If you have a product or course you would like AMBA to consider for CEU Pre-Approval, please download the
Our Position Regarding Offshore
The AMBA has always been a strong
advocate of privacy and security of medical
information. We believe that members must be vigilant
in protecting patient privacy and confidentiality of
sensitive medical information. We support privacy and
security compliance under Federal and State privacy
laws and provide extensive support and information for
meeting compliance standards and recommendations.
Our association does not support or
encourage billing work to be sent offshore for
processing in another country. In the event of a
breach of protected health information (or even a
contract issue), US authorities and courts would more
than likely not be able to hold a foreign contractor
or business associate accountable. It is for this
reason that we believe offshore outsourcing is huge
for the medical billing industry.
For medical billing purposes, there are
two usual scenarios that involve offshore outsourcing:
Usually, under both
the doctor's patients are unaware their health
information is being processed offshore and they are
therefore, unable to opt out of having their
protected health information processed by an
offshore processor. However, in some cases, even the
doctor him/herself is unaware their billing is being
contracted out to an offshore processor because the
billing company either has an offshore location or
they are contracted with an offshore processor. If a
doctor is uninformed about the business associates
his/her billing company is utilizing, they also
cannot opt out of offshore outsourcing should they
It is incumbent upon
providers and doctors to use due-diligence to know
where their billing work is being processed as they
are responsible for any breaches or
wrongful/improper disclosures of their patient's
protected health information. They are also
responsible for their contracted biller's improper
disclosures as well as the business associates
billers may contract with.
The main attraction for
contracting with an offshore processor is the
fees typically charged. However, we have noted
that often practices end up bringing their billing
back in-house due to communication issues or as a
result of large increases in outstanding accounts
receivables and turn-around time. Additionally,
offshore workers typically do not possess the skill
level necessary at all knowledge levels to get
claims paid and appealed properly, creating
unnecessary and costly errors. Time zone barriers
also present constraints on basic communications
between the practice and the offshore processor. And
finally, an offshore worker simply cannot be
expected to have a personal responsibility or stake
in spending the extra time or effort that is often
required to get a claim paid properly.
Billers must also be aware of
where medical information is stored when they
contract with billing software or record storage
companies that operate in the cloud. You may
contract with a company that has an American
address, but that company contracts with a company
located in another country to store your data.
Again, due diligence is required before committing
to this type of service.
The savings from relying on offshore companies could well become much more costly, time-consuming and penalty-laden than planned.
We understand the myriad of
reasons and rationale used for offshore outsourcing.
We are concerned that some of our members have lost
their jobs as a result of this practice. We would
prefer that billing jobs stay in the US with
American billers who are qualified to perform
billing services. Only a trained and
knowledgeable US biller can ensure practices a
successful outcome by providing quality
billing services while complying with
enforceable rules and regulations.
Outsourced Billing and Coding Compliance Risks – Warning to Billers, Coders and AMBA Members on Offshore Outsourcing
Recently, HIPAA Compliance Risks of conducting business offshore outsourcing companies has made its way back into the spotlight. One expert feels that due to a recent Supreme Court case, it's doubtful that HIPAA compliance could be directly enforced by U.S. regulators for offshore business associates.
Under the new HIPAA Omnibus Rule, (effective 9/23/13) business associates are now directly liable for HIPAA compliance – meaning not only are the doctors you do business with responsible for your compliance, but YOU ARE DIRECTLY RESPONSIBLE as a business associate for improper disclosures and breaches and you are responsible for business associates that you contract with, including software vendors as well as offshore processors. The American Medical Billing Association’s Outside General Compliance Counsel, Liles Parker, points out that doing business with offshore processors is a risk that members may want to steer clear of and simply conduct business within the United States because US law provides protections and relative ease with which to resolve conflicts that more than make up for any savings by conducting business offshore.
Below are additional resources you may want to review regarding the compliance risks of doing business offshore:
32,000 patient records exposed on contractor's unsecured website (by offshore processor)Offshore outsourcing was an issue raised by then Representative Ed Markey (D-MA) with the Secretary of HHS as a privacy concern. This is his letter to HHS and the HHS reply all from 2004.
Individual Membership $99
Business Membership $199
See a list of Companies that Outsource American Jobs
Copyright © 2013, AMBA All Rights Reserved
IACET is dedicated to quality in continuing education and training. Members of the organization are educational professionals and organizations that strive to provide the highest quality in continuing education and training.
Member of the American Education Research Association (AERA)