Companies that have RECENTLY Off-Shored & More Who May — (2019)

Companies that have RECENTLY Off-Shored & More Who May — (2019)

MORE COMPANIES … 2019—-updated

RI RCMAustin, TX operations

 cutbacks tentatively planned — April, 2019



–cutbacks tentatively planned — April, 2019



cutbacks tentatively planned — March, 2019

 – Davenport, Iowa

cutbacks tentatively planned — June, 2019



— cutbacks tentatively planned for 2019


MEDNAX/American Anesthesiology 

— lay-offs (March, 2019)


layoffs tentatively planned for July, 2019


St. Mary’s Hospital — Saginaw, Mi.

(***part of the R1RCM/Ascencion off-shoring operations***)

–layoffs — to be completed by June, 2019 


COTIVITI/VERSCEND is rumored to be making plans to LAY-OFF and OFF-SHORE.  (work queues have slowed way down and US coders are ‘on the bench’ more frequently in recent weeks!)





This is an ENTIRE THREAD on OFF-SHORING and people who have lost jobs due to this Corporate Practice taken entirely from our JOBS for American Medical Coders FaceBook group…, comments, etc. ……………….. 01.21.2019 Several group members have asked me to compile a list of the Companies that did all the recent LAY-OFFS that were reported here last week…… Here goes!

1) TENET HEALTHCARE – – – approx. 1000 employees affected  

2) R1 RCM —-

**Formerly Accretive Health (Jan 2017) **Acquired Intermedix Feb 2018) (from serves more than 15,000 US healthcare providers Lost $58.8M in 2017 2300 employees transitioning to R1: Jan 24, 2018…/agreement-to-bring-h…/
3)  Intermountain Healthcare “Everyone recognizes the cost of healthcare in the US is too high” March: Intermountain braces for more job cuts…/intermountain-healthcare-empl…
4a) Ascension in Indianapolis (St Vincent’s)
4b) Ascension in Wisconsin – approx 80 employees affected [–word coming in — Nationwide approx 150+ coders affected; also that Ascension = R1 RCM ] .
Accenture through bcforward  [Accenture is Philippines]
5) Temple University Radiology Dept. approx 16 coders affected
6) Envision Physician Services laid off the the entire Radiology department (South Florida division)
7) T-Systems – Dallas – 08.18 and 10.18  —  ER Coding Staff affected ……………………………………………………………………..………………….

01.23.19 —

1)  Verscend-Cotiviti  —  HCC Coders

2) ABEO  —  Billing Personnel 


ATI Phys. Therapy– Bolingbrook, IL —  43 employees affected & more expected to be laid-off in the near future due to off-shoring.


…..Comments…  01.21.19 layoffs 


If anyone knows of anymore … that I missed … put the name of the Company  and/or Facility  in the comments here … I will update the post.

