suffice. They are usually responsible for keying in the images into the software that work in conjunction with industry standard imaging tools. If any discrepancy or mismatch occurs, during entry, the software immediately identifies it and responds accordingly, which entails sending the end-user an alert and prompting him/her to take instantaneous action.
If no mismatch is spotted, the data is stored in the software and undergoes a strict quality check to guarantee its impeccable accuracy. Organizations usually deploy advanced, high-speed scanners to ensure superior image quality and images can be scanned into a variety of digitized formats such as RTF, TIFF, PDF, GIF and JPEG. The scanned images are either submitted to consumers via CDs or are uploaded to FTP servers.
There are many Image Data Entry softwares available in the market that are platform independent and can run on any operating system. They enable data entry operators to adeptly and clearly delineate specific zones within a bigger image, while simultaneously shedding light on multiple zones. They also help set resolution on individual zones within an image and allow operators to zoom and pan an on-screen image at their own discretion.
Tuesday, October 19th, 2010
Managing the documents of an office is no child’s play. If the windows of a typical corporate house are thrust open, all the important paper documents, carelessly heaped on the tables, will be blown away by a sudden gust of wind, reducing the office into a mess of loosely strewn papers. The office will be a picture of utter chaos with all employees going berserk over their lost documents and frenetically chasing the ones that are still within their office premises. If the office has a Document Management System in place, it will come to the fore, during such crisis, whipping it back into shape.
Document Management System revolutionizes the way in which an office operates. Whether it is all about decluttering papers or simply improving the way electronic files functions, a Document Management System will indisputably take preponderance over other systems that are already existent. However, a distinct difference persists between Document Management Software and Document Imaging Systems. Document Imaging Systems contain a portfolio of tools that helps translating paper records into electronic files, whereas Document Management Software comes in handy during effective management of electronic files.
Document Management Systems vastly improve business processes without drastically changing the same. These days, industries have to stringently abide by certain laws that require specific procedures for record keeping. As for instance, it is mandatory for providers of financial services to demonstrate that they have not tampered with information in order to comply with Sarbanes-Oxley. Against a volatile yet regulated industrial backdrop, Document Manage Systems enable corporate conglomerates to faultlessly comply with the rigid security and record-keeping rules. However, it is to be borne in mind that compliance can only be facilitated; but not guaranteed.
Document Management Systems have gained phenomenal popularity across many industries, these days. More and more accounting and human resources sectors, where paper-files are widely used, are turning towards Document Management Systems for respite and support. Many businesses, according to the Patriot Act, have to allow Government prompt and uninhibited access to their records. Since Document Management Systems help comply with certain Governmental rules and regulations, it is hugely popular with the manufacturing and Governmental sectors for regulatory protocols.
Document Management Systems have an obvious head start over other systems for certain benefits that they dole out to end-users. Cost-efficiency is one of the greatest advantages of Document Management Systems because it can totally obliterate the “lost document” costs, making up for the extra time that it takes to create a document from its scratch, after it is lost or misplaced. Document Management Systems significantly save office space, ridding it of cluttered paper records.
Document Management Systems guarantee unprecedented security of data, immaculately maintaining its integrity and integral value. They grant only authorized, password-protected access to certain individuals, while ensuring that the contents of all the documents are encrypted. A DMS also ensures that audit trails show the documents that have been accessed or updated.
Every organization must have a well-structured, streamlined infrastructure that ensures data back-up, during unpremeditated disasters. Data Management Systems shield paper records from disasters by creating their electronic versions that can be backed up in various ways, including offsite data backups. Document Management Systems even allow multiple users to simultaneously access the same record from any corner of the world.
A Document Management System reinforces a steady consistency of standards between various departments, especially in large companies. In presence of a Document Management System, all the departments can function hand-in-hand with unparalleled steadfastness and uniformity and consistency can be obtained to the degree it is wanted.
However, before acquiring Document Management Systems, one has to define the problem one is challenged with; otherwise it will be a sheer waste of time and resources. Document Management Systems can be tailored to the demands of a problem. If one is seriously contemplating on installation of a Document Management System in one’s office, one must first and foremost assess one’s problem and then, take the plunge.
