Outsource Healthcare Services to Optimize Your Medical Operations

Hospitals and clinics involve many medical or healthcare processes that go beyond diagnosis and treatment. The administrative side requires several procedures to keep healthcare systems running. These procedures require capital, yet hospitals and clinics of all sizes are facing modest or weak operating margins. 

Tina Wheeler, a Deloitte leader for the healthcare sector, suggests that medical organizations consider medical outsourcing or offshoring some healthcare processes to companies out of the country.

Aside from financial challenges, medical organizations are also seeing fewer qualified candidates for healthcare processes. In-house expertise is becoming hard to find. The labor shortage is compounded by new technologies that need to be implemented, which in turn, also require skills and capital.

All these reasons position outsourcing or offshoring as a viable solution to financial and labor problems. Healthcare outsourcing to the Philippines may supply you with cost savings and labor. Needed skills and knowledge may also be met by offshore healthcare workers in the Philippines.

What is Healthcare Outsourcing?

Healthcare outsourcing in the Philippines or anywhere else is the employment of third parties to handle non-clinical or non-core medical functions. Healthcare organizations can then focus on core responsibilities such as patient care. The third parties here can be top healthcare BPO companies in the Philippines.

The Philippines has long been a prime location for outsourcing teams or offshore staffing. Healthcare BPO companies in the Philippines cater to numerous healthcare providers. Just last year, Optum, a large US healthcare provider, revealed its plans to invest in medical BPO in the country.

Administrative operations in healthcare organizations can be outsourced or offshored. On rare occasions, outsourced physician services may be employed too. 

Commonly outsourced healthcare services include the following:

• Medical billing
• Medical transcription
• Medical coding
• Off-hours phone services
• Medical scribing
• Prior authorization processing
• Recredentialing
• Accounting
• Bookkeeping

What are the Five Steps in the Health Care Process?

The five steps in the healthcare process, from a non-traditional operational viewpoint, are less about a linear patient journey and more about a cyclical, continuous service model that must be managed with precision. This is the operational framework that allows providers to scale and deliver high-quality care efficiently. The steps are:

1. Patient Assessment & Data Ingestion

This is the foundational step, but it’s not just a physical exam. This is the data-intensive phase where all patient information, from lab results and medical history to insurance details and patient demographics, is collected. This process is often highly manual and prone to errors.

• The Overlooked Problem: This stage is a major choke point. A patient’s care can be delayed or compromised due to incomplete or inaccurate data. In an operational context, this leads to billing errors, appointment mix-ups, and a poor patient experience right from the start.
  
• The Operational Fix: Digitize and automate. You need a remote team to manage the massive volume of data entry, validation, and scrubbing. By leveraging skilled talent, you can ensure data is clean and immediately accessible in your EHR system, creating a single source of truth for the entire care journey.

2. Diagnosis & Treatment Planning

This is where the clinical expertise of doctors and nurses comes into play. However, it’s also a collaborative process that relies on the accurate, timely synthesis of the data collected in the first step.

• The Overlooked Problem: Clinicians waste valuable time searching for data or trying to make sense of incomplete records. This not only delays care but also introduces the risk of human error.
  
• The Operational Fix: A robust and well-managed health information system is critical. A remote team can provide back-end support by ensuring all diagnostic images, lab results, and consultation notes are properly coded and integrated into the patient’s file. They can also manage the secure transfer of this data between specialists, enabling seamless, collaborative care planning without the physical hand-off of files.

3. Implementation of Care & Service Delivery

This is the execution phase. It includes everything from prescribing medication to scheduling surgical procedures and coordinating follow-up appointments.

• The Overlooked Problem: The most brilliant treatment plan fails if its implementation is flawed. This is where administrative and logistical hurdles such as scheduling conflicts, insurance pre-authorizations, and patient no-shows can create chaos.
  
• The Operational Fix: This is a prime area for a remote team. They can act as a centralized command center for patient logistics. They handle all pre-authorization calls, schedule and confirm appointments, and send automated reminders to patients. This level of meticulous, proactive coordination ensures the treatment plan is executed efficiently, reduces no-shows, and prevents administrative bottlenecks that can delay care.

4. Revenue Cycle Management & Billing

This is the business side of the process. It’s the critical step where services rendered are translated into payments. It’s often viewed as a separate function, but it’s inextricably linked to every step of the patient journey.

• The Overlooked Problem: Incorrect coding, late claim submissions, and a lack of follow-up on denied claims can result in significant revenue loss. Many providers lose up to 10% of their potential revenue due to a messy and inefficient billing process.
  
