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Let's TRY to be a thorn in side off offshore medical billing companies

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PMRNC:
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

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

RichardP:
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??).

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


--- Quote --- 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.
--- End quote ---

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


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

You did indeed, thank you!

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