outsourcing business from usa - is viet nam a sleeping tiger?
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Outsourcing Business from USA Is Viet Nam a sleeping 9ger?
By Shivaji (Sam) Sengupta
me@shivaji.info www.shivaji.info
www.LinkedIn.com/in/shivaji
www.Twi@er.com/ShivajiSengupta
Worldwide and U.S. Business Process Outsourcing Services 2012-‐2016 Forecast
IDC expects the worldwide BPO market to reach $202.6 billion in 2016, represenQng a five-‐year CAGR of 5.3%. The U.S. market is expected to grow at a five-‐year CAGR of 4.2%, reaching $92 billion in 2016. IDC concludes that BPO services vendors are beginning to assist the transforma9on efforts of their customers. Evidence is now seen in case studies from providers that describe case studies where they have leveraged their automated sub-‐process solu9ons, big data, business analy9cs, mobility, cloud delivery, and so forth, and as a result, customers are not only reducing errors/defects in their processes but beginning to standardize processes globally, analyze business performance (oLen in real 9me), and gain more insight and control over their business operaQons.
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Latest Trends affecQng the USA Outsourcing Model
Here are few trends which give idea of what is stored in future for this outsourcing industry:-‐ 1. Client will ask for increased standardized solu9ons from their
outsourcing contracts, so the vendor will have to differenQate their services through performance rather than pricing.
2. Industry leaders and analysts predict that industry will face cost pressure, though short term, and Vendors/service providers, will be under pressure for more flexible pricing contracts.
3. Smaller alliances, which have focus on opera9onal efficiencies, good quality control, lesser back office costs, will have rising trend.
4. The rising energy cost will pressure companies to look for areas where cost reducQon can be done. Taking advantage of technology and outsourced work to save cost will be on the priority list of the companies.
5. Cloud based technologies will grow, as they are cost effecQve.
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
BPO Maturity Scale
Ad Hoc
Defined
Linked
Integrated
Functional strong,Process barely visible
Functional strong,Process boundaries visible
Functional strong,Process strong butwith gaps
Functional and Process strong
Increasin
g BPO Maturity
Key: - Process orientation- Functional orientation
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Types of BPO
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Finance and AccounQng BPO
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Outsourcing advances in Publishing Business
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Insurance Processin
g
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
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Three Tenets of BPO
Flexible & Stable
ConQnuous Incremental Training & Mentoring
Standardized and
Repeatable
Process People
BPO
Technology
Technical Specialist
Human Capital
Sub Contract
Clients
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Top IT Outsourcing DesQnaQons
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✪ India 51%
China 3%
Philippines 21%
Ireland 7%
Advantage India
As the markets in outsourcing have become Knowledge intensive, India has become the most preferred global hub for outsourcing for knowledge services (KPO). India has large pool of skilled manpower resources such as Chartered Accountants, MBAs, Doctors, Lawyers, Research Analysts, Sogware engineers, which is necessary for growth of KPO. The areas of KPO are, where India has edge over other desQnaQons, are :-‐ 1. Finance and AccounQng outsourcing 2. Legal Outsourcing 3. Services that require advanced English like Content and Medicine
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
China Challenges
Undertaking any form of business transacQon in china presents unique challenges as a result of both cultural and regulatory factors. High levels of employee churn amongst outsourced service providers coupled with limited cultural awareness of the importance of proprietary informaQon. It is important to note that the PRC IPR enforcement regime is focused heavily upon registered rights, so local registraQon of IPR within china can be helpful. There are several key challenges which need to be addressed in a china outsourcing, including: • Language • Due Diligence • Regulatory • ProtecQng IP • Contractual
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Advantage Philippines
From an outsourcing perspecQve, the Philippines is one of the global Qtans. Ranked 2nd ager India as a business process offshoring market by desQnaQon, the Philippines has emerged as a power-‐player that has aggressively taken advantage of the outsourcing trends over the past decade. Choosing the Philippines for your BPO requirements presents disQnct advantages: • Lifestyle, language and professional skills that are culturally specific to Western
partners • A mature, funcQonal democracy operaQng in a free-‐trade environment • A steady supply of highly qualified and skilled manpower • Well organized and workable labour laws • English speaking populaQon • A 'value added' and pro-‐acQve work ethic • Access to state-‐of-‐the-‐art technology • Deregulated financial systems • U.S. based legal system
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Country Snap Shot – BPO PerspecQve
India China Philippines Ireland
High End BPO
Process Maturity
Technology Competence
Scale
Project funding
High End BPO
Language
Process Maturity
High end BPO
Quality
Technology Competence
Rising Costs
Quality Issues
Rising Costs
Language
Low end BPO
Labor Shortage
High Cost
Tax Benefits Gone
PosiQ
ves
NegaQ
ves
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Weakness Threats
Strengths Opportunity
Viet Nam SWOT
ENVISIO
N RE
COGN
IZE
DEVELOP
REDUCE
Clients Looking for AlternaQves
ConnecQvity
Real Estate costs
Focused Delivery Teams
Language
25% 50% 100% SCALE OF IMPACT
Business Friendly
Geography
Young Workforce
AccounQng Standards
Sub ContracQng
Value BPO Processes
Domain Experience
InflaQon
Stable Government Labor Costs
Technology Skill Sets Technology Infrastructure
Regional Business
Core Team -‐ Trainer
Vietnam Plan of AcQon
BPO Capability
Workflows & Technology
Partnerships & Alliances
Business Development
Market – India
Market – USA
Market – EMEA
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Its not all about wages
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Healthcare Outsourcing
What is Healthcare
Health insurance is designed to give you peace of mind. It allows you to focus on your health -‐-‐ instead of medical bills that could pile up when you are not feeling well. When a individual buy health insurance, the health plan pays for many of your medical expenses, whether you visit your doctor for prevenQve care, such as a yearly check-‐up, or you receive medical treatment for a health concern. Health Insurance can also help cover your bills if you need to go to the emergency room. Your health insurance can protect your family members as well, and even extend beyond medical care: certain kinds of insurance can lower the cost of prescripQon drugs, and vision and dental care. You can buy health insurance through your employer, a broker, and directly from an experienced, accredited insurer such as a Health Insurance Company. You pay a premium -‐-‐ a monthly charge -‐-‐ for your insurance and if you get insurance through your employer, your employer may also pay some of the cost. You ogen pay some other costs toward medical bills, too.
