Author Topic: Let's TRY to be a thorn in side off offshore medical billing companies  (Read 4354 times)

PMRNC

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Maybe we can't stop it but we can be a thorn in their side. SHARE this on all social media sites. TELL the Associations you belong to you will NOT tolerate being a part of an association that is endorsing or advocating offshore medical billing companies! Let's TAKE back our industry!!  http://www.billerswebsite.com/offshoremedbilling.htm
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

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The paragraph below hints at the face of the future for run-of-the-mill medical billing.  Complex medical billing may escape this fate for a while longer.  This is tallmanusa's favorite go-to company, per his many references to athenahealth on this board.  As these software algorithms become refined, I'm sure they will show up in other large medical billing companies.  A great deal of trading on Wall Street today is simply software algorithms talking to each other, with minimal human intervention.  Seems like the process of medical billing is heading that way as well, at least for the simple stuff.

http://www.faqs.org/sec-filings/111020/ATHENAHEALTH-INC_8-K/b88654exv99w2.htm
Last Paragraph on Page 3; page numbers are at bottom-right side of page.

Athenahealth continually works to minimize human intervention across our service offerings. During Q3 2011, the athenaCollector team made significant headway in reducing manual work related to the denial management process. Leveraging the athenaRules engine, the team designed a sophisticated routing process to ensure that denied claims are forwarded to the appropriate specialist. This allows a significant portion of volume to be routed offshore to our business process outsourcing (BPO) partners, an important step in standardizing and ultimately automating denials work. This same routing engine will soon forward certain claims to a document creation engine. When completed, certain claim denials will result in an appeal being generated and returned to the payer with no manual intervention. We expect that the fully automated appeals process will improve average client DAR and reduce operating costs for athenahealth.

Srinivasan Krishnamurthy, Offshore Operations Manager at athenahealth
http://www.slideshare.net/krishms

PMRNC

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Richard.. have you ever played Poker?? if so .. you tipped your hand.

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

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I don't play poker and I seriously have no idea what you mean by I tipped my hand.  I'm pretty dense that way.

For all the reasons you list at the page you linked to, I am against sending medical information off-shore to be processed.  We have been asked by our clients on several occasions to partner with them in setting up off-shore processing centers.  We have always said no and always will.  One of our clients went ahead and set up an off-shore processing center anyway.  It only lasted about 6 months, because it was impossible to provide proper oversight in the Philippines from Beverly Hills.

Another of our clients wants to switch EMRs from Practice Fusion to AthenaHealth, and so asked us to check into using AthenaHealth's PM system.  They have one, but only they can use it.  If you want to use AthenaHealth's PM system, you must let them do your billing.  (Note that you can use their EMR and have someone outside of their system do the billing; you just can't use their PM system.)  And those who elect to have AthenaHealth do their billing must assign payment to AthenaHealth.  AthenaHealth bills the insurance carriers and the carriers send payment to AthenaHealth.  AthenaHealth takes their cut (about 6%) and forwards the rest to the client / doctor.

I came across the quote I posted above, from AthenaHealth's SEC filing, while researching the company.  Our client is not pleased that AthenaHealth will ship their patient data to India to be processed and so at the moment has decided to stay with Practice Fusion.  Linda, your rallying cry "Let's Take Back Our Industry" is admirable, but it's not likely to happen - for the reasons that are evident in the quote I posted from AthenaHealth's SEC filing above.

You are of course free to keep me in the dark about what you meant by saying that I tipped my hand.  But being a curious fellow, it would be lovely if you could expand on that comment a bit.

And congratulations on becoming a grandmother-to-be (did I get that right??).
« Last Edit: June 05, 2013, 11:19:14 PM by RichardP »

PMRNC

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It's all good, I misread that first sentence and apologize.

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Linda, your rallying cry "Let's Take Back Our Industry" is admirable, but it's not likely to happen - for the reasons that are evident in the quote I posted from AthenaHealth's SEC filing above.

Well, like I said, maybe we can't stop it but we could make things difficult.

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And congratulations on becoming a grandmother-to-be (did I get that right??).

You did indeed, thank you!
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

DMK

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The other thing that billers can do, and encourage the doctors they work for to do is to actually TELL PROVIDER RELATIONS that they are sick and tired of dealing with the offshore processors when calling on unpaid or incorrectly paid claims!  I just did it with Blue Shield.  The person I was referred to has been great. 

I was tactful, but I let her know how tired I was of having to start at the bottom and talk to India to a person who could not only NOT fix the problem, they couldn't explain why there WAS a problem. 

We have several patients who work for Blue Shield and they talk about how much more work it's creating internally to fix the offshore problems.

Not to get on a soapbox, but America is in trouble because we keep farming everything overseas.  We should be processing our own paperwork, manufacturing our own goods, and making our own food products.  I can see importing things we can't make or get, but we've got to stop sending out the average person's jobs.  On the flip side, Americans need to quit thinking they're all "management material".  You flip burgers when you're a kid, get some skills, then go work and work your way up the ladder.  Every young person should have a least one crap job on their resume.  It shows they have done something no one else wants to do, and they're trying to do better.  And don't even get me started on the unions!  They're the main reason everything goes overseas.  You can't pay someone $20.00 an hour to sew a $10 t-shirt.  Something's gotta give!

RichardP

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Linda, apology accepted.  But you write in a way that shows you don't intentionally give offense, so none was taken.

They're the main reason everything goes overseas.

