International · Non-voice · Dedicated seats · AKO-RCM-CLM-2026-01
A US healthcare back-office process that does not touch your calling floor.
Akontec is placing a United States revenue cycle management and medical billing process with selected BPO service providers in India. The work is entirely non-voice. No dialler, no patient contact, no sales target, no talk-time metric. Your team works inside the client's practice management system and the payer portals, and is measured on accuracy and turnaround.
The work, end to end
The claim lifecycle
Between the visit and the payment sits a sequence of administrative steps, each of which can stop the money. That sequence is the process. Highlighted stages are the ones that decide whether the account is healthy.
On the word "non-voice." AR follow-up here is performed through payer web portals and electronic status enquiries, not by calling payer representatives. The small residue of complex cases needing a phone call is routed to the client's onshore team, not to your floor. No agent on this process makes or takes a call as a matter of routine, and no telephony infrastructure is required.
The most durable offshore vertical in the industry
Healthcare providers in the United States cannot stop billing, cannot stop chasing unpaid claims, and cannot easily bring the work back onshore at the same cost.
Volumes do not fall in a downturn
If anything, tighter payer behaviour increases the follow-up workload. For a service provider that means long tenure, low seasonality and a predictable monthly invoice — the opposite profile to a marketing-funded voice campaign.
It rewards investing in people
Certified coders are scarce and command a premium, but they are also difficult for a competitor to poach at short notice and difficult for a client to replace. A coder trained on one specialty becomes more valuable each quarter rather than less.
Attrition runs materially below voice
Well-run RCM floors hold people. Plan for eighteen to twenty-four per cent annualised on the non-certified roles and materially lower on certified coders — but budget six weeks of ramp for every exit, because each one costs that.
How it differs from a voice campaign
| A typical voice campaign | This process | |
|---|---|---|
| Revenue driver | Talk time, calls handled, sales made | Seats deployed and accuracy sustained |
| Seasonality | Marked — campaign cycles, holidays, client marketing spend | Minimal — claims are filed every day care is delivered |
| Agent profile | High energy, high churn, low training investment | Detail-oriented, credentialed, trained over months |
| Attrition exposure | High; replaceable within a week | Lower, but each exit costs six weeks of ramp |
| Infrastructure | Dialler, telephony, recording, voice QA | Secure desktop, controlled bay, no telephony at all |
| What breaks the account | Missed sales targets | A compliance failure or a coding integrity breach |
What Akontec brings, and what you bring
Akontec brings
- The client relationship, and the commercial risk that sits behind it. You invoice Akontec against the seat register, not the covered entity.
- The commercial structure — a flat rate that does not move downward during the term.
- The compliance framework, the payer rule register and the process manual.
- Process governance: named owners, a published escalation ladder, monthly calibration against your own internal audit.
- The assessment pack, the coding test, and unbranded job descriptions you can advertise on your own letterhead.
You bring
- A dedicated, access-controlled bay — not a shared floor with any other account.
- Hiring capability, including at least six currently certified coders in wave one.
- Supervision at the published ratios: two team leaders, an auditor, a trainer, a delivery manager, an MIS analyst and a named security officer.
- The security control set in full, audited before go-live and quarterly thereafter.
- Delivery discipline — the willingness to escalate a coding instruction rather than follow it.
Steady, non-seasonal back-office volume; a rate set per seat rather than per claim; and a client who cannot afford to churn the vendor every quarter.
Ambulatory and outpatient, six specialty groups
Coding complexity is moderate rather than facility-level, which keeps the certification bar realistic for a provider building a team from a mixed talent pool.
| Specialty group | Share of volume | Coding profile |
|---|---|---|
| Family medicine and internal medicine | ~30% | Outpatient E&M, preventive visits, chronic care management |
| Urgent care | ~18% | E&M with procedures, injections, point-of-care testing |
| Behavioural health | ~15% | Time-based therapy codes, telehealth modifiers, authorisation-heavy |
| Physical and occupational therapy | ~14% | Timed treatment units, therapy caps, plan-of-care documentation |
| Diagnostic radiology | ~12% | Professional component billing, modifier 26/TC discipline |
| Podiatry, dermatology and minor surgical | ~11% | Global period rules, lesion sizing, modifier 25/59 |
What the process is worth to a provider
An illustration at twenty-five seats, on Chennai and tier-two metro salary bands as at the third quarter of 2026, at an indicative INR 95 to the dollar. It is shown so you can test the process against your own cost sheet — not as a representation of what you will earn.
- Indicative contribution
- 41.5%Of revenue at 25 seats, after all direct and allocated cost.
- Per seat, per month
- ₹51,288Contribution after salary, statutory, facility, tooling and overhead.
- Break-even
- Month 3On day-zero investment of about ₹18.25 lakh, assuming the ramp holds.
- Margin at 60 seats
- 47.5%The overlay roughly doubles while productive headcount quadruples.
Nothing in that band is a forecast, a projection or a commitment. Revenue is contracted in dollars and settled in rupees at the reference rate on the invoice date. The INR 95 basis is an illustration, not a hedge or a floor. Price your own cost sheet at a rate you would still be comfortable with, not at the rate that makes the model look best. The full profit and loss, the scale table and the risks are here.
Everything a delivery partner needs before contracting
Nine sections. Scope, productivity basis, an illustrative provider profit and loss, the service levels you will be held to, and the things we will not promise you.
Next step
Fifteen seats is the minimum. Twenty-five is where this works.
This proposal is an offer to open contracting, not a contract. Acceptance authorises Akontec to issue the contracting pack — Master Services Agreement, Business Associate Agreement, NDA, Information Security Schedule, Technology Baseline and Schedule A commercials — and to schedule the readiness audit.
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