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Attention U.S. Physicians and
Healthcare Providers

Have you been searching for an outsourced solution for your practice management? Are you concerned about finding the right medical billing staff or company for your specialty? If you answered YES, we have the answer for you. PMRNC has been providing U.S. medical billers and practice managers with educational resources since April of 2000. Our subscribers receive a free listing within our billing center listing area at The subscribers listed here are billers and or consultants who specialize in a particular area of specialty.

PMRNC has maintained a very strong voice in the U.S. Industry on the dangers of U.S. medical practices outsourcing overseas. Our listing area here for specialty billers, in addition to our state by state listings at are only medical billers and medical billing companies within the United States and utilize only in country business processing.

Aside from the obvious ideology that we need to keep work here in our own country, there are many other important factors providers should consider when they are contemplating outsourcing to offshore medical billing companies.

Can you oversee day-to-day operations of offshore medical billing companies?

No, of course not, unless you plan to spend all of the savings they promise you on travel. If you outsource offshore, and do NOT plan to oversee day-to-day operations, you are putting yourself and your practice at critical risks! Overseas companies do not HAVE to adhere to our federal government mandates. Sure, they may promise you, "assure" you, or maybe even guarantee it in their contracts, but it won't be worth the ink used in that contract. The bottom line, again, is that offshore medical billing companies do NOT have to adhere to US federal guidelines or rules! If you are not able to oversee operations of an offshore medical billing company, than you are not able to oversee such operations as patient demographic entry, charge entry, payment posting, account follow-ups, etc.. This is most likely going to lead to decreased reimbursement and an increased risk of liability for HIPAA and OIG breaches.

Offshore outsourcing does indeed have increased risk with many legal concerns with regards to HIPAA, OIG, and the overall integrity of a practices data. In fact, any problems could, and may very well, mean the need for a foreign attorney. Just research the wait times for courts in other countries. The legal arm of the U.S. cannot be extended to other countries. As U.S. Physicians and other healthcare entities outsource overseas, they therefore assume all legal consequences related to any breach, regardless of any promises of compliance or Business Associate Agreements.

Offshore outsourcing companies will always come in with a price that will likely get the attention of most healthcare providers, there is no denying that, Reasons for lower pricing are simple. Offshore workers are far less trained in the complex details of the US Healthcare system, and are MORE likely to create costly billing mistakes, which could end up costing your practice a lot more than just money. Another thing to consider are your patient's. Will the majority of them be satisfied  speaking with someone overseas about their medical information here in the U.S?  Will they appreciate not being able to speak with a representative they can't understand? Will they appreciate the fact that their personal health information is across the continent? I am guessing the majority of patients would NOT appreciate it at all.

Offshore medical billing companies cannot appreciate the responsibilities we have here in the US, there will always be communication issues, language barriers and increased risk of compliance issues which could literally end a provider's practice. Consider your practice and most of all consider your patients.

Although a practice or billing company may outsource it's business processes, they are ultimately responsible for privacy. When outsourcing within the united states a company will present and sign accountability with a Business Associates degree. Offshore companies are not held accountable to US laws. They are merely a cost savings benefit to the US healthcare provider or billing company. Their compliance may be indicated but is not necessarily "mandatory" in it's outside US boundaries. Physicians should ask, is the risk worth the savings? The answer is obviously NO!

So why are other vendors and associations within our industry supporting it?

It wasn't that long ago that I realized that there were actually associations that represent our industry fully supporting offshore entities either by listing or supplying providers with a listing of companies overseas,  There are even associations certifying offshore companies and advertising them with the US billing companies! I have yet to be able to receive an answer as to "why" they support it, I can only guess it is due to membership fees, certifications, and other goods being sold. In my opinion these trade associations should be rallying AGAINST offshore outsourcing at a great benefit to their members! Aren't associations supposed to stand up for issues that affect their members and their industry? I would think so.

So what can we do?

Over the last few years there have been a few bills introduced that would, not kill offshore outsourcing, but certainly regulate it and make it more difficult for businesses to do business overseas, however those bills seem dead in the water.  We can continue to watch U.S. proposed legislation that would help stop this risky business and protect patients privacy, we can also continue to educate U.S. Healthcare providers on the risks they assume by offshoring their medical practice's most important procedures.

Our promise to you:

We have, and continue to rally against offshore outsourcing. We do not process any memberships, sell any services or products to any company doing business offshore to the best of our knowledge. We will continue to uphold this promise! None of our billing companies listed here, OR otherwise, do business with any offshore company, to the best of our knowledge

Linda Walker



Practice Managers Resources & Networking Community


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