Outsourcing  back office to foreign countries like India has been gaining traction for several years, and while it has flourished among companies in the general economy, it hasn’t really penetrated the healthcare sector.

But as concerns about logistics and communications have eased, returns on investment touted and reimbursement pressures continuing to mount within healthcare, provider and payer organizations are starting to give the concept a try.

Outsourcing firms occupy a curious position right now, either poised to benefit greatly from corporate downsizing amid a turbulent economy, or possibly undergoing contraction themselves as all businesses seek shelter from the financial storm.

Manoj Malhotra, CEO of Salient Business Solutions, a New Delhi, India-based contractor of back office services for various American and European industries, concedes that it’s hard to tell how things will break going forward.

“We’ve seen both situations,” he said. “On one hand, companies are looking at outsourcing as a necessary way to provide greater flexibility for staffing, a better bottom line and improved productivity. On the other hand, marginalized mid-sized players who depend on a certain volume may not find (outsourcing) viable if they cannot reach that minimum volume level.”

At this point, however, Malhotra’s organization, which employs more than 32,000 people worldwide, is in growth mode, providing financial and accounting services, research and analytics, human resources, technology consulting and customer relationship management to a number of business segments in the U.S. economy.

Specific to healthcare, Salient’s services focus on data management, including claims processing and billing and coding for providers and payers. Contrary to popular perception about offshore contractors, Malhotra says his firm does not replace clients’ existing in-house staff, but instead augments processes already in place.

“They can use their existing staff to offer front-end management and leave the back office management to us,” he said.

Salient specializes in claims transactions – particularly those problematic denials that require a lot of painstaking legwork to resolve, Malhotra said.

“About 80 percent to 90 percent of the transactions requiring data involves normal processing, but it’s that other 10 percent that needs to be handled separately,” he said. “It is this 10 percent that can make or break a company. We will typically work with each insurer and manage the status of each outstanding claim, making sure they get all the information they need. Using us for these functions frees our clients to spend their time more effectively, which is concentrating on patient care.”