I’m planning to put this information in a document/blog post on the JFAMC website, so I can update Company names as needed….as well as add any articles/news links related to the Off-Shoring Topic ….
Great job! Is there a plan what we can do to spread the word and let these companies know how we feel?
 Surely they know…. 🙁
Ah ha!!!!   THERE’S the list of the baddies!
—  I was part of #6!  Sad but true.
—   mine’s not on here thank goodness. We’re busy, but i see many on indeed also there is a current ad for tenet that’s scary
—  Tenet’s ASC division recently acquired a surgery center in our area. They are partnered with Memorial Hermann somehow. The article I saw said they lost $9M 3Q 2018. The CEO was quoted saying profit is their#1 concern
—  I saw an article or a comment, somewhere, that indicated that Conifer Health covers the ‘billing component’ for Tenet Healthcare. I would like to have a ‘verifying link’ to corroborate that information, if possible!
This is the most recent article I could find linking Tenet to Conifer…/tenet-s-net…
— Thank you!
—  I’m going to ask a stupid question. I know sometime last year I signed a petition going around on here to send to Washington about the offshoring going on in our field. Does anyone know if it got enough signatures to send and if it got sent??
Pretty sure, it did not … We may TRY AGAIN…  Several people, Elizabeth Burke,  Mark Sluyter, and others are trying to address it ‘legislatively’…….by contacting members of Congress … and bringing awareness to the situation. Most of the PUBLIC have no clue that their PHI is ‘at risk’ of being sent to other countries. Likewise, most State and Federal Legislators have NO CLUE that it’s happening. They don’t know, they don’t understand the issue, so it’s OFF THEIR radar! EDUCATION and AWARENESS are KEY to getting any movement on this issue!! 
In the majority of cases, WE NEED TO EDUCATE the Legislators…….LOCAL,  STATE and FEDERAL!
We, NEED to GET THE WORD OUT  …  to Patients, Family Members, Neighbors, Church Groups, Bowling Teams, PTA associations, Neighborhood Associations, Quilting Groups, Coffee Klatches, Book Clubs, Senior Citizens groups … whatever Social Groups with whom you may be associated  … The more we can get ‘buy in’ from THE PUBLIC and let them know that THEIR PROTECTED HEALTH INFORMATION (PHI) is now in the hands of FOREIGN NATIONS … the more likely we will be to find a way, eventually, to GATHER ENOUGH SIGNATURES….
 I have contacted my Congresswoman. She actually attended the same elementary and high school that I did and still lives locally. My son was best friends with her nephew all through school so I am hoping to get some time with her to discuss this issue. Praying we all get our voices heard and the information out there for the public to finally be aware of what is going on with their private information.
 AWESOME! Be PREPARED to ‘explain’ it to her….We’re finding that many of the Congressmen and women HAVE NO IDEA what we’re talking about many times!!! Once they understand…they too, are APPALLED at the practice!
—  that is what I am thinking will be the case!
—  the link to the legislative form letter can be found on The Coders Direct website!
—   thank you!
—   I am mistaken, this is no longer available on their website. I will poke around and see if I can find a copy
—   somewhere in this thread is the correct link posted by Kimberly Shutters.
I didn’t realize Tenet was a for-profit health system until yesterday.
—  We have an Ascension hospital here. I hope that doesn’t happen here, I know a lot of people who work there.

Has anyone come up with a form letter that we can each modify for our state and US congressmen and women? Is there a lobbyist that we can work with to get the President’s attention? I feel like it starts with this group, the largest collection of medical coders. If each of us send the letter to just one of our representatives that would be 23,000+ letters. Next we have a letter made up for citizens/patients to send, we post it to each of our Facebook pages, talk to our friends and neighbors, get them to send it as concerned patients. I truly think people don’t know! I didn’t until I recently became a coder, and I love staying on top of current events and politics. I don’t feel comfortable drafting the letter, but we have some very informed leaders within this group. 😉.  

COME ON JFAMC let’s take control of our future!  

—  JFAMC has grown to 23,000+ group members and I am GRATIFIED and VERY PROUD of that fact! However, if we ‘ONLY CONSIDER’  AAPC membership totals … they currently have posted on their website that they have 180,000 members and growing. ….. (not Counting other Credentialing Organizations….AHIMA, PMIC, PAHCOM, etc…) Our JFAMC membership only represents approx 12% of  ‘just’ AAPC’s total membership.

— there are form letters on the Coders Direct website. I have a website dedicated to this and I have a speaking engagement booked for Feb 5th at Bucknell University’s Institute for Public Policy. There are a lot of advocates working on this. Feel free to join us if you would like! We’d love to have you.
No photo description available.
— could you provide the direct link to the form letter? I am not finding it on the website.
Oh no!! They took down the link. I’ll ask about that next time I talk to them. Kimberly Shutters  —  do you have a copy of the template Rich and Mark were using for letters to legislators?
—  Success!!  Here is the link (embedded in my article)…
—  thanks!
—-  Forgive me, (new to this field) but what does this mean for the future of newly certified coders? Kind of makes me nervous
—  This is what happens when countries like India and the Philippines get involved in coding! These are very smart but very desperate people who learn very fast and make very little money. It will happen like it always does: fast and little pay doesn’t equal quality. These companies in this country are so greedy they would rather pay someone $20 a day (or less) rather than $20 an hour. I’m just sick about it and I know they need to eat and live but hey so does my family!
—  In many cases, their pay is ‘much less’ and they’re using clinically trained employees — Pharmacists, Nurses, Physicians — who train and get certified as CPC’s or CCS’s and they work, for what we, in the US, would consider ‘peanuts’! And they’re GLAD TO GET IT!!
 ** Several months ago, a friend and I spoke to a person who was trying to arrange ‘training and education’ for their coders and personnel in an ‘over-seas location’. During the conversation, the topic of ‘pay’ came up. We were told that ‘certified coders’ made the equivalent of .28 cents per chart, while ‘un-certified coders’ made .26 cents per chart! My friend and I were APPALLED and we protested to this man that he was paying ‘slave wages’ to his people.  He was adamant that the pay was fair, and I quote, because “we don’t pay them in US Dollars. We pay them in Rupees”.  (we were STILL APPALLED!) **
…I don’t have any idea what the exchange rate between Rupees and Dollars are…but it’s a painful thought that any professional, in this case, they were talking about having hired Pharmacists, and other Clinically Trained, university-educated people for these positions, and they’re willing to work for an amount that WE, in the USA consider INSULTING.
From a Business perspective, these companies can hire 3 or 4 employees/coders for a lower rate than they can hire ONE US Certified Medical Coder. THAT’S the Primary Reason, that OFF-SHORING is so attractive to facilities, companies, etc. Coupled with the fact that the technology is available now to send the records to them in an ‘instant’, their employees work the accounts while the US employees are asleep, and send it back, again, ‘in an instant’….. it’s an intriguing combination for the facilities and coding companies. They can even hire a team of USA Auditors to review/repair codes/claims and still save money!

