Patient access outsourcing
Definition
Patient access outsourcing is when a healthcare organization hires an outside partner, like ROI CX Solutions, to manage tasks like appointment scheduling, referral coordination, patient intake, and phone coverage. The partner acts as an extension of the organization, using the same processes and standards, to ensure patients receive consistent service across every location.
Also called: patient access BPO, outsourced scheduling, outsourced front desk, healthcare BPO
Quick facts
- Function: Outsourcing
- Domain: Patient access
- Used by: COOs, operations directors, practice administrators
- Related KPIs: Call abandonment rate, referral-to-care time, no-show rate
What work is typically outsourced?
Healthcare organizations can outsource one patient access function, or several. Common tasks include:
- Inbound and outbound patient calls
- Appointment scheduling
- Referral intake and coordination
- Patient intake
- Insurance verification
- Prescription refill requests
- Appointment reminders and follow-ups
How does it work day to day?
The outsourcing partner will follow the healthcare organization’s procedures, use its electronic medical record (EMR) system and follow its scheduling rules. Team members represent the organization when communicating with patients and a designated account lead monitors performance and reports on agreed upon metrics.
What are the common models?
- Overflow coverage: The partner handles calls that in-house staff cannot answer, helping reduce missed calls and long wait times.
- Peak-hour coverage: The outsourcing partner provides additional support during busy periods, such as morning call surges or seasonal increases in demand.
- Fully outsourced function: The provider manages an entire function, like appointment scheduling, and follows the organization’s procedures.
- Surge support: The partner provides temporary help to clear backlogs, process outstanding referrals, or manage unusually high call volumes.
- Dedicated team vs shared agents: Dedicated teams work exclusively for one healthcare organization, while shared agents support multiple clients.
Why do multi-site groups outsource patient access?
Multi-site medical groups outsource patient access to address staffing shortages, improve consistency across locations, and reduce delays in referral handling. Outsourcing is also great for providing more reliable coverage without requiring the organization to recruit and train additional employees at every office.
What are the risks, and how are they managed?
The three main risks of patient access outsourcing are:
- Protected health information (PHI): Outsourced teams may access sensitive patient information. Healthcare organizations should use appropriate business associate agreements (BAAs), role-based access controls, workforce training, and verified security safeguards to protect that information.
- Loss of control: Organizations can maintain oversight through documented procedures, shared performance metrics, regular reporting, and clearly accountable partner lead.
- Patient experience: Consistent scripts, staff training, call monitoring, and quality reviews help ensure patients receive accurate, professional service that reflects the organization’s standards.
Patient access outsourcing vs. patient engagement software
Patient engagement software automates tasks like appointment reminders, online scheduling, and digital intake. A patient access outsourcing partner provides people to manage those tasks, answer questions, resolve exceptions, and complete work that needs human judgement.
What results can groups expect?
Patient access outsourcing can improve appointment attendance and help more patients reach the care they need. In fact, ROI CX Solutions was able to help a leading healthcare client achieve a 75% reduction in no-shows across 14 departments. We also helped another client, Treasure Coast Community Health, reduce call abandonment rate from 27% to 5%.
FAQs
Will patients know they’re talking to an outside team?
Not necessarily because outsourced teams can communicate under the healthcare organization’s name and follow its established procedures. The organization should determine how the team identifies itself and ensure all communications are accurate and transparent.
How long does it take to transition?
The transition can take a few weeks to a few months, depending on the services being outsourced and training requirements. Limited overflow coverage usually takes less time than transitioning an entire patient access function.
Can we outsource only after-hours or overflow calls?
Yes, healthcare organizations can outsource specific coverage periods or functions without transferring all patient access work. After-hours coverage and overflow support allow in-house teams to retain ownership of routine operations while the outsourced team handles calls they are unable to answer.
