Outsourcing Business from USA: Is Vietnam a sleeping tiger?

1. 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

2. 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

3. 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

4. BPO Maturity Scale Integrated y rit u at ing s a re c In Ad Hoc PO B M ✪ Defined Linked Functional and Process strong Functional strong, Process strong but with gaps Functional strong, Process boundaries visible Key: Functional strong, Process barely visible - Process orientation - Functional orientation

9. Three Tenets of BPO Flexible & Stable ★ Clients ★ Human Capital Sub Contract Technical Specialist Technology BPO ConQnuous Incremental Training & Mentoring People © Shivaji Sengupta 2013-‐2015 All Rights Reserved Process Standardize d and Repeatable

11. 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

12. 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

13. 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

14. Country Snap Shot – BPO PerspecQve NegaQves PosiQves 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 © Shivaji Sengupta 2013-‐2015 All Rights Reserved

15. Viet Nam SWOT DEVELOP Business Friendly Clients Looking for AlternaQves Geography Value BPO Processes Young Workforce Opportunity Domain Experience Stable Government Labor Costs Sub ContracQng ConnecQvity Focused Delivery Teams Language InﬂaQon AccounQng Standards Threats Weakness Technology Skill Sets ENVISION RECOGNIZE Strengths Regional Business Technology Infrastructure Real Estate costs REDUCE © Shivaji Sengupta 2013-‐2015 All Rights Reserved SCALE OF IMPACT 25% 50% 100%

16. Vietnam Plan of AcQon Market – USA Market – India BPO Capability Core Team -‐ Trainer Workﬂows & Technology Partnerships & Alliances Business Development © Shivaji Sengupta 2013-‐2015 All Rights Reserved Market – EMEA

18. Healthcare Outsourcing

19. 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

20. 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 • Print and Le@er GeneraQon for Surveys • USPS / Fax / CD-‐ROM Processing • Capturing of Survey Responses • Repository / Workflow ApplicaQons • InvesQgaQon / Audit / QA • Audit Trail Adhering to Compliance Measurements for Case TAT • Outbound / Inbound Call Center Coordina9on of Benefits (Commercial, RxCOB) • Integrated Le@er GeneraQon to Providers and Insured Fraud & Abuse, • Document ill Hospital BFulfillment • ANSI 837 Receipt Audit © Shivaji Sengupta 2013-‐2015 All Rights Reserved • Provider Contract Fulfillment • Contract Approval and CredenQaling: Direct Access into Client’s ApplicaQons • Contract Repository & Workflow • Premiums / Provider Reimbursements / PBM Payments • EOB DistribuQon/Processing/ Payments • Address Search Processing • CredenQaling File Conversion • CMS Compliance Trail Provider Contract & Creden9aling Management Payment Processing • Complete InformaQon Channel for Medical Benefit RequesQng • Mailroom OperaQons • Instant NoQficaQon for Expedited Requests • Integrated Variable Content Management for Approval and Denial • Address Search Processing Pre-‐ Authoriza9on & Referrals • Repository Workflow • CMS Compliance Trail • Address correcQon and re-‐ mail Return Mail

21. 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 © Shivaji Sengupta 2013-‐2015 All Rights Reserved

22. 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

23. Claims AdjudicaQon and Adjustments MEDICAL– Professional, Ins9tu9onal, Prescrip9on, Rehabilita9on, ER, DMEPOS DENTAL – Oral Surgery, Orthodon9cs, Periodon9cs Prosthodon9cs, Endodon9cs VISION – Rou9ne Vision, Preven9ve Vision, Lens& Frames, Lab order Entry Psychiatric– Psychology, Mental Health, Stress Management Fully Insured/Self-‐Funded Plan Coverage Commercial/Managed Care(HMO, POS)/ Indemnity (PPO, OOAPPO) Product Coverage Strong Project Management Team Mul9ple Surgery Reduc9on/CCI/NCD Proven Quality Management System Pre-‐Authoriza9on & Penal9es Capabili9es Unique Training Methodology Timely filing/ Provider Appeals Buddy System–Unique Knowledge Re-‐Pricing Exper9se sharing plaiorm Skilled Examiners & SMEs •  Buddy System •  Progressive Evalua9on •  Train-‐the-‐Trainer Approach •  People Focused Career Progression Methodology •  Six Sigma Control •  Best Prac9ces Deployment •  Team Based Performance •  Web Interfaced Dashboard Services Delivery © Shivaji Sengupta 2013-‐2015 All Rights Reserved •  Quality Control Process •  Stra9fied Internal Audit Controls •  QC Tools based Analysis & CAPA •  Knowledge Agreement Analysis Quality •  Sta9s9cal Process Controls •  Competency Resource Mapping •  ISO Cer9fied Process Documenta9on •  Con9nuous Process Improvement Process Control • Intranet Knowledge Base Tool • Web based PPM and TAT Controls • Secured and Integrated Workflow Model • Semi-‐Automa9on Custom Developed Tools Technology

24. Typical SoluQon Client •  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 © Shivaji Sengupta 2013-‐2015 All Rights Reserved

25. Typical Project Team Program Management Team Technology Support Team Delivery Head Account Manager Design Recruitment Site Head Director PMO AdministraQon Development OperaQons Training Quality Technical Project Manager IT TesQng SME / Business Analyst InformaQon Security Release Management © Shivaji Sengupta 2013-‐2015 All Rights Reserved

26. Typical Team Approach Solu9on Analysis Project Ini9a9on Func9onal Requirements (Including Desired Quality Levels) Project Planning Build Vendor & Client Teams Prepara9on Implementa9on Deployment Planning Systems Test Solu9on Analysis © Shivaji Sengupta 2013-‐2015 All Rights Reserved Detail Design User Training Implementa9on Stress Test Solu9on Conﬁgura9on & Prototyping Produc9on Documenta9on

27. Q & A THANK YOU

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