WE, as US Coders need to ‘STEP UP OUR GAME’!

**Dual Credentials…

**Enhanced Education…
I don’t know that ‘anything’ will completely STOP OFF-SHORING!!  Unlike workers 40-50 years ago, we now live in and must function in a GLOBAL ECONOMY!!!——-To quote Gordon Gekko, ‘GREED is GOOD!’ …(from the movie ‘Wall Street’, produced in 1987)… And BUSINESSES … Companies and Facilities … operate on PROFIT and GREED! 
(from a group member)
—  one US dollar is equal to 71.23 rupee. The Philippines is one US dollar to 52.79 Philippe piso.
—  How does that break down to a ‘per chart’ situation?
 I don’t know I just googled US dollar to rupee and came up with a currency converter.  I was also told before that most coders in the Philippines make about 2.80 us an hour.
—  You can BET YOUR BOTTOM DOLLAR, as SE Asia employees gain experience and begin to command higher salaries  …  that the companies will move to lower waged populations!   Reports are that Certified Coders in the SE Asian countries are bringing home approx. $2.80 an hour.  We’re already seeing companies moving to ‘other areas’; such as Malaysia, Africa, etc., where they can pay lower wages.  
SO DO THE MATH! The companies who are OFF-SHORING  can hire 3-4 workers to work 8 hours a day for less than a US coder will work for One Hour! If they’re making $2.80 an hour times 10 hours…..they’re making $28 a day!  I know of many coders who step out of school with the ink still wet on their shiny new diplomas who think they will START OUT as coders making $35 or $40 an hour!! 
Is it any wonder the companies are fleeing to lower-waged countries???
I certainly don’t know all the answers! I’m not sure ANYONE has ALL the Answers! I have my opinion!  You have yours!  Just like noses and belly-buttons, NEARLY EVERYONE has one!!!) 
This same basic issue hit the steel and auto industries back in the ’70’s …and we’re JUST NOW seeing  ‘some’  of THOSE JOBS come back to the USA.
All we can do, is TRY!!!
The GOOD NEWS, is this!  —   Every month, there are reports of Facilities and Health Systems who are RE-SHORING the work back to the USA!!!
The OFF-SHORING gets a lot more press! But a lot of the jobs ARE coming back! This OFF-SHORING ‘nightmare’ has been going on since the early to mid 90’s…and US Coders are STILL HERE… STILL LEARNING… STILL GETTING CERTIFIED… STILL ACTIVELY CODING! They haven’t KILLED US OFF YET!!! 🙂
We’re Tougher than we LOOK!! 🙂.
— be careful about describing an entire country as “desperate”, please. Assigning a negative characteristic to an entire nation and it’s people is easily, easily misread. Some of these foreign economies are weak, citizens are poor, they have corrupt governments and citizens don’t have many opportunities. We don’t know that anyone is “desperate” we also don’t know that an entire population “learns very fast”. Generalizations about people based on nationality or cultural identity are problematic.  
For everyone looking for Coders Direct link to their HIPAA Awareness Campaign and sample letter can be copied and pasted into your correspondence with your Congressman or Senator…
Thank you!
Is Lexicode using OFF-SHORED personnel???
— not a 100% sure
— Thanks!


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