Thursday, August 12th, 2010
Healthcare Outsourcing to India has now primarily boiled down to quality. Indian companies are fast catching up to match or even, exceed international quality standards by virtue of their steady and consistent quality improvement, thereby, staying a notch above their international competitors. Moreover, the global economic slump has hastened the trend. India lately has become the health care hub for many uninsured and under-insured Americans as well as US corporations, who are bent on slashing their employees’ medical bills. When it comes to educational and technical qualifications, Indians definitely have a head start over others, working in the parent locations.
Most health care professionals in India are thoroughly familiar with the rules and regulations of Medicare, Medicaid, Blue products, Managed Care, Third Party Liability, Workers Compensation, Preferred Provider Organizations and Indemnity Insurers. They are also equipped with a complete understanding of CPT, HCPCS, ICD-9 and coding Level I, II, III. Many Indian service providers have, not only, attained Six Sigma and CMMI certifications but have also upgraded their quality standards to the new ISO 9000:2000 model. Although India’s biggest strength is its highly qualified and English-speaking human-resource pool, the Indian health care industry is embracing internationally recognized quality protocols with a frantic pace. This is born out of the realization that the industry cannot solely thrive on the advantages of cost-cutting and English speaking manpower.
Cost-cutting has definitely got its advantages. In the event of an economic downturn, it has been largely successful in swaying the opinions of American companies, who otherwise used to frown upon the very thought of India being their one-stop destination for business. The global health care industry, swamped by a barrage of regulations, is increasingly pressurized to slash costs, paving the way for Indian IT companies to tap into its market, especially pertaining to imaging, disease management and claims processing. Till date, although India primarily caters to the US market, UK based companies are slowly turning their attention to offshore markets. Speculations say that European players will take a wee while to take the final plunge because of state-governed health regulatory system in most of these countries. Healthcare outsourcing also saves a substantial chunk of the cost of conducting medical billing and coding onshore. Moreover, outsourcing these functions saves a lot of space, which can otherwise be utilized for core functions.
The health care outsourcing space, in relation to India, can be segregated into 4 main blocks: Providers (hospitals and physician groups), Payers (Healthcare insurance companies, third party administration, etc), Drug manufacturers (clinical research and bulk drug outsourcing) and Pharmacy chains. Many Indian companies are already catering to global clients- health care service providers, health insurance companies and medical equipment firms- predominantly in areas pertaining to customer and claims management systems, maintenance of electronic medical record services etc. Although the once much-hyped medical transcription is looking down, outsourcing in imaging, disease management and claim processing are expected to generate millions of revenues in the coming years.
India is also foraying into other areas in relation to clinical research organizations that carry out various pathology tests on patients in the wake of a new drug development. As a result, many Indian companies are getting their facilities accredited by the College of American Pathology (CAP), the global standard for pathological governance. India is also poised to show phenomenal growth in yet another health care sector- the medical BPO. Despite stiff competition from Singapore and Thailand, India is still a hard-to-beat attraction for Westerners because of its superior health as well as customer care, subsidized rates and the analytical thought process of its people that has the power to develop complex applications and manage complex process, critical to any health care BPO.
Monday, April 26th, 2010
Heath Information Technology (HIT), used to manage personal health information, has heralded a new change to the present health-care system. As health-care service providers and beneficiaries, all over the world, sing its praises and extol its virtues, they are turning a blind eye to its potential downsides. New Healthcare Information Technology is rapidly changing the patient/doctor relationship by facilitating communication and information-sharing between the two. But is this change for better or worse?
Computers and other electronic devices have certainly made it easier for doctors, health care providers (such as hospitals, labs, and X-ray facilities) and patients to store, share and access health information. But it fails to charm many, who may not have been impacted by Healthcare Information Technology at all. Greater accessibility to individualized health information- whether that is through a formal electronic medical record, a self-created personal health record or a quick instant-messaging session with a physician- has taken its toll on the traditional roles of patients and doctors. It will not be long, when more patients will access their electronic records, latest test results and recommended articles about their health-concerns, before visiting a hospital or doctor.
