Tips for Healthcare Executives

Building a Successful Partnership with Outsourced Enrollment Period Help


Open enrollment is often stressful and hectic. Without the right support, staff can easily become overwhelmed, and their work can suffer. Finding the right solutions to these problems is important, which is where outsourcing can be helpful. 

The Open Enrollment Period can be crucial for insurance businesses in the healthcare sector. From completing paperwork and helping with policy selection to sorting through medical billing, many different things need to be done. Outsourcing is quickly becoming a popular method for keeping up with the demands of enrollment periods, with the healthcare BPO market estimated to reach $132B by 2025. 

Who Outsources & What Tasks Can Providers Assist With?

We’ve already established that outsourcing is a common practice, but who is benefiting from it in healthcare? There are a variety of healthcare sectors that commonly outsource, especially during enrollment periods.

Healthcare Sectors Using Outsourcing
Some healthcare sectors that outsource include:
Hospital infrastructure management is often outsourced. Outsourcing partners can help improve efficiency and establish proven workflows.
Health Insurance Providers
Insurance companies utilize outsourced talent to meet surging demand during enrollment periods, payer Medicare, group and commercials licensed agents for enrollment.
From clinical and patient care services to payroll management, outsourcing can empower clinics to do what they do best: focus on patients.
Specialist Offices
Specialist offices often don’t have the large staff that clinics and nursing homes do, so outsourcing is an ideal way to ensure operation without expanding the internal team.
Mental Health Facilities
Medical billing and policy compliance can be complicated in the mental health field, so working with experts is a great way to get peace of mind.
With data entry taking up a large portion of a lab’s operation time, outsourcing can relieve professionals to focus on more specialized tasks.
Nursing Homes and Assisted Living Facilities
With nursing home and assisted living facility budgets getting tighter and tighter, finding ways to provide the same high-quality services at a lower cost is essential. Outsourcing is an excellent way to access experienced employees without paying for the costs associated with full-time hires. Maintaining compliance standards is often improved through outsourcing and a need for these facilities.
Specific Outsourced Tasks
When it comes to outsourced tasks, it’s important to find the right provider who can match your needs exactly. Let’s go over some specific examples of outsourced tasks.
Data Collection and Entry Services
If there’s one thing you can count on during an enrollment period, it’s that they come with lots of data. From collecting data to entering it into your system, outsourcing BPO service partners can take over this task and free up your staff to focus on other things, such as working directly with policyholders. Many have found that data collection and entry is one of the least risky areas to outsource.
Medical Claims Processing
During enrollment periods, it’s easy for medical claims to back up. Medical claims are undoubtedly essential during any time of the year, but it’s important not to let them pile up during enrollment periods. By outsourcing this work area, you can build up your team and ensure they have enough resources.
It’s essential to have the right systems in place to handle the influx associated with enrollment periods. If you’re not confident in your current IT standing, then outsourcing could be the best option.
If you want your staff to be able to focus on working with new policyholders and guiding them through the enrollment process, then finances may be an area to outsource. When you find the right outsourcing partner, they’ll not only provide you with current support but can provide recommendations for future decisions.
From billing disputes and corrections to understanding various therapeutic options, the right BPO provider will have certified medical billers and coders.
When outsourcing tasks, it’s essential to understand your business, its core values and goals, your current staff, and past needs you’ve had during enrollment periods. Effectively preparing for enrollment periods can save you time and money, so selecting the right outsourcing partner is one of the most important things you can do.

Selecting the Right Outsourced Enrollment Period Partner 

Selecting the right outsourcing enrollment partner is essential, especially during critical enrollment periods. Because of the stress that enrollment periods often bring, along with the increased workload and time constraints, finding the right partner will relieve pressure from not only your team, but also you.

There are a few essential things to look for in an outsourced BPO services partner. 

Selecting the Right Outsourced Enrollment Period Partner
Exceptional Customer Service
A commitment to exceptional customer service is something that shouldn’t be compromised on. If you trust outsourced staff to be customer-facing, then they’re representing your business and influencing your reputation. Your policyholders deserve the best, which means selecting the right outsourcing partner with a dedication to customer service.
Emphasis on High-Quality Services
As we mentioned previously, your outsourcing partner will influence the opinions of policyholders. Ensuring that you’re employing talented, diligent workers is essential so that you can trust them and feel comfortable with their work.
Experienced Communication Skills
When it comes to enrollment periods, it’s important to have a team of experienced communicators. When working with the right healthcare BPO outsourcing partner, you won’t have to worry about implementing extensive training. Making sure that your healthcare BPO provider can handle the fast-paced, high-pressure open enrollment conversations is essential.

Having a discussion with the BPO services provider before selecting them is crucial so that everyone’s on the same page about the level of expertise you’ll be receiving.
Proven History of Success
One of the best ways to understand an outsourcing partner’s services is to look at their history. What do their testimonials say? Are there case studies you can review?

