7 Myths About Offshoring Your Revenue Cycle Processes

9 Minute Read
Posted by Global Healthcare Resource & Lisa Eramo on May 31, 2023 3:25:36 PM

As healthcare providers continue to face staffing shortages and shrinking margins, Sixty-one percent plan to outsource their revenue cycle processes in the next two years. It's not surprising considering the benefits: Regulatory compliance, operational continuity, reduced accounts receivable, enhanced patient financial experience, and lower costs—just to name a few. 

Still, many healthcare providers may be hesitant to outsource out of fear they will lose control of their revenue. It may be especially common when considering an outsourcing partnership with a company that leverages a global talent pool. Why? Long-standing myths about international or ‘offshore’ outsourcing persist. 

Learn About Our Revenue Cycle Services
Below are seven myths debunked and the questions you should ask RCM companies to feel more at ease. 

Myth #1: Language is a barrier. 

Truth: Offshore employees responsible for communicating with clients, patients, or payors can speak and write in English fluently. Starting with the hiring process, experienced offshore RCM companies require testing in order for candidates to be considered for voice related positions. Upon hiring, ongoing communication training covering topics such as phone and email etiquette, pronunciation, grammar, active listening, de-escalation techniques, and more are conducted in conjunction with process-related training. 

Questions to consider: From what country (or countries) does the vendor’s workforce originate? What level of fluency in English is required? How does the vendor assess this fluency? What additional training is provided, if needed?

Myth #2: Cultural barriers are a roadblock. 

Truth:  Many RCM firms provide significant cultural sensitization training so international employees understand the nuances and complexities of the U.S. healthcare system. They also provide refresher training multiple times a year on regulatory changes that impact patients and providers.

Questions to consider: What is the onboarding process for international workers? Does it include cross-cultural communication training, and if so, what does that training entail? How does the vendor assess proficiency?

Myth #3: International employees lack qualifications.  

Truth: Experienced offshore RCM companies will be able to build and train teams to meet the exact employee requirements established by the client. Examples of employee requirements may include: individuals must have certain certifications, an advanced clinical degree, or the ability to speak multiple languages. Reputable offshore companies will carefully hire and train qualified employees to meet and/or exceed the key performance indicator (KPI) metrics established in the partnership agreement. 

Questions to consider: Can you hire or train based on our employee requirements? Can you provide a detailed outline of your hiring, training and QA processes? Which KPIs do you use to assess performance?

Myth #4:  RCM vendors leveraging global talent have trouble finding and retaining staff. 

Truth: Skilled offshore RCM firms will have an in-house talent acquisition team to facilitate hiring and assess turnover trends. Most RCM companies operating offshore have offices strategically located near prominent universities and offer very competitive compensation and benefit packages, as well as growth opportunities. Like in the United States, offshore RCM companies use a variety of channels including advertisements, employee referral programs, job fairs and social media to attract applicants.  Utilizing the proven hiring strategy of an experienced RCM partner will open your organization up to a wider talent network.

Questions to consider: What is your attrition rate? How long does it take to ramp-up a project on average? How do you attract and retain qualified staff?

Myth #5: An international workforce is less productive and not cost-effective in the long run. 

Truth: It is standard practice for offshore RCM companies to provide detailed KPI's within the service level agreement signed by both parties. In addition, accompanying reports to measure and track productivity are conducted at a frequency requested by the client (weekly, monthly etc.). Before a partnership begins, clients know exactly what to expect and have the reporting in place to ensure volumes and accuracies are being met. Established KPIs and reporting prevent any surprises and ensure a highly cost-effective relationship.

Also, organizations with inclusive cultures are twice as likely to meet or exceed financial targets and eight times more likely to achieve better business outcomes.

Questions to consider: Can we add specific KPIs to the service level agreement (SLA)? How do you track KPIs and what reporting can we expect? At what frequency will we receive the reports? 

Myth #6: It's not secure to share healthcare data internationally. 

Truth: You do not have to sacrifice data security for cost-efficiency; international RCM firms can help you improve both areas. Many RCM outsourcing companies leveraging global talent are HIPAA and SOC 2 Type 2 compliant, meaning they aggressively safeguard data against unauthorized access. The audit determines how well an organization safeguards customer data and how those controls operate over a 9-month (minimum) time frame. Reports are issued by third party auditors who review the following principles: security, confidentiality and availability. 

A study conducted by Kaspersky found that 40% of healthcare workers in North America are not aware of cybersecurity measures in place at their organization to protect IT devices. Meanwhile, offshore employees of reputable RCM firms are consistently trained on HIPAA compliance and how to identify phishing scams and other cybersecurity threats.

In addition, common physical safeguards to protect data include no phones or other personal electronic devices are permitted inside offshore offices, nor external internet access or print screen functionality on company computers.

Questions to consider: How do you protect patient information and ensure ongoing compliance? Is your organization SOC2 Type2 Compliant?

Myth #7: Time zone differences are impossible to manage. 

Truth: Time zone differences will allow your organization to get a jumpstart on work submitted within the last 24 hours, improve turnaround times, and expand operating hours. When it is nighttime in the United States, it is daytime in other countries like India and the Philippines making it easy for U.S.-based providers to extend inbound calling hours and holiday coverage for patients. 

Most offshore RCM firms have daytime and nighttime managers ensuring 24/hour coverage as well as U.S.-based management to help support clients from onshore. 

Questions to consider: What coverage do you provide, and how can we leverage that to improve the patient financial experience? Is there an onshore and offshore team to help manage the relationship?.


There are many benefits of an international workforce. Although it may be overwhelming to think about establishing and managing workers internationally, the good news is this: You don’t need to. Instead, partner with an RCM firm that does the work for you and passes on the savings. Learn how Global Healthcare Resources can help.

Schedule a meeting

Founded in 1999, Global Healthcare Resource has been a leader in revenue cycle management solutions and proudly employs 6,000+ HIPAA compliant coders, billing professionals and patient call center agents. Global operates as an extension of your office to improve productivity and increase ROI.