How do I pick the right medical virtual assistant?

Choosing a medical virtual assistant for your clinic or hospital (MVA) is not just about filling administrative and clinical task gaps. It is about protecting patient data, improving patient experience, and increasing efficiency and productivity.

Whether you’re a solo psychiatrist, a dentist in a small group, a therapist in private practice, or a specialist employed by a hospital who wants help with your own panel, this framework will help you pick the right MVA and set them up to succeed.

Start with the job to be done

Before you talk to any vendor or candidate, get clear on what you actually want them to do.

Here is the one page brief you can use for hiring and onboarding your virtual assistant.

Core administrative and clinical task

• New patient intake
• Scheduling appointments
• Taking patients’ vital signs
• Preauthorizations and insurance verifications
• Medical billing and coding support
• Phone answering
• Patient communication
• Patient follow-ups
• And more!

You can label each task as daily, weekly, or monthly, and define what a good outcome looks like. Write one line on what a good outcome looks like (e.g., Verify benefits for all new patients 24–48 hours before visit.)

Tools you use

List every software they need to skilled in:

• EHR / EMR or practice management (PM) system
• Phone system / VoIP
• Patient portal
• eFax or document management
• Clearinghouse and billing software
• Secure messaging / chat tools

For each one, note:

• Exact software name and version
• Access role you will grant (e.g., scheduling only, billing only)
• 1–2 screenshots of the most common workflows (scheduling, eligibility check, claim status, etc.)

Hours and coverage

Define:

• Time zone of your practice (EST/PST)
• Required coverage hours (e.g., 8 a.m.–5 p.m. Eastern)
• Weekend or evening coverage needs
• Typical call volumes and peak times by weekday
• Average call length
• Rules for warm transfers and escalations
• Any bilingual or accent needs for your patient population

Success metrics

Pick a short, focused list (you don’t need all of these; choose what matters most):

• Average handle time
• Abandoned call rate
• No-show rate
• Clean claim rate
• Days in A/R (accounts receivable)
• Denial rate and denial overturn rate
• Portal response time

Set simple target ranges for 30, 60, and 90 days so everyone knows what “good” looks like.

Quick questions to align your internal team

Before you bring in an MVA, ask yourselves:

• Which two tasks will move revenue or access the fastest in month one?
• Which tools must be mastered in week one to avoid errors?
• What single metric will we look at every morning to confirm we are on track?

This keeps you from overwhelming the assistant with everything at once.

Non-negotiables for Healthcare Professionals Hiring a Medical Virtual Assistant

Because MVAs will usually handle protected health information (PHI), you must treat them like any other vendor under HIPAA.

HIPAA compliance

Any MVA company or independent contractor that touches PHI is a Business Associate under HIPAA. That means you need:

• A signed Business Associate Agreement (BAA)
• Documented HIPAA training for anyone who will touch PHI
• Policies for privacy, security, and breach reporting

A BAA is legally required whenever a covered entity shares PHI with a business associate, and it must spell out how PHI can be used, what safeguards are in place, and how breaches will be reported.

Ask for:

• A copy or sample of their standard BAA
• Proof of annual HIPAA training completion
• A summary of their breach response process

Security guidelines

Treat their security like you would treat your own IT environment. At a minimum, you should understand:

• Device controls and ownership (who owns the laptop they use for your work?)
• Full disk encryption
• Multi-factor authentication (MFA) on all systems that access PHI
• Password vaults and password policies
• Endpoint protection (antivirus, antimalware)
• Audit logs (who did what, when)
• Role-based access in your EHR / PM
• How access is revoked when someone leaves

Good outsourcing practices for medical billing and virtual staff typically include encryption, secure transmission, firewalls, and strong endpoint security.

Standard procedures

Look for written SOPs (standard operating procedures) for:

• HIPAA-compliant scheduling
• Insurance verification and benefits documentation
• Prior authorization checklists
• Medical claim submission and follow-up
• Denial workflows and appeals

Ask to see at least one real (de-identified) SOP.

Minimum necessary access

Your assistant should see only what they need to do their job.

• Use role-based permissions in your systems.
• Hide clinical notes, labs, and sensitive sections if they’re not required.
• Before day one, test a dummy chart to verify they cannot see more than they should.

HIPAA’s “minimum necessary” standard applies to business associates as well, and your BAA should reinforce that.

