While the recent global market meltdown has impacted outsourcing for both clients and service providers, the Healthcare industry has emerged as a relatively defensive sector that is offering opportunities for growth.

The healthcare reform finally became a reality and was signed into law on March 23, 2010. Known as the Patient Protection and Affordable Care Act (P.L. 111-148) (called 'PPACA'), this law not only brings new insurance coverage to 32 million Americans but will overhaul the entire healthcare system, affecting healthcare payers, healthcare providers, and service vendors.

Another regulatory requirement mandated by the government is the HIPAA 5010 standards and these changes need to be implemented in medical coding from ICD-9 to ICD-10 by October 1, 2013.1 These changes will require healthcare organizations to upgrade software and systems and implement new processes to facilitate compliance with the latest standards.

A further impetus to growth has been achieved with the US government's grant of USD 10 billion annually to physicians for adopting healthcare IT services. This amount is a part of the economic stimulus package and it aims at creating Electronic Health Records (EHR) for each person in US by 2014.

While the credit crunch has forced the healthcare industry players to recognize the need to reduce their cost-to-serve, the American Recovery and Reinvestment Act 2009 makes it mandatory for them to focus on investing in cost effective, state of the art IT systems to pave the way towards electronic claims processing and thus halving the cost-to-collection. As organizations contend with increasing regulatory and legal complexities, healthcare outsourcing strategy opens up opportunities to decrease costs, increase efficiencies, address scalability, while providing ample time to healthcare organizations to focus on core competencies.

How Wipro Helps

Wipro Healthcare BPO is a full-spectrum, end-to-end provider of Business Process Outsourcing (BPO) services covering Healthcare Payers, Healthcare Providers, and Medical Device companies.

We have more than 2500 resources delivering back-office functions and multilingual contact center support services to clients out of our delivery locations spread across the globe. The scope of services ranges from customer interaction centers to back office functions. These include healthcare claims administration, provider and member call support and capability in revenue cycle management.

Wipro has qualified Healthcare professionals delivering high-end domain intensive services such as Medical information dissemination, Medical Device Reporting, and Remote Patient Monitoring

Healthcare Payer

Wipro's Healthcare BPO arm is geared to handle the increased volumes of enrollment, healthcare claims processing, and customer service which the Healthcare Payer industry will be facing due to the changes brought about by the law.

Wipro has been working with leading US Healthcare Payer firms providing integrated outsourcing services for over seven years. Wipro offers Healthcare Payer specific BPO services for customer centric processes. These include:

• End-to-end claims management including front end keying, claims processing, adjustments
• Member enrollment management
• Customer service center for healthcare providers
• Customer service for members
• Policy administration
• Network management