Twelve questions to ask any offshore billing vendor

Why this list exists

We are one of the vendors you would be asking. Publishing the questions is not generosity — a buyer who asks these gets a better vendor whoever they pick, and we would rather compete on the answers than on who has the better deck.

Money

1. What is the price, in a number, today? A vendor who needs a discovery call to tell you the price is working out what you will tolerate.

2. Is it a percentage of collections? If so, your invoice rises when your month goes well, and the vendor is incentivised toward the easiest claims rather than the oldest.

3. What is the minimum term? A company that needs a twelve-month lock-in to keep a client is telling you about month two.

4. What is not included? Clearinghouse fees, software licences, and anything requiring a US-licensed professional usually are not.

Compliance

5. Will you sign a BAA before anyone gets a login? Before, not after the first week.

6. Are you HIPAA certified? A trick question. There is no such thing — no government body certifies anyone. A vendor who says yes has bought a logo from a training company, and you have just learned how they handle claims they cannot substantiate.

7. Where is our data stored? The only genuinely safe answer is "in your system, we do not copy it".

8. What happens to access when somebody leaves? Same day, confirmed in writing, and revocable by you because the credential is yours.

The work

9. Is the person dedicated to us, or pooled? Pooled staff never accumulate payer knowledge, which is most of the value.

10. What hours do they work? If the answer is not your business hours, your payer calls are being made at a time the payer is closed.

11. What do we get every week, in writing? Ask to see a real one, redacted. A dashboard the vendor built and grades itself against is not reporting.

12. Tell me about a client who left and why. The most revealing question on the list. Every vendor with real clients has lost one. A vendor who cannot answer either has no clients or is not going to be straight with you.

How we answer number twelve

We are early and have not lost a client yet, because we do not have a long list to lose one from. That is a worse answer than a mature vendor with a good story, and we would rather write it here than have you find out on the call.