As businesses know, customer experience is a top priority and businesses can't afford to drop the ball when it comes to customer support. Up to 89% of consumers have switched to a competitor after a poor customer experience. By contrast, companies that focus on a positive customer experience are 60% more profitable. The contact center has become the front line in delivering seamless customer experiences. But is managing an in-house customer call center the best approach for your business? Or, would call center outsourcing make more sense? In this article, we delve into everything you need to know about call center services and outsourcing.

What You Need to Know about Call Center Services

Call center services are more than just answering calls. They're your business's first line of defense in maintaining customer relationships, resolving problems, and offering product or service support. The services range from technical help desks to telemarketing, lead generation, customer support, and even crisis management.

In essence, call center services have to maintain the delicate balance between being cost-effective and providing quality customer support. To achieve this, they rely on a combination of skilled personnel, cutting-edge technology, and proven strategies. But these can be demanding to manage in-house, particularly for small to medium enterprises (SMEs) who have limited resources. That's where call center outsourcing comes in.

The Pros and Cons of Call Center Outsourcing

Call center outsourcing involves entrusting your customer service operations to a third-party company. But like any other business decision, it comes with its benefits and downsides.

Pros:

Cost-Effective: Outsourcing eliminates the overhead costs that come with running an in-house contact center, such as recruiting, training, salaries, and technology upgrades. With an outsourcing partner, you only pay for the service package you need.

24/7 Availability: As businesses operate in an increasingly global market, customer support has to be available around the clock. Outsourcing partners have teams across different time zones, ensuring that someone is always available to handle customer queries.

Access to Expertise and Technology: Call center outsourcing companies are experts in their field. They are equipped with the latest technology and have a team of well-trained professionals to handle customer interactions. This means your customers will receive a higher level of service.

Cons:

Less Control: When you outsource, you lose direct control over how your customer service is handled. Although you can set guidelines, you will have to trust your outsourcing partner to represent your brand accurately.

Potential Quality Issues: Not all outsourcing companies deliver the same quality of service. If you don't carefully vet your provider, you may risk damaging your brand's reputation.

When is it Time to Outsource?

Recognizing the right time to outsource is crucial for your business. Here are a few indicators that it might be time:

Rapid Business Growth: If your company is growing faster than you can keep up with hiring and training customer service staff, call center outsourcing is a viable option.

Customer Complaints Increasing: When your customers are frequently expressing dissatisfaction with the speed or quality of support, outsourcing can provide a quick and effective solution.

Budget Constraints: If maintaining an in-house contact center is straining your resources, outsourcing is a more cost-effective solution.

Need for 24/7 Support: If your business is expanding into new markets across different time zones, an outsourcing partner can provide the around-the-clock support your customers need.

Blending Technology and Human Touch in Outsourced Call Center Services

The successful implementation of outsourced calling services hinges on a harmonious blend of technology and people. On the one hand, technology enables efficiency and effectiveness. Advanced tools such as automatic dialers, interactive voice response systems, and CRM software streamline processes, improve call handling times, and provide personalized service. Artificial intelligence and machine learning technologies can also help analyze call data for better decision-making and performance improvement.

On the other hand, no amount of technology can replace the human touch which is crucial for customer interaction. Skilled, empathetic, and customer-centric agents are the heart of call center services. They handle complex customer queries, empathize with customers during challenging situations, and provide the human interaction that customers appreciate. Therefore, the real power of call center outsourcing lies in the strategic blend of cutting-edge technology and well-trained, customer-oriented personnel. When these two aspects work in harmony, businesses can offer top-notch, consistent, and reliable customer support through their outsourced contact centers.

Exela’s Commitment to Transformative Call Center Services

With Exela's Call Center Services, businesses can convert their pain points into stepping stones toward remarkable growth and customer satisfaction. Overwhelmed by limited resources or the inability to scale? Exela offers a practical, cost-effective solution that not only scales with your growth but also eliminates the need for you to invest in an expensive in-house infrastructure. Worried about compliance issues? With our rigorous adherence to applicable laws and regulations, we provide peace of mind and ensure your contact center operations are above reproach.

