the consensus is that overseas billing companies are highly effective and the quality of their work is generally excellent. moreover, due to their location, many overseas billing companies are able to process claims overnight, after employing billing services or providers close their offices for the evening. From a practical standpoint, american billing companies have found that the time zone issue works to their benefit. This allows for claims to be billed to government and private payors in record time, thereby speeding up reimbursement and greatly improving a practice’s cash flow. CONTRACTS, BUSINESS ASSOCIATE AGREEMENTS, AND INDEMNIFICATION CLAUSES Overseas third-party billers are no different from domestic thirdparty billing companies in many respects. They often utilize a billing contract that is similar to ones used by their american Many billing companies are now facing an indefinite economic future. Declining reimbursement rates and expanding Medicare, Medicaid, and private payor audits have made it more difficult for health care organizations to remain profitable counterparts and have no problem signing an appropriate business associate agreement that outlines their obligations to safeguard PHI. Furthermore, they will readily point out that their employees have been trained regarding the importance of medical records privacy. Finally, overseas billing companies are often more than happy to sign an indemnification agreement which holds them liable for any billing problems or privacy breaches that might occur due to their negligence or due to the improper actions of their employees. unfortunately, absent a bond to back up the agreement, an overseas indemnification provision may be worthless. Disadvantages of Overseas Outsourcing Collectively, it is easy to see why many domestic billing companies have decided that the benefits of utilizing an overseas third-party billing company are almost too good to pass up. unfortunately, many companies fail to consider the negative aspects of overseas outsourcing, choosing to focus primarily on the cost-savings to be achieved with this practice. several of these disadvantages include: 22 HBma BILLINg • JaNuaRY.FeBRuaRY.2014 ONCE DATA IS TRANSFERRED OVERSEAS, IT IS VIRTUALLY IMPOSSIBLE TO GUARANTEE THAT IT WILL REMAIN PRIVATE Despite assurances to the contrary, once a patient’s medical and financial information has been transferred outside of the united states, the billing company transmitting this data has effectively lost control of the information. moreover, if a breach does occur, there is little or no remedial action that a billing company or health care provider can take to minimize any resulting damage. as a covered entity, a health care provider is obligated to report the breach and will likely be held accountable for the breach by the Department of Health and Human services, Office of Civil Rights or by a similar state-based regulatory body. BREACHES unfortunately, if a breach occurs, it will quickly become crystal clear to a billing company that neither the boiler-plate confidentiality provisions contained in a billing agreement nor an executed business associate agreement were effective in preventing further unauthorized disclosures from taking place. adding insult to injury, efforts to seek indemnification from an overseas billing company will be difficult, if not impossible, to achieve. In most instances, a company will have engaged an overseas billing company in India, Pakistan, Indonesia, or another country where labor costs are significantly lower than they are in the united states. The bottom line is simple: overseas billing companies are not bound by united states laws or regulations. moreover, even if a billing company does violate one or more of its own domestic laws intended to safeguard the privacy of medical information, how will you go about seeking to enforce such a statute? IT IS ExTREMELY DIFFICULT TO ExERCISE DUE DILIGENCE WHEN USING AN OVERSEAS BILLING COMPANY When you engage an overseas billing company to handle your coding or billing functions, you are relying on the foreign company to conduct due diligence on its employees before allowing them to have access to your data. assurances that all employees have (Be Aware of the Risks continued)
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