• The Operational Fix: Outsource this function to a specialized medical BPO team. They’re experts in the complex billing regulations of different countries and insurance providers. They focus exclusively on precise coding, timely claim submissions, and aggressive follow-up on denials. This isn’t just a cost-saving measure; it’s a strategic move to optimize your cash flow and ensure you are fully compensated for the services you provide.

5. Evaluation & Continuous Improvement

The final step is not about finishing the process but about learning from it. It involves analyzing outcomes, patient feedback, and operational metrics to refine the entire system.

• The Overlooked Problem: Many healthcare organizations lack a systematic approach to this step. They may rely on anecdotal feedback or conduct evaluations only after a problem has become severe. This missed opportunity for improvement leads to the same mistakes being repeated.
  
• The Operational Fix: A remote team can be tasked with data analytics and reporting. They can track key performance indicators (KPIs) like patient wait times, claim denial rates, and patient satisfaction scores. This data provides the actionable insights needed to identify inefficiencies and implement process improvements. By having a dedicated team focused on this analysis, you transform your operations from reactive to proactive, ensuring a culture of continuous improvement is built into the very fabric of your organization.
  

What are the 4 P’s in Healthcare?

The “4 P’s” of healthcare are predictive, preventive, personalized, and participatory. These are often discussed in a purely clinical context. You’ll hear them framed as a visionary, patient-centric future. But from a strategic operations and outsourcing perspective, they are not a lofty vision; they are a mandate for operational transformation.

For a global healthcare provider, these “P’s” are simply unachievable with an old-school, in-house team structure. They demand a level of data management, communication, and process efficiency that can only be built by leveraging a specialized, skilled remote team.

Here’s a breakdown of the 4 P’s from a purely operational and outsourcing lens:

1. Predictive: The Data & Analytics Engine

Forget the clinical jargon about genetics. Operationally, Predictive medicine is a massive data problem. You can’t predict patient risk without a continuous flow of clean, structured data from disparate sources like EHRs, wearables, lab results, and claims data.

• The Problem: Your in-house team is bogged down by manual data entry, and your IT generalist struggles to integrate complex systems. The data you need to make predictive models is fragmented, inaccurate, and often sitting in a silo.
  
• The Operational Fix: You need a specialized remote team of data entry specialists, data scrubbers, and health informatics professionals. They are the ones who meticulously clean, code, and organize the data. This foundational work, often overlooked as “low-level” administration,  is the very engine that powers your predictive models. Without a dedicated, scalable team to manage this data at a high volume and low cost, your “predictive” aspirations are just a PowerPoint slide.

2. Preventive: The Remote Patient Engagement Team

This is not just about telling patients to eat better. From an operational standpoint, Preventive care requires continuous patient engagement and monitoring. It’s a 24/7 service model.

• The Problem: Your in-clinic staff is already at capacity with direct patient care. They don’t have the time or resources to follow up with patients on their diet, exercise, or medication adherence. The result? A lot of great advice given during a 15-minute consultation is never acted upon.
  
• The Operational Fix: You need a remote team of patient engagement and support specialists. Operating from a global talent hub like the Philippines, they can provide round-the-clock follow-up calls, virtual check-ins, and proactive appointment reminders. They act as your “digital front door,” a continuous point of contact that reinforces the clinical advice and keeps patients on track with their wellness plans. This is a scalable, low-cost way to ensure preventive care isn’t just a suggestion—it’s an implemented, measurable outcome.

3. Personalized: The Precision Administrative Service

Everyone talks about personalized medicine in terms of drugs and treatments, but the most significant operational challenge is Personalized administration. Each patient’s unique care plan requires a customized billing and insurance claims process.

• The Problem: Your in-house billing team uses a one-size-fits-all approach. When a patient’s personalized treatment plan involves multiple specialties, complex procedures, and different insurance payers, your billing gets messy. The result is a high claim denial rate and frustrated patients who have to navigate a bureaucratic nightmare.
  
• The Operational Fix: Your remote team is your secret weapon. A skilled team in a global talent hub is trained to handle the complex, intricate details of medical coding and RCM for personalized care plans. They can meticulously track services, verify a patient’s specific insurance coverage for each part of their treatment, and ensure every claim is submitted with surgical precision. This is how you optimize revenue, reduce denials, and ensure the administrative experience for each patient is as seamless as their clinical one.

4. Participatory: The Digital Front Door & Community Manager

Participatory medicine is not about giving patients a pat on the back. It’s about building a digital community and a seamless communication channel.