Our experience of over 30 years coupled with our global network, state-of-the-art technology, and unwavering customer focus makes us a preferred choice for businesses. However, our approach goes beyond just offering services. We focus on outcomes. For instance, when you partner with us, you aren't just getting a call center service. You're tapping into a system engineered to enhance customer satisfaction, increase sales, and significantly reduce costs.

We provide tailored solutions to match your specific business needs, all while maintaining an impressive standard of service. Our team’s expertise in technical areas ensures high-quality customer interaction, and our dedication to meeting your Service Level Agreements (SLAs) means you can expect us to consistently deliver to your specifications. Plus, our services are available 24/7, ensuring we're there when your customers need us.

Our approach to workforce management, enhanced by predictive analytics, ensures you have the right staff levels to meet demand at any given time. Our dedication to data analysis offers you deeper insights into who is calling and why, allowing for continuous improvement in your customer service delivery. Moreover, our ability to provide a seamless customer experience across multiple channels positions your business to meet and exceed the expectations of the modern, omni-channel customer.

With Exela, you’ll see more than just the outsourcing of your contact center needs. You will witness a transformation in your customer service delivery, an increase in customer satisfaction, and a substantial reduction in costs, all provided through a service model that delivers the resilience and redundancy necessary for business continuity. We are able to apply knowledge, insight and proven strategies obtained from years of contact center experience to your company’s project plan. Let your team focus on more complex tasks and what they do best - your core business, and allow Exela to focus on what we do best – contact center! In a world where customer experience is paramount, Exela stands ready to propel your business to new heights.

Empowering Your Business with Exela: The Future of Call Center Services

Call center outsourcing looks different for every business which is why it’s important for businesses to partner with a company that tailors solutions to their needs. At Exela, we do just that. Outsourcing your call center services can be a game-changer in providing superior customer service and driving business growth. Learn more about our Contact Center Services today.

Revenue Cycle Management for healthcare organizations has never been more important. Put simply, this process involves optimizing revenue integrity by reviewing every administrative and clinical function contributing to the collection of revenue and applying best practices to ensure maximum reimbursement for healthcare services in a timely manner.

The healthcare revenue cycle is complicated and intricate, with many factors that impact who pays, how much they pay, and how they pay. Patients may have no health insurance and are billed directly. Others have Medicaid or Medicare. Many are covered through a private insurance plan, often offered through their employer, which could involve any of the numerous US insurance companies - and in some cases multiple companies in collaboration. Mix that with the wide range of visit types and procedures, as well as coverage terms like deductibles, copays, and coinsurance, and you’ve got an environment ripe for errors and missed opportunities.

Clearly, in today’s complex and fluid healthcare industry revenue cycle management is about much more than just billing and collecting payments. Fortunately, with the help of digital solutions and third-party administrators who specialize in healthcare billing, healthcare providers are able to manage the complexity of these billing cycles, maintain reliable cash flow and deliver high-quality care to their patients.

The Goal of Revenue Integrity

According to the National Association of Healthcare Revenue Integrity (NAHRI), the goal of Revenue Integrity is “to prevent recurrence of issues that can cause revenue leakage and/or compliance risks through effective, efficient, replicable processes and internal controls across the continuum of patient care, supported by the appropriate documentation and the application of sound financial practices that are able to withstand audits at any point in time.” In other words, identify missed income for healthcare providers, determine the cause, and find ways to mitigate the issue in order to prevent it from happening with future payments.

Today, technology plays a crucial role in assisting providers, payers, and consumers in communicating efficiently, which breaks silos and improves durable revenue cycle management strategies. There are several critical areas that healthcare managers could focus on to ensure their medical facility optimizes its revenue cycle.

Reducing Claims Denials

As per the Healthcare Financial Management Association, claim denials cost an average of $5 million per year to each healthcare provider. Just reducing this amount could save a lot!

