Outsourcing RCM to an India-based team can work well or badly, and the difference usually shows up in the vendor selection conversation, not six months in. Six questions worth asking directly:
1. What’s your claim denial rate across current clients, and how is it tracked?
A vendor that can’t give you a number, or gives you one without explaining how it’s measured, hasn’t been asked this enough to have a real answer ready.
2. How is payment posting reconciled — daily or batched?
Daily reconciliation catches posting errors (wrong check number, wrong amount) before they compound into a reporting mess. Batched, delayed reconciliation is where small errors turn into a backlog.
3. What’s your process for claims/invoice adjustments — is there a documented approval step?
Adjustments without an approval trail are a compliance and audit exposure, not just a process gap.
4. What time zone coverage do you actually provide?
“24/7” can mean a rotating on-call person or a fully staffed overnight team — ask which, and what response time each covers.
5. How is data access controlled on your end?
Ask specifically about identity and access management — who can see what, and how access is revoked when someone’s role changes.
6. Can I see a real (anonymized) example of a claim or order moving through your process end to end?
A vendor confident in their process should be able to walk you through an actual example, not just describe capabilities in the abstract.
None of these questions are about cost. Cost is the easy comparison. The vendor differences that actually matter show up in the answers to these six.