If you’re speaking with an outsourcing provider and they’re not able to deliver a clear history of success, they may not be the right choice. Especially during enrollment periods, it’s essential you have the best staff possible – the right outsourcing partner can make that happen and help you achieve your business goals.
Financial Effectiveness
Financial effectiveness and resourcefulness are key components many insurance businesses look for during enrollment periods. Ensuring you can get the highest quality work at an affordable price can be challenging, but it’s possible. It’s essential to evaluate a variety of potential partners to gain an accurate idea of what pricing aligns with your business goals.
Choosing a Bilingual Provider
Many people don’t consider the importance of choosing a bilingual provider, but it can be extremely helpful. Being able to rely on them for generalized support, especially when guiding people through the policy selection process, can relieve stress and improve accessibility.
Wondering what one of the most critical factors to look for is? Compliance, compliance, compliance. If a partner’s employees don’t understand HIPAA regulations, that’s one of the best signs you should look for other options.

Using workers that don’t have a comprehensive view of compliance could put your business at risk. Especially when it comes to enrollment periods, it’s essential to ensure that everything is done well – which also means being done legally.
The needs of insurance businesses can quickly evolve during enrollment periods, so scalability is an essential capability to look for in a potential outsourcing partner. Being clear about potential needs is necessary, but you should also have a general understanding of their full capabilities.

The right healthcare BPO partner will prioritize flexibility and understand the demands that come with various seasons. We’ve seen the power of this firsthand, as we increase our healthcare member management staff in preparation for the fall Annual Enrollment Period.
Examining Your Options
There are so many different things that can set outsourcing partners apart from the rest. For example, at Everise we value loyalty and incentivize our agents to stay with us long-term – resulting in more experienced agents, fewer transfers, and increased member satisfaction.

When it comes to picking the right provider, it’s important to evaluate multiple different options. This is one reason why giving yourself ample time before the enrollment period begins is important.

Setting Clear Expectations 

Empowering your outsourced team by giving them the right resources and setting clear expectations is one of the best things you can do to set them up for success. Being able to outline your expectations, as well as how they fit into your business goals, will provide a sense of direction and help the integration process. 

Setting Clear Expectations
Establish a Timeline
Timeliness is vital during enrollment periods. Having a clear timeline is one of the best ways to convey your expectations, and it can also be an important success metric.
Communicate Effectively
How will your outsourcing partner communicate with your current team? Will they be communicating with you? Considering these questions beforehand will help you prepare and ensure everyone’s on the same page.
Define Outcomes
What exactly will you be outsourcing? By taking a look at your business goals, as well as your enrollment period needs, you can define desirable outcomes. Everyone must be fully aware of these outcomes and why they matter during the enrollment period.
Clarifying Roles and Responsibilities
Another way you can empower your team to perform at their best is by clarifying their roles and responsibilities before they even start. What do we mean by that? An important part of choosing the right outsourcing BPO services provider is communicating exactly what you’re looking for and what task outcomes you want.
Business Reviews
One of the best ways to gauge success, make sure everyone’s on the same page, and understand the specific benefits you’re getting from outsourcing is by establishing monthly and/or quarterly business reviews. This time can be extremely valuable, letting staff know you’re there to support them and allowing you to gain an accurate picture of the work being done.
Understanding Expectations
From encouraging integration with your current team to getting desired results, there are so many different reasons why everyone must understand the expectations of them. When creating expectations, it’s essential to have a clear timeline, define the desired outcomes, and be direct about everyone’s roles.
Confidentiality Guidelines
Confidentiality is not often thought about, but it can be incredibly important. If you’re unsure what guidelines to implement, consult a legal professional.

Effective Communications 

Communicating with your outsourcing staff can make or break an enrollment period. Communication is often the key to reaching business goals, so let’s go over some tips. 

Effective Communications
Use Data
Data is one of your most powerful tools, so don’t be afraid to use it. Whether you’re showing past results or giving directions for future ones, data can be a clear and direct way to communicate.
Be Realistic
There are so many challenges that outsourced staff face, so being realistic is important. Enrollment periods are often stressful enough, and integrating with a new team can add to that. While it’s important to hold your team to high expectations, it’s also essential to be understanding and put yourself in their shoes.
Be Collaborative
Every executive has a different level of involvement that they want with their team. Whether or not you wish to be deeply involved during enrollment periods, it’s important that your team has the tools they need to collaborate. This can often mean having the right software and understanding everybody’s roles.
Provide Context
While outsourced staff will be experienced, they’ve likely never worked for your business before. Providing context is an excellent way to bring them up to speed and help them understand the specific goals they were brought on to help achieve.
The Importance of Communication
Especially during the beginning stages of an enrollment period, establishing clear communication guidelines is an excellent way to remain aware. It can be difficult to trust new staff entirely, so consider what strategies you can use to encourage open and honest communication.

Monitoring Progress and Outcomes 

We’ve gone over why outsourcing is a popular option, as well as some best practices; now, let’s go over how to monitor progress. 

You’ve most likely hired outsourced staff for one reason: to help you accomplish business goals during an enrollment period. But how exactly can you make this happen?  