More than 20% of healthcare claims are routinely denied, with some providers experiencing up to a 40% denial rate. However, 90% of these denied claims could have been prevented.

Organizations can recover this loss by utilizing analytics that can provide a deeper view and help dig into patterns to understand the reasons behind denials. Such insights can help health systems implement prevention plans and procedures for recovering the denials.

A significant portion of revenue leakage comes from inaccuracies and errors that lead to denied claims. Unfortunately, the process of correcting and resubmitting these claims can also be costly and time-consuming. That’s why it’s critical for healthcare providers to take steps to prevent their claims from being denied. One proven strategy to reduce denied claims is partnering with a claims processing company like Exela. Our Global PCH solution substantially reduces the number of denials by correcting errors before the claims are even submitted, allowing healthcare companies to confidently submit “clean claims,” which are more likely to be accepted by insurance companies on the first pass.

By leveraging automation technology, streamlining communication between providers and payers, and reducing the number of resubmissions, PCH is able to significantly accelerate the revenue cycle time.

To learn more about Exela’s PCH solution, and for an in-depth look at Revenue Integrity, download this recent edition of Exela’s quarterly publication PluggedIN.

Fix Medical Coding Errors

Clinical documentation has a tangible impact on the revenue cycle. Unfortunately, there are cases where bills are unpaid due to documentation errors or medical coding. Managing these discharged-not-final-billed (DNFB) cases is essential for hospitals to improve revenue cycle performance.

Medical coding is a complex process requiring proper coding and proper documentation. Medical coders require compliance with government regulations and private payer policies as well as education in medical terminology, diseases, anatomy, and physiology. Documentation comes from the physician who needs to accurately detail the treatment and care provided so medical coders know which codes and modifiers to use. Any error could cost the provider.

Due to its complex nature, healthcare providers may choose to outsource their medical coding needs. LexiCode, our medical coding services, aids providers of all sizes, scaling to each organization’s needs with quality assurance and productivity monitoring. Partnering with LexiCode, providers experience timely medical coding resulting in steady cash flow.

Hone in on Revenue Integrity

A revenue integrity (RI) plan is an essential component of optimizing the revenue cycle. This includes accessing current workflows for inefficiencies, implementing improvements, and upgrading technology where it can help. Unfortunately, not all providers have the time and resources to create a proper RI plan.

Exela enables healthcare providers to attain revenue integrity through integrated solutions and proprietary technology that address the entire revenue and reimbursement lifecycle. Our Revenue Integrity solution helps identify and recover underpayments, maximize reimbursement from third-party payers, and provides a streamlined RI process.

Leveraging decades of experience with Exela and our cutting-edge technologies, we maximize reimbursements and dollars recovered, and reduce or eliminate related overhead, all while enhancing employee, provider, payer and patient satisfaction. To know more in detail, take a look at our PluggedIN focusing on Revenue Integrity.

Digital transformation in healthcare continues to be a key topic in many healthcare leaders' minds. Healthcare providers of every size face the same challenge of improving patient care and engagement while managing costs. However, many obstacles create complications including limited staffing, outdated systems, payer contract complexities, and more. By embracing digital transformation, healthcare providers can begin to tackle these obstacles and accomplish their goals for the future.

Digital transformation in healthcare affects many aspects of the business from freeing up resources that can be devoted toward patient care and increasing patient engagement to improving operational and financial efficiencies. With AI, automation, and technological advancements, the healthcare industry stands to gain improved processes, quicker payments, and fewer claims denials.

Digital Transformation in Healthcare Starting with Automated Claims Processing

Claims management and processing is a major operation in need of digital transformation in healthcare. This is often a thorn in healthcare providers' sides because of its complexity. Claim denial rates are between 6% and 13%, which eats away revenue.

These statistics highlight the importance of submitting clean claims right from the start. However, this is easier said than done especially when relying on manual processing and outdated systems. Many healthcare claims are being denied for simple reasons such as a spelling error, incorrect coding, missing patient identify information. Given that healthcare organizations' resources are stretched thin, it makes sense that claims processing would be vulnerable to human error.