Vendor Questions That Reveal Real Readiness

When you speak with an agency or independent MVA, ask:

• Will you sign my BAA without edits and provide proof of annual HIPAA training?
• How do you lock and wipe a lost device?
• Can you show me an audit log from last week with user, time, and action (de-identified)?
• What is your incident response timeline in hours? (From detection to notification to you.)
• Who is your security contact if we have a concern?

The goal is simple: they should be able to answer clearly and specifically, not just say “we’re HIPAA compliant.”

Onshore, Nearshore, or Offshore?

You can find excellent MVAs in all three categories. The key is matching the work to the location.

Onshore (US-based)

• Easiest HIPAA and cultural alignment
• Familiar with US payers, terminology, and accents
• Best for complex benefits checks, escalated billing calls, or sensitive conversations
• Higher cost of hiring

Nearshore (e.g., Latin America, similar time zones)

• Similar working hours
• Good balance of cost and communication
• Often strong English and familiarity with US systems

Offshore (e.g., Philippines, South Asia)

• Largest cost savings
• May have accent differences or different holidays
• Great for back-office work and well-scripted calls
• Always review call samples that match your patient base and set clear holiday coverage plans

Decision Checks Before You Pick

Work through these practical questions:

• Do your patients expect a local voice for billing or clinical-adjacent conversations?
• Will a four-hour time overlap cover your peak call windows and internal huddles?
• Are complex, high-touch benefits checks common enough to justify onshore rates?
• Can you split work (e.g., offshore back-office + onshore escalation calls)?

Experience That Actually Matters

Not every “healthcare VA” has the experience you need. Focus on:

Specialty experience

Workflows differ in:

• Primary care
• Psychiatry and therapy
• OB/GYN
• Dentistry
• Chiropractic
• Cardiology, and other procedure-heavy specialties

Ask for two examples that match your clinic:

“Tell me about two practices similar to mine. What did you do for them, and what changed in their no-show rate, collections, or call handling?”

Listen for payer-specific steps and real outcomes.

Payer mix

Experience with your payer mix reduces ramp time and denials. For example:

• Medicare and Medicare Advantage
• Medicaid and managed Medicaid
• Top local commercial plans
• Workers’ comp, dental plans, behavioral health carve-outs

Ask them to walk through a live benefits estimate for a sample patient (you can use a de-identified example).

EHR and PM familiarity

Look for familiarity with common systems such as:

• Epic, Athenahealth, eClinicalWorks, AdvancedMD
• Kareo, DrChrono, Dentrix, Open Dental
• TherapyNotes, SimplePractice, and similar systems

A short screen share while they navigate a demo environment tells you far more than a resume line.

Billing and coding exposure (for RCM roles)

For revenue cycle roles, ask about experience with:

• CPT and HCPCS codes
• ICD-10 diagnosis coding (at a basic operational level)
• Clearinghouse workflows
• Claim edits and scrubber rules

Certifications like CPC or similar are a plus, but you must still make sure licensed clinical judgment stays with clinicians and coders, not the VA.

Interview Prompts That Reveal Skill

Use concrete scenarios instead of generic questions:

• “Walk me through benefits verification and a same-day estimate for a new patient.”
• “A prior authorization was denied for ‘medical necessity.’ What are your next three steps and what would you document?”
• “Here is a mock EOB and denial code. What are your next actions and how do you note them?”

Role-play a scheduling call and a no-show recall call (listen for empathy, clarity, and accurate documentation).

Take notes on:

• How well they structure their steps
• How they communicate uncertainty
• Whether they know when to escalate to your team instead of guessing

Tool Compatibility and Setup

Good MVAs live and die by their tools. Test this before you sign.

Phones

Confirm:

• Caller ID displays your practice name, not an unknown number
• Call quality is clear and stable
• Warm transfers work as you expect
• Voicemail greeting, routing, and retrieval are simple
• How long recordings are stored, who can access them, and how they’re protected

Many practices use recorded calls for QA and training, which is common in virtual assistant setups.

Secure messaging

Decide what lives where:

• What belongs in chat (quick questions, logistics)
• What belongs in the EHR inbox (orders, patient decisions, messages that impact care)
• What must be a phone call (urgent issues, upset patients, anything safety related)

Ensure your messaging platform is HIPAA compliant and covered by a BAA if it includes PHI.