Monitoring Progress and Outcomes
Be Specific with Expectations
You should be clear about your expectations before your healthcare BPO provider partnership begins. Ideally, you would have clear expectations laid out before you start evaluating potential partners. Don’t be afraid to be specific and involve your current staff in this process.
Be Clear and Concise
While it’s good to be specific with your expectations, they should also be reasonable and achievable. Setting clear and concise guidelines is an excellent way to make sure that a potential outsourcing partner can fulfill your needs.
Put it in Writing
When you’ve chosen your new outsourcing partner, consider getting everything put in writing. This is an excellent way to ensure everyone’s held accountable and you receive the help you’re enlisting.
Involve the Partner
Different outsourcing partners will have various standards for how involved they want to be. While it’s essential to consider these standards, you can also ask for adjustments to be made based on your unique business needs.
As we mentioned previously, it’s important to have consistent reviews scheduled. One of the best ways to conduct these reviews is to have specific success metrics put in place. You can then use these metrics to inform your staffing decisions and understand the ROI of your outsourcing.
Direct Involvement
One of the best ways to get peace of mind during enrollment periods is to be directly involved. This can be as simple as checking in with staff or having a set time when they can speak to you. Establishing open communication as an expectation is much easier when staff feels comfortable, so consider the level of involvement you’d like to have and some practical ways to make that happen.

The Benefits and Disadvantages of Outsourcing

Just as with many business practices, outsourcing has both benefits and disadvantages. It’s essential to consider both of these things when deciding whether or not to outsource, so you can get a comprehensive and holistic view. 

Key Benefits of Outsourcing
Outsourcing has various benefits, which is one of the reasons why so many insurance businesses are using it to further their achievements during enrollment periods.
Cost Savings
If you have a tight budget, outsourcing may be able to help you save money. Outsourcing BPO services can significantly reduce the overhead costs associated with hiring and training new employees and maintain the necessary infrastructure to support the service in-house. When you choose the right healthcare BPO partner, you won’t have to worry about sacrificing quality for affordability.
Access to Specialized Expertise
Outsourcing BPO services can provide companies with access to specialized knowledge and technology that they may not have in-house, allowing them to improve the quality of their services and stay competitive in the market.

It’s essential to find a healthcare BPO provider that’s committed to educating their staff and providing them with continual opportunities for improvement. We’re dedicated to this, as our College of Insurance provides licensee training courses and practice exams, along with mentorship and subject-matter support.
Focusing on Core Business Activities
Your current staff has their own expertise, and they should be able to focus on those strengths during enrollment periods. By outsourcing non-core activities, companies can focus their resources on core business activities, resulting in higher productivity and profitability.
Scalability is perhaps one of the most important benefits of outsourcing. Outsourcing BPO services can allow companies to scale up or down their services as needed, depending on their business requirements and demand. As the enrollment period continues, you can make adjustments that align with your business goals.
Improved Efficiency
BPO service providers often have streamlined processes and technologies in place, allowing them to deliver services more efficiently and effectively than in-house teams. This ties into the first point, as it can save money.
Risk Reduction
Outsourcing BPO services can help companies reduce risks associated with compliance, legal, and regulatory issues, as service providers often have expertise and experience in handling these matters. It’s essential to have an accurate understanding of an outsourcing partner’s specialized services before working with them, so you can be sure they’ll genuinely reduce risk.
Key Disadvantage of Outsourcing
There are some considerations that need to be kept in mind when it comes to outsourcing BPO services.
Quality Concerns
When you’ve worked with your in-house staff for an extended amount of time, you understand the quality of work they provide. This isn’t the case when it comes to outsourced staff. There isn’t a guaranteed way to know the quality of work you’ll receive, which is why involvement and success metrics are so important.
Communication Barriers
Communication can sometimes be challenging depending on your outsourcing partner’s location. If you’re concerned about this when evaluating potential options, consider asking them how they’ve confronted communication issues in the past.
Loss of Control
A degree of control is lost when you choose to outsource BPO services. It’s essential that you find a partner you feel comfortable with, so this loss of control is acceptable.
Employee Impact
It’s possible that BPO outsourcing could have a negative impact on your current employees. Taking your in-house team into account is important when you’re considering whether or not outsourcing is right for you. While there is a potential negative impact on employees, there is also the potential for them to be less stressed and more focused.
Weighing Your Options
There are pros and cons to BPO service outsourcing. Whether or not it’s right for you will depend on your business structure and goals, as well as the demand that you have during enrollment periods.

Healthcare Executives and Outsourced Help

As we mentioned previously, healthcare executives have various levels of involvement when working with outsourced help. When finding what works for you, consider your business goals, current staff, and employee expectations. One of the best ways to succeed during an enrollment period is to have the right team, so don’t hesitate to evaluate potential outsourcing partners.

Current Employee

If you are a current employee and in need of assistance, we are here to help. To ensure that your request is addressed as efficiently as possible, please open a ticket on Workday. Our dedicated support team will be happy to assist you.

Learn More

If you are a potential candidate interested in joining our team, we encourage you to explore the opportunities on our career page. There, you will find all the information you need and the positions we currently have available. We look forward to hearing from you and seeing how you can contribute to our dynamic team.

Learn More