Once again, digital transformation in healthcare can step in and smooth the process. Exela is a leading claims processing provider with a solution that enhances claim processing by unifying data from all incoming communication channels, performing pre-submission checks to create clean claims, and intelligently routing correspondence for optimal processing using automated decisioning. Exela’s Healthcare Claims Processing solution reduces denials and resubmissions by applying business rules to produce clean claims prior to submission. Using automation and artificial intelligence, Exela increases transaction processing rates and accuracy while reducing manual processing and rework.

Take Complex Claim Processing Further

According to a 2021 CAQH report, only 21% of medical administrative transactions are digital while the rest are paper. Exela leverages exclusive vendor contracts with leading health plans for complex paper claims processing.

Embrace digital transformation further with Exela's PCH Global solution, a powerful digital platform that not only provides a single point of access for claims management but provides a central bridge between all parties including the provider, payer, and patient.

PCH Global promotes clean claim submissions by identifying certain-to-denied claims, thereby improving first-pass rates. Its iterative feedback loop technology helps the system continuously learn and improve to identify errors enabling proactive claims management with system flexibility as your contracts change.

Finally, the system automatically tracks and records any addition, deletion, or modification to transactions along with user reference and timestamps providing clear audit trails and ensuring full compliance.

Digital Transformation of Remittance Payments

The 2021 CAQH report determines that the healthcare industry could save 48% of annual spending by transitioning to fully electronic transactions. Manual processing significantly slows down operations especially when human errors are taken into consideration. Automation streamlines this process reducing errors, posting payments quicker, and improving overall efficiency making it a terrific place for digital transformation in healthcare.

Exela's Medical Lockbox simplifies the healthcare payment process by digitizing and automating manual, paper processing tasks. Using a state-of-the-art scanning platform and intelligent OCR/data capture technology, Exela’s Medical Lockbox solution converts paper EOBs from any source into 835, electronic remittance files, payment reconciliation and posting to the healthcare organization's medical billing system. By streamlining the payment path, Exela’s Medical Lockbox solution reduces the time it takes for payments to post and allows quicker access to deposited funds. Submitting secondary claims or patient billing, depending on the patient’s coverage, makes the payment cycle faster from Primary, Secondary, Tertiary or Patient payments.

Not only does Exela's Medical Lockbox streamlines payment processing, but it also features a web-based denial management tool designed to increase the recovery rate on denied claims. This web-based management tool presents the original claim and all related remittance information in a single view simplifying the process for users to adjust the claim, bill the patient, or appeal the denial. Insights are gleaned through reimbursement metrics presented within Exela’s Medical Lockbox’s configurable reporting function. These insights are valuable with billing system audits and contracts negotiations.

Automated Contract Management

Healthcare payer contracts vary greatly, each having different policies, regulations, and parameters. The contracts of each insurance company are often revised and updated annually so healthcare organizations need to renegotiate several payer agreements every year.

Keeping track of the current contracts and any annual updates is an enormous task that burdens healthcare resources. Without a handle on contract management, healthcare organizations are vulnerable to underpayments which affect their bottom line. Contracts and underpayment management are yet another place where digital transformation in healthcare is needed.

Exela’s Revenue Integrity solution automates the contract management process, document scanning, indexing, profiling, loading and maintaining all third-party payer agreements. Agreement terms are tracked and providers are presented with notifications of important dates as well as amendments and updates. Instead of using limited resources to keep track of contracts, automation is ready to step in.

Exela’s Revenue Integrity solution also offers predictive contract modeling that provides accurate reimbursement calculations for current and future contractual agreements. By providing multiple scenarios and utilizing the most recent one-year patient data set, the platform presents the net dollar and percentage increase or decrease.

This solution also identifies retrospective, current and prospective underpayments from all contractually obligated third-party payers.

Summary

Digital transformation in healthcare opens many doors and it’s time providers embrace the opportunities available to them. AI and other technologies are ready to streamline antiquated processes, increasing efficiency and accuracy while freeing up personal time.