ClaimOps / Partner FAQ
Section 09The questions partners actually ask before signing
Eleven answers, followed by the full list of things we will not promise you and the shorter list of things we will.
Is this genuinely non-voice, or does AR follow-up mean payer calling?
Genuinely non-voice. Follow-up runs through payer web portals and electronic status enquiries. The small residue of cases needing a telephone call is routed to the client's onshore team. You do not need telephony, a dialler or voice-trained agents.
We do not currently employ certified coders. Can we still bid?
Yes. Ten of the twenty-five seats need a current AAPC or AHIMA credential; the other fifteen do not. Most partners hire six to eight certified coders and sponsor the rest through certification during the first two quarters, bonded against a retention undertaking.
Who owns the client relationship?
Akontec. You will not be introduced to the covered entity as the contracting party, and direct approach to the client is a material breach. In return, Akontec carries the commercial risk of the client relationship and pays you against the seat register regardless of when the client pays.
What happens if the client cuts seats?
Sixty days' written notice on staffed seats, which is the Akontec standard and is the same notice you would receive on any staffed engagement here. We do not reduce a seat count with immediate effect.
Can we run this on a shared floor to improve utilisation?
No. A dedicated, access-controlled bay is a condition of the business associate obligations, not a preference. This is the requirement most often underestimated by new partners and it is checked at the readiness audit.
Is any part of this automated, or is it all people?
It is a people process. Every code, every posting, every appeal and every follow-up touch is done by a named employee on your roll. There is no automation credit in the rate and no assumption that tooling will let you run below the published seat mix. What you are being paid for is trained headcount, and that is what the client is buying.
How quickly do we get paid?
Invoice by the third working day, paid on the agreed terms from receipt of a correct invoice. The payment-terms field is left open in the commercial terms because it is settled at contracting with your finance team, not assumed here.
What is the realistic attrition on this process?
Lower than voice, higher than most partners expect. Plan for eighteen to twenty-four per cent annualised on the non-certified roles and materially lower on certified coders. Build your bench and your certification sponsorship around that, not around a best case.
Can we sub-contract part of the work?
No, and not to a group company either, without written consent. Every person with access must be on your background-verified roll and inside your controlled bay.
Can we use our own productivity or workflow tools on this process?
Only with written approval, and only inside the agreed processing boundary. Anything that reads, stores or transmits protected health information is a control change and goes through the security officer, not the floor. Spreadsheets kept outside the client system to track work are the most common finding at audit and the easiest to avoid.
How is the composite quality index calculated?
It is a weighted score across coding accuracy, entry and posting accuracy, turnaround compliance and documentation completeness. The weights and the calculation are set out in full in the SLA and KPI schedule that accompanies this proposal — not left to interpretation.
What we will not promise
Every proposal in this market contains claims that cannot survive contact with a payer. This section exists because a partner who is told the truth at the start does not become a dispute in month six.
On money
- We do not guarantee a collection outcome. Days in AR, net collection rate and denial overturn rate depend on payer behaviour, physician documentation and client decisions that no offshore team controls.
- We do not guarantee volume. Seats are contracted; throughput is not.
- We do not promise incentive earnings on this process. The rate is flat and there is no variable upside built into it.
- We do not promise a rate increase at renewal, and we will not agree an indexation clause we cannot fund from the client contract.
- We do not promise to reimburse the cost of attrition, ramp or re-training.
On people
- We do not promise that this process can be run with fewer people than the published seat mix. There is no tooling shortcut and no automation credit in the rate.
- We do not promise that an experienced biller becomes a productive coder inside the ramp window. Some do not, and they must be replaced rather than carried.
- We do not promise that your attrition will match ours or anyone else's.
On operations
- We do not promise that the client's practice management system will be available. Downtime at the client end is not a service level failure at yours, and equally is not billable idle time beyond the agreed allowance.
- We do not promise that payer rules will stay still. Policy changes will force rework, and rework is part of the process, not a change order.
- We do not promise that every certified coder you hire will pass our certification test. A current credential is necessary and not sufficient.
- We do not promise same-week resolution of client-side documentation queries.
On compliance
- Akontec does not claim any certification it does not hold, and will not permit a service provider to represent Akontec as holding one.
- We will not agree to a coding instruction that the documentation does not support, from anyone. If that instruction arrives, your team escalates it and stops. This is the single non-negotiable term in the engagement.
- We will not accept a floor that is not ready in order to hold a go-live date.
- We will not agree to a control waiver on the basis that a client is willing to accept the risk. The obligations here are statutory, not commercial.
What we do promise
- You are paid against the seat register on the agreed terms, whether or not the client has paid Akontec that month. The client credit risk sits with us, not with you.
- Sixty days' written notice on staffed seats. No same-week reductions.
- A rate that does not move downward during the term.
- Named owners on our side who answer within the published response times.
- A scorecard whose calculation is published in advance and does not change mid-month.
- No metric in the service level that depends on payer behaviour.
- Full disclosure of any control we have implemented but not independently certified.
- That we will not place a second provider on your bay, your team or your specialty during the term without telling you first.
Known risks, and who carries them
Set out with an owner against each, so that the allocation is a decision rather than an argument.
| Risk | Carried by | Mitigation in this structure |
|---|---|---|
| Client stops paying or becomes insolvent | Akontec | You invoice Akontec against the seat register, not the covered entity |
| Volume falls below the level that keeps seats productive | Shared | Seat count reduced on 60 days' notice rather than seats left idle at your cost |
| Certified coder salary inflation | Provider | Sponsorship and retention bonding; rate held flat for the term in both directions |
| Rupee appreciation against the dollar | Provider | Not hedged; price your cost sheet at a rate you can live with |
| Payer policy change forcing rework | Shared | Payer rule register maintained by Akontec; rework excluded from turnaround breach where the register changed mid-cycle |
| Quality failure leading to service credit | Provider | Published composite, monthly calibration, remediation before any credit applies |
| Security or privacy incident | Provider, with Akontec support | Control set audited before go-live and quarterly; 24-hour notification obligation |
| Client-side documentation quality | Client | Excluded from the provider score and reported to the client monthly |
| Loss of the client contract | Akontec | 60-day notice; where possible, seats redeployed to another Akontec process |
Next step
Still have a question this page does not answer?
Send it with your application. Every enquiry is read by a named person at Akontec, and questions asked before contracting are the cheapest questions in the engagement.
Apply to deliver this process Read the commercial terms