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Healthcare Programs
• Mailroom/Claims Capture
• Membership and Provider Eligibility
• Edit ResoluQon for Suspended Claims
• Provider /Member Correspondence/Suspended Claims
Claims Processing
• Print and Fulfillment of Membership Kits
• Inbound & Outbound Mailroom OperaQons
• Membership ApplicaQon Review and Approval
• Premium Processing
• Membership Enrollment Card ProducQon and fulfillment Enrollment & Membership Management
• Provider Contract Fulfillment
• Contract Approval and CredenQaling: Direct Access into Client’s ApplicaQons
• Contract Repository & Workflow
• CredenQaling File Conversion
Provider Contract & Creden9aling Management
• Premiums / Provider Reimbursements / PBM Payments
• EOB DistribuQon/Processing/Payments
• Address Search Processing • CMS Compliance Trail
Payment Processing
• Print and Le@er GeneraQon for Surveys
• Capturing of Survey Responses
• Outbound / Inbound Call Center
Coordina9on of Benefits (Commercial, RxCOB)
• USPS / Fax / CD-‐ROM Processing
• Repository / Workflow ApplicaQons • InvesQgaQon / Audit / QA • Audit Trail Adhering to Compliance Measurements for Case TAT
• Integrated Le@er GeneraQon to Providers and Insured • Document Fulfillment • ANSI 837 Receipt
Fraud & Abuse, Hospital Bill Audit
• Complete InformaQon Channel for Medical Benefit RequesQng
• Instant NoQficaQon for Expedited Requests • Integrated Variable Content Management for Approval and Denial
Pre-‐Authoriza9on & Referrals
• Mailroom OperaQons
• Repository Workflow
• Address Search Processing • CMS Compliance Trail
• Address correcQon and re-‐mail
Return Mail
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Payment Methodology
MEMBER ENROLLS IN AN INSURANCE PLAN THROUGH EMPLOYER
PATIENT GOES TO A PHYSICIAN/HOSPITAL
PHYSICIAN/HOSPITAL PROVIDES SERVICES
PRVOIDER PREPARES AND SUBMITS THE MEDICAL CLAIM TO THE INSURANCE COMPANY.
CLAIM IS RECEIVED AT HEALTH INSURANCE COM. THROUGH FAX/ ELECTTONICALLY, ETC.
CLAIM IS DATA ENTERED
CLAIMS LOADED INTO THE ADJUDICATION SYSTEM
INSURANCE COMPANY VERIFIES THE CLAIM
INSURANCE COMPANY PAY /DENY THE PROVIDER
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AdjudicaQon Process
Member ValidaQon
Provider ValidaQon
DOS/POS/DX/Procedure Code/Modifiers/Billing Amount
ValidaQon
Edits/Suspend ValidaQon
Resolve the edits based on claims P&P
End Process (File/Deny)
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Typical SoluQon
• Current Work for Daimler Trucks NA (Portland, OR)
• Accounts Payable Workflow Solution
• Just Renewed Contract for an Additional 5 Years
• Potential Architecture Leverage of Existing Platform for DAG Services (Moving Towards One Main System)
• Potential Ramp Time Reductions for DAG Based on Knowledge Gained from DTNA Implementation
Client
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
Typical Project Team
Delivery Head
Site Head
OperaQons Training Quality
Support Team
Recruitment
AdministraQon
IT
InformaQon Security
Program Management Team
Account Manager
Director PMO
Technical Project Manager
SME / Business Analyst
Technology
Design
Development
TesQng
Release Management
© Shivaji Sengupta 2013-‐2015 All Rights Reserved
THANK YOU
Q & A
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