The element of human-touch, which once dominated a doctor-patient relationship, will slowly dwindle into oblivion as more patients, with full access to their electronic heath-records, will be able to skip their appointments with doctors altogether. They will instead randomly send a text message or email to their care-providers or go through their personal health records or smart-phone applications to seek answers to their questions.
Over-abundance of accessible data can also spell disaster for physicians and the health care industry in general. Moreover, potential liability and reimbursement questions may crop up, in the wake of increased flexibility in communication between doctors and health-savvy patients. Greater doctor/patient interaction may also intrude upon and foil the doctor’s capacity to assess data thoroughly in the interest of making accurate diagnoses.
While many people will certainly reap the benefits of the new Healthcare Information Technology, thus having greater control over their health care issues, the others, who are not so tech-savvy, may never know what all this fuss over HIT is about. In this age of often “irrational exuberance” over the latest technological advances, it is easier, for the majority of policy-makers and health-care stakeholders, to turn their backs upon people, who are not well-acquainted with technology. Moreover, health issues often come laden with emotional dimensions which the “efficiencies” of technology-based relationships will never be able to address.
Technology, through seamless and perfect health-care delivery, will indeed make lives easier for people. But it can never beat the humane elements of the relationship that exists between a real, live doctor and his patient.
Thursday, April 15th, 2010
There aren’t any fixed educational or experiential criteria for pharmacists, or other health professionals, who are licensed to dish out Medication Therapy Management services. In most cases, a doctor of pharmacy (Pharm.D) is an eligible provider of Medication Therapy Management(MTM) services. The same rule applies to a fresh graduate. If he lacks sufficient professional experience to do his job effectively and efficiently, an extra training and education in geriatrics will help seal the gap.
If a pharmacist has a certification in a certain area, he is, inevitably, more adept in providing core MTM services in those specialty areas. Pharmacists, who are science graduates with years of professional experience under their belts, are also at par with the ones, who have certifications.
All drug-plan sponsors must employ people with versatile and complementary skills, experience and knowledge. Every plan should have a minimum educational and experiential standard which all MTM service-providers, including all community-based pharmacists and other health professionals, must meet, before they are recruited. Plans should also incentivize their work-force, encouraging them to work better and harder. The entry-level Pharm D degree and specialty certification have, indisputably, added a whole new dimension to this profession. Health-professionals are contemplating other forms of recognition, customized and tailored to the needs of MTM programs.
Thursday, April 8th, 2010
Drug utilization review is the process of assessment of drugs, consumed by a population, in terms of their efficiency and potential risks, in order to dodge fraud, dangerous interactions and over-prescribing and therefore, inevitable disasters. In every US state, according to the mandates of the Omnibus Budget Reconciliation Act of 1990, many private drug utilization review boards, which supervise outpatient prescriptions for Medicaid patients, work for health insurance or pharmacy companies.
The Drug Utilization Review program, an inventive and computerized system, not only, puts prescription drugs of Medicare Plan under the microscope, but also, makes recommendations about best prescription drugs, drug problems and drug interactions, which are available to pharmacists and physicians.
The knowledge of the prescribed drugs is of utmost importance. People can easily access thousands of potential drugs in the market. Some random combinations of medications can have an enormously negative impact upon the health of consumers, making them horribly sick. As a result, medical costs spiral out of control. Many people have died an untimely death for consuming prescribed drugs that should not have been prescribed. Consumption of medicines inappropriately can also result in death. In some cases, drug utilization review board urges the pharmacists to speak to people when they are prescribed new medications. Although this will not entirely stop the consumption of potentially hazardous medicines, with a little bit of co-operation from the patient’s end, it will definitely help control the problem.
The Utilization review services include Prior Authorizations, reviewing of set quantity limitations and application of step therapy program. They track, flag and report on prescription drugs that need more scrutiny, thus enabling significant savings for both the member and payer.
All exception requests are processed within a standard time period of 48 hours, whereas expedited ones are processed faster, within 24 hours. The final decision or outcome is usually forwarded to the prescribing physician and pharmacist for their discretion.
Utilization review is the prime source of utilization management, which gauges and evaluates the suitability, aptness, medical need as well as competence of health care services procedures and facilities in terms of the established criteria or guidelines of an applicable health benefits plan. It begets new activities or decisions based upon the scrutiny of a case.