The questions worth asking, including the ones we answer badly
Fourteen questions to put to any offshore billing company, and our own answer to each one. Three of them count against us and are answered anyway, because you will ask them eventually and it is better that you get the real answer here than a worse one somewhere else.
Most vendor evaluations go wrong the same way. The sales call covers capability, which every vendor can describe, and skips continuity and data, which are the two things that actually hurt later. The questions below are ordered the way the risk arrives.
Whether they can do the work at all
How many United States healthcare clients have you worked with?
More than twenty United States practices, under subcontract and confidentiality terms that do not permit us to name them. That is a normal position in this industry and it binds us the same way it would bind anybody else. What it means for you is that there is no logo wall here, and you should be equally careful with a vendor who produces one without their client’s written permission to be named. The follow-up worth asking any vendor is how many were in your specialty, not how many in total.
Can I speak to two clients who have used you for six months?
Not without their written permission, which the confidentiality terms above do not give us. What we offer instead is the smallest commitment we can make binding: one seat, one month, thirty days notice. A reference tells you how a vendor performed for somebody else. A month tells you how they perform for you, and costs about the same as the meeting where you would have discussed the references.
What will one seat actually get through in a day?
Ask for a number, in writing, for your specialty and your payer mix, before you sign. The answer depends on whether the work is verification, follow-up or appeals, and a vendor who gives the same figure for all three has not thought about it. Then ask the question underneath it: at what volume do you tell me I need a second seat? A vendor whose answer is never is a vendor whose queue will silently grow.
Which of your people has done this before, and which are being trained on my account?
Worth asking plainly, because the honest answer for any new operation is a mixture. Ours is that coding and credentialing require existing knowledge and we hire for it; accounts receivable and verification we train for, on the workflow rather than on a vendor’s menus. You are entitled to know which of those is going on your account.
Whether they will still be doing it in March
What happens when my biller is ill, on leave, or resigns?
This is the question that exposes a one-seat model, and it is the one most rarely asked. A dedicated person is the whole value of the arrangement and also its single point of failure. Do not accept a reassurance. Put it in the agreement: a named second person trained on the same workflow, the standard the replacement has to meet, and how many working days you will wait for one. If a vendor will not write that down, the cover does not exist.
Who supervises the person, and who do I ring when something is wrong?
Ask for a name and a second name above it. On a small operation those may be the same two people for every client, which is worth knowing rather than discovering. Ask what happens to your escalation at nine in the evening their time, because that is the middle of your working day.
How long am I committed for, and what does leaving cost?
Ours is one month minimum and thirty days notice, with no annual term, no setup fee and no percentage of collections. The reason to ask is not the length. It is that an annual lock-in tells you what a vendor expects the first three months to look like.
What is the price, and what is not in it?
Ours is published rather than quoted: $1,500 to $2,500 a month per seat depending on the role. Ask any vendor for the list of things that are extra. Training, onboarding, software, reporting and overtime are the usual five, and a price that arrives only after a discovery call is a price that varies by what the call reveals about your budget.
What happens to the patient data
Will you sign our business associate agreement, not just your own?
Yes, and before access rather than alongside it. A vendor who will only sign their own paper is telling you which clauses they have removed.
Do you hold SOC 2 or ISO 27001?
Ask for four things rather than a yes: the report itself, its date, whether it is Type I or Type II, and the scope it covers. A certificate without those is decoration, and a Type I says only that the controls existed on one day. Ask us on the call and you will get a straight answer with the paperwork behind it, which is worth more than a sentence on a web page that ages.
Does anybody outside your company touch my data?
Ask it exactly that way. Subcontracting is where an offshore arrangement quietly becomes three companies, each with a copy of your patients. Ours is one company, one floor, company-owned machines, and the answer should be in the agreement rather than in an email.
What can leave the building, technically rather than by policy?
A policy against downloading and a machine that cannot download are different things. Ask which one you are buying: whether printing, removable storage, personal email and local saving are blocked at the machine, and ask to be shown it rather than told it. A video walk of the floor is a reasonable request and a vendor who refuses one has answered you.
How quickly is access revoked when somebody leaves my account?
Ask for the number of hours and ask who confirms it to you in writing. The gap between a person leaving and their login closing is where offshore access outlives the relationship, and it is invisible from your side unless somebody is required to tell you. A control nobody reports on is a control nobody can check.
What happens to my data when we stop?
The answer should be that there is nothing to return, because nothing was kept outside your own systems. If a vendor has copies, ask when they are deleted, who confirms it, and what they were for.
What we cannot hand you, in one place
A list of named clients, because the terms we work under do not permit it. A reference call, for the same reason, unless a client gives written permission first. And a long corporate history, because the company is young even where the people are not. If any one of those rules us out, it should, and finding out now costs you nothing.
What we offer against them is the smallest commitment we can make binding and the fewest things hidden: a published price, one month minimum, thirty days notice, no percentage of what you collect, a business associate agreement before access rather than after, and the controls written down including the ones we do not have.
Questions
Why publish the questions that make you look worst?
Because a buyer asks them anyway, usually to somebody else, and gets a worse version of the answer. We cannot name clients, we cannot produce references without permission, and the founder is still close enough to the work to answer for it himself. Those are facts about how we are set up rather than opinions about it, and a page that omitted them would be a page you should not trust on anything else either.
What should I do instead of checking references?
Buy the smallest thing that produces evidence. One seat, one month, one queue, with the numbers agreed in advance: what gets worked, how it is measured, and what counts as failure. Thirty days of your own data beats two phone calls about somebody else.
What should I measure in the first month?
Agree it before the month starts, or it becomes an argument afterwards. For an accounts receivable seat the useful set is small: the share of the assigned queue actually worked, whether every payer call carries its reference number, whether the follow-up date was kept, and the money recovered against the same month before. Activity counts without a money figure are a report that cannot fail.
Is a dedicated seat better than a percentage of collections?
It is better when you have enough work to keep a person busy and worse when you do not. The arithmetic is on our comparison page rather than asserted here, because it depends entirely on your collections and the rate you have been quoted.
Test the answers before you test the vendor
Send an aged AR report and you get back what is recoverable in it, in writing, before anything is agreed. It is the cheapest way to find out whether a vendor can read your data properly.
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Next step
Ask us the hard ones on the call
One seat, one month, thirty days notice. The smallest way to find out whether any of this is true.
Or write to ops@softhomeglobal.com