Don't want to start an argument, but the issue is quite a bit more complicated than simply "it's the union's fault".  Even if you cut the union worker's pay by half or more, that pay would still be far above the dollers per day that the foreign workforce earns.

The foreigners who make that $10 shirt cannot afford to live in the United States on what they get paid to make that shirt.  Which means that Americans could not afford to live in America if they accepted the same wage that the foreigners get paid to make that $10 shirt.  So, how does America pay its workforce a liveable wage while at the same time keeping the price of its products low enough that Americans will buy them instead of foreign-made products?  How do you create a society worth living in when it is the consumer chasing the lowest possible price that drives production to the cheapest possible labor markets?  A discussion of those questions is beyond the scope of this board, but they are the fundamental economic questions governments have struggled with for decades. 


DMK

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Agreed.  But where does it end? By Americans buying American made (difficult to find, I agree).  By Americans realizing that they are the problem and the solution.  It has to start somewhere!

PMRNC

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Union is now a dirty word and before you get upset.. let me say I'm a union brat, born and raised. My dad was union and my husband is union. I can't even tell you the problems I've had since they are NOT bound by State Dept of insurance, they pretty much have their own rules (ERISA) and as far as the ACA goes with Union based (collective bargaining plans) OH this is going to be a nightmare. MOST union plans are already in a pickle because their plans don't meet the minimum necessary.. with commercial carriers and those carriers governed by state dept of insurance patients who's companies go over the 80% spending threshold will be issuing annual rebate checks. When's last time anyone got a check from a union? LOL Remember Union's pay dues, assessments.. it's really extortion if you want my opinion, but that's another post for another time.

We are in trouble. And again. I can't say we stop it.. but we can't keep quiet. I think we need to be right there at every turn the offshore companies make to make it difficult for them. EDUCATE our providers, YELL at these Associations who CLAIM they don't support offshore yet have no problem putting all their certified offshore companies right up in the member roster AND those offshore companies are contacting and marketing to the same Associations US MEMBERS!!   Enough is enough, time we just stopped doing NOTHING.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

asilva03

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I am definitely with Linda on this one. I have seen too many times in forums where the offshore companies are pretty much bad mouthing the billing companies here in the U.S. It is almost like they are taunting us and making it seem like we don't know what we are doing and that is why the doctor's are outsourcing to them. Granted there have been and still are a few bad apples in the bunch, but to just totally discredit all billing companies in the U.S. because of that is not fair when the real issue many doctors hire these offshore companies because it is cheap labor. My motto is you get what you pay for, whether it's sacrificing patient data (don't let the patient find out) or any other part of your practice.

PMRNC

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I also think consumers/patient's are NOT educated enough on where there information goes OR how they can indeed stop it on their end. Patients should ASK physicians if not disclosed to them WHERE there information is going. There are legislative bills pending to at least put that guideline in place. Many patient think they don't have a choice however they need to remember they have legal rights with their information and whether a provider sending their info offshore is perfectly legal a stink raised by a patient or two or three... CAN and most likely WILL make a difference. Patients don't realize the power they have. My own attorney drafted me a letter for all of my physicians with my rights NOT to have an EHR for myself or my family. So next time you run across a physician who is using an offshore company stop and educate them on both the ethical and legal risks they are taking. Tell family members to ask their physicians. It's so much better than sitting back and doing nothing.

If you are a billing company and you are receiving the same solicitations, take down the name of the company, find their website and look for their "Associations and/or Affiliations" and see if there is a common denominator on where these companies are getting your information, you will find a link.
Linda Walker
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One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RoVeada

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Re: Let's TRY to be a thorn in side off offshore medical billing companies
« Reply #11 on: September 25, 2013, 01:05:59 PM »
I have been getting calls all this week from off-shore companies in India. I try to politely decline their "services" to sub-contract.
...if you can find a path with no obstacles, it probably doesn't lead anywhere.

PMRNC

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Re: Let's TRY to be a thorn in side off offshore medical billing companies
« Reply #12 on: September 25, 2013, 01:32:43 PM »
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I have been getting calls all this week from off-shore companies in India. I try to politely decline their "services" to sub-contract.

Yes, it does get to be really irritating and another point to be made is that they obviously don't have to honor our "DO NOT CALL LIST" either!

I'm beyond polite now, I simply tell them not to call anymore and hang up.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

RichardP

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Re: Let's TRY to be a thorn in side off offshore medical billing companies
« Reply #13 on: September 27, 2013, 04:11:38 PM »
I have been getting calls all this week from off-shore companies in India.

Answering machines are pretty good for screening out such calls.

shanbull

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Re: Let's TRY to be a thorn in side off offshore medical billing companies
« Reply #14 on: November 21, 2013, 03:53:47 PM »
Actually I think unions could very well now be helping, indirectly, with their efforts elsewhere. Increased wages in China for each of the past five years have already resulted in some companies moving their manufacturing facilities back here to the states, because it's just not financially feasible or profitable enough any more to outsource as the cost of raw materials and wages has risen. When there is less differentiation in pay by country, there is no incentive for U.S. companies to offshore. As labor movements and legislation in developing countries are beginning to take off, it's a win-win for workers around the globe. They get paid a livable wage, and we're not competing with people who are willing to take cents on the dollar for the same work. Pointing to China as a cautionary example to big corporations might be a good idea. Supporting worker's rights abroad is definitely in our best interest. When wages are more equal internationally, American companies will hire qualified American workers over anyone else.
« Last Edit: November 21, 2013, 03:56:45 PM by shanbull »