Healthcare BPO (HIPAA-compliant)

Overview

What we deliver

We run HIPAA-compliant healthcare BPO services covering patient support, claims, scheduling, and revenue cycle tasks for payers and providers.

We deliver healthcare BPO services for payers, providers, and digital health firms that need scalable, compliant support. Our agents handle patient inquiries, appointment scheduling, eligibility checks, prior authorizations, claims status, and basic revenue cycle tasks across voice, chat, email, and secure portals. Every workflow is built around HIPAA requirements, with role-based access, audited systems, encrypted communications, and regular privacy training for staff. We work inside your EHR, payer portal, or contact center platform, so data stays in approved environments. Our QA team monitors calls for both service quality and protected health information handling. We staff with healthcare-experienced agents and run continuous training on plans, products, and policy updates. Reporting covers service levels, first contact resolution, and compliance indicators so your leadership and audit teams always have a current view of how the program performs and where to invest next.

Fit Check

Built for teams like yours

Who it's for

Health plans and payers
Hospitals and health systems
Medical groups and clinics
Digital health and telehealth firms
Pharmacy and DME providers

Pain points we solve

Long patient wait times
Backlogs in prior auth and claims
Risk of HIPAA breaches
Inconsistent member experience
High cost of in-house support

What's included

Capabilities

Everything we cover in this engagement.

Patient and member support
Appointment scheduling and reminders
Eligibility and benefits verification
Prior authorization support
Claims status and follow-up
Revenue cycle support tasks
HIPAA-trained agent staffing
Secure access to EHR and payer portals

How we work

Our process

A clear, predictable path from kickoff to outcomes.

01

Assess

We map workflows, systems, and HIPAA controls in scope.

02

Design

We build SOPs, scripts, and security controls aligned to your policies.

03

Train

We hire and certify agents on plans, systems, and privacy rules.

04

Launch

We pilot live volume with close oversight and daily huddles.

05

Optimize

We tune staffing, training, and QA based on weekly performance data.

What you get

Deliverables & outcomes

What you get

HIPAA-compliant operations setup
Trained healthcare agent teams
SOP and script library
QA and privacy monitoring
Performance dashboards
Quarterly governance reviews

Outcomes you can expect

Shorter patient wait times
Faster claims and auth handling
Strong HIPAA compliance posture
Higher member and patient satisfaction
Lower total cost of service

Timeline

10 to 16 weeks to go-live

Engagement

Monthly retainer, Project, Sprint

Tools we use

Epic, Cerner, Availity, Salesforce Health Cloud, Genesys, Microsoft Teams

KPIs we track

Service level, AHT, FCR, member CSAT, HIPAA exceptions

Client stories

What clients say

"

My books were 90 days behind and I was avoiding my accountant. They cleaned up nine months of mis-categorized Shopify and Stripe entries, set up proper rules in QuickBooks, and now my close lands on day four of every month. First time in three years I opened a P&L without wincing. Cash forecasting actually makes sense now.

D.R.

"

We had been prototyping an AI quoting agent for nine months and could not get it past demo quality. They came in, scoped a real eval set, swapped our retrieval layer, and added guardrails for the edge cases that kept burning us. Went live in seven weeks. It now handles 41 percent of inbound quote requests without a human touching them.

Kyle A.

Proof