My first trip to India was over ten years ago.

I owned a medical billing company and wanted to research the medical billing business process operations (BPO’s) in Chennai. This was a time before digital media had taken over and any company could have an unreliable website. They could make it appear as if they had a large company, when in reality, they may have been working in a remote village with limited internet connection. I felt I had to go to India and research companies first hand.

I asked my friend, who also owned a medical billing company, to come with me. When he agreed I was so excited. This was my first trip to Asia and the eighteen hour travel was exhausting. After the jetlag was under control, I was ready to do research. I came prepared with a list of the top ten medical billing BPO companies and visited each one.

Chennai, India is where it all began. The first India medical billing BPO was started in Chennai in 1994. Today there are plenty of medical billing BPO’s all across India, but Chennai is by far the mecca of medical billing talent.

The YES culture. I felt like royalty visiting many of the companies, there were red carpets, bouquets of flowers, and even welcome signs with my name on it. Everyone we met seemed really happy to greet us, and we certainly stood out. The people of India would say yes to any request, even if they knew it was not feasible. They want to please so badly that it was almost like they could not help themselves. It takes some coaching and conversation to tell them that it is okay to set realistic deadlines for themselves. It is better to set the expectation than to have a client be disappointed you were unable to deliver in the unreasonable time frame originally promised.

I have seen a significant change and improvement in India’s infrastructure and technological advancements over the last decade. Many more businesses continue to move their back office operations to India. When evaluating countries to outsource, India is a democracy, a relatively safe place, low crime rate and politically stable for over 60 years.

Most of the companies I visited hired many “freshers”, employees with no medical billing experience. They are put through a limited training program and put onto the production floor. The business structure was based on paying employees as little as possible while charging the client as much as possible. I fundamentally disagree with this style of business, experienced employees are crucial in all aspects of the process. Since India has socialized medicine, most people do not even understand the medical billing process and how important their role is to ensure a claim will get paid.

After my trip I decided to start 4D Global, an American owned and managed medical billing BPO in India. I was set out to employ the best and most experienced talent in all of Chennai. I vowed to treat my staff with respect, everyone will have a voice and make it an enjoyable place to work. Provide our employees with a work family were we can celebrate birthdays, weddings, births and holidays. I want to create a work environment where everyone would want to work and advance within the company. I am proud to say that we have been able to do all of that and more.

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