• The Problem: Your in-house staff is stretched thin. They can’t respond to every patient portal message, social media inquiry, or app notification in a timely manner. This communication breakdown leaves patients feeling disengaged and unheard.
  
• The Operational Fix: This is a perfect role for a remote team. You can task a team with managing your digital communication channels, responding to inquiries, and moderating patient forums. They ensure patients feel heard and are given the information they need to be active participants in their health. By outsourcing this function, you’re not just saving money; you’re building a resilient, responsive “digital front door” that fosters a more empowered and engaged patient population. This is how you build a reputation for patient-centric care at scale.
  

Benefits of Offshore Healthcare Jobs in the Philippines

More Focus on Core Services

Because of understaffed medical teams and the overwhelming amount of software and equipment maintenance, core services such as patient care may be given less attention. 

However, Doug Brown of Black Book Research raises outsourcing as a potential resource-saver. Hospitals and physician organizations can pour all their efforts and a bulk of their resources into patient-centered processes.

Higher Cost Savings

Labor costs in the Philippines are lower than in countries like the US, UK, or Australia. You can pay a Philippine remote team’s salaries, bonuses, taxes, and other mandatory benefits and still not break the bank. 

You also deal with less overhead costs for discovering members and hiring offshore teams. Staff turnovers will not affect your operating costs much as well. 

According to Black Book Research, double-digit cost savings are promising due to outsourcing in 2024, with estimates anywhere between 27% and 64%.

Trained Assistance in Medical Services

In-house teams are usually swamped with multi-field processes. One person or a few people cannot possibly do billing, transcription, coding, HR, IT, marketing, legal work, accounting, and more alone. 

An offshore team will have the training and the efficiency to perform focused non-core medical services. Clinical process outsourcing companies in the Philippines will also have more experience in performing healthcare tasks.

English-Proficient Workers

One of the biggest draws of Philippine remote workers is their high English proficiency. At the same time, a huge percentage of Filipinos speak English. For these reasons, the Philippines is a common location for medical outsourcing.

Scale Operations with Less Costs and In-House Labor

When times arrive for high healthcare demand, medical organizations may quickly become overwhelmed. Outsourcing takes away the pressure of scaling operations for high demand. In addition, the more outsourced work there is, the higher the cost savings may be.

What Services Do Hospitals Outsource?

Medical Billing

Medical billing was one of the first outsourced healthcare services. It has grown and will continue to grow, according to Global Market Insights, Inc. By 2032, estimates show that medical billing outsourcing companies in the USA alone may become a 41.9-billion-dollar industry.

The tremendous growth of the market just in the US reflects the trend of medical billing outsourcing to save on operating costs. Healthcare organizations struggle with high in-house medical billing. 

Offshore medical services may immensely help keep costs down. Small, critical access and community hospitals benefit the most with their limited capital. The benefit is why these smaller healthcare providers make up 71% of outsourcing engagements.

Medical Transcription

Outsourced medical transcription services are a more recent development. Transparency Market Research projects that the medical transcription outsourcing market will reach USD 96.7 billion by 2028.

Medical transcription services are becoming a growing need in healthcare organizations. Telehealth and remote healthcare services are becoming more popular due to the boom of interconnection during the COVID-19 pandemic. These processes require accurate medical transcription. Appointments, diagnoses, and other digital transactions must be transcribed correctly.

By outsourcing medical transcription, healthcare organizations must relinquish control. Decision-making regarding transcription will be handled by the offshore team. This factor makes communication and coordination paramount between the offshore team and the medical organization.

Other Healthcare Processes

Outsourcing medical coding and other healthcare responsibilities may be done successfully too, at lower costs than domestic hiring. 

Using an offshore salary calculator, salary costs for a middle-level laboratory technician, a medical advisor, and a medical writer in the US, UK, and Australia compared to the same roles in the Philippines are laid out in the table below.

Role	US Annual Cost	UK Annual Cost	AU Annual Cost	PH Annual Cost
Laboratory Technician	USD 52,000	USD 49,000	USD 47,000	USD 7,000
Medical Advisor	USD 364,605	USD 78,000	USD 82,000	USD 11,000
Medical Writer	USD 80,000	USD 65,000	USD 75,000	USD 9,200

Consider Outsourcing Medical Processes to the Philippines

The outsourcing market for medical or healthcare processes is only expected to grow from here. You can take advantage of this trend by offshoring your administrative procedures to the Philippines. You gain cost savings and the required labor and skills for these administrative tasks. Most importantly, you will be able to focus on taking care of your patients in the end.

Reach out to Penbrothers to discuss how we can tackle your business challenges together.