EHR access

Before day one, work with your IT or vendor to:

• Create role-based accounts (no sharing logins)
• Set session timeouts
• Turn on audit logs and know where to find them
• Limit access to clinical content that is not required

Review a sample of audit logs after week one to be sure behavior matches expectations.

Documentation

Provide:

• Call scripts and talking points
• Smart phrases or templates for notes and portal messages
• Simple rules for documenting outcomes (e.g., “All benefit checks get the same note structure.”)

Clear documentation makes it easier for clinicians and billers to trust and use the assistant’s work.

Sanity Checks Before Go-Live

Before you fully flip the switch:

• Can overflow calls be routed to the MVA without losing caller ID or call quality?
• Do you have a simple note-naming rule so clinicians can scan quickly?
• Who reviews the first ten notes or call logs, and by what date?
• Do clinicians know what the MVA will and will not do so expectations are aligned?

What to Measure

You don’t need a dashboard with 50 metrics. Start small and meaningful.

Patient experience

• Call answer time
• Call abandonment rate
• CSAT (simple “How was your experience?” after calls)
• Portal response time

Listen to at least two recorded calls per rep per week in the first month.

Access and growth

• Same-day or next-day appointment availability
• No-show rate
• Referral conversion rate (sent vs. scheduled vs. seen)

Track these by provider and by clinic location, where applicable.

Revenue cycle

Medical billing virtual assistants can reduce operational costs and help lower denials when implemented well.

Watch:

• Accuracy of insurance verification
• Clean claim rate
• Days in A/R
• Overall denial rate
• Time from visit to payment

Use a small code and payer set as a control group to see impact clearly.

Quality and compliance

• Documentation completeness (checklists are fully filled)
• HIPAA audit findings or issues
• Error rate per 100 encounters (incorrect benefits, wrong insurance, wrong patient)

Scoreboard Questions to Drive Action

Look at your data weekly and ask:

• Which single metric improved the most in week two, and why?
• Where are exceptions piling up, and what root cause will we fix this week?
• What change would cut denials for our top payer this month?

This keeps everyone focused on improvement, not just activity.

Pricing and Contract Tips

All-in pricing

Clarify what is included in the hourly or monthly rate:

• Training and ramp-up time
• Holiday coverage
• Software seats if provided by the vendor
• Supervisor/QA time
• BAA and basic security controls

Ask how surge volume (seasonal spikes, new location launches) is billed.

Coverage and backups

You want:

• A named backup MVA, not just “someone else from the team”
• A written handoff plan (what gets handed over, how fast, and by whom)

Quality rights

Protect your ability to maintain standards:

• Right to record calls for QA (subject to state law)
• Right to own all SOPs and playbooks created for your practice
• Right to request a replacement if quality drops, with clear timelines

BAA and incidents

Put your expectations into the contract:

• BAA signed before PHI is shared
• Breach or incident notification timelines (e.g., within X hours)
• Data return or destruction rules at the end of the relationship (mirroring HIPAA guidance)

Contract Questions That Prevent Headaches

Ask directly:

• What is replacement time in business hours if my assigned assistant is out or not a fit?
• Who pays for retraining if you swap in a new resource?
• Can I end for convenience with short notice if quality drops, and what does that cost?
• How long is the initial commitment, and what happens at renewal?

Red Flags

Be cautious if you see:

• Refusal to sign a BAA or vague answers on PHI and security
• No call samples, or samples that clearly don’t match your patient base
• Over-promising on clinical tasks outside an assistant’s scope (e.g., diagnosing, changing medications, giving clinical advice)
• Only vanity metrics (call volume, “tasks completed”) and no real operational or RCM numbers
• Obvious high turnover without a documented backup and handoff plan

Two or more of these in a single conversation is a good reason to pause or walk away.

Where to Find Candidates

You can:

• Recruit directly (job boards, your network)
• Use specialized MVA agencies like Wishup that pre-screen for HIPAA awareness, US workflows, and common EHRs

Good healthcare-focused services often:

• Keep a bench of pre-vetted assistants
• Handle replacements, contracts, and payroll
• Provide supervisors and QA to shorten ramp-up

Managed, healthcare-specific vendors can shorten launch time for small practices, but you should still run your own pilot and quality checks.

Buyer Questions for Any Marketplace or Agency

Ask:

• How many assistants on your bench match my specialty and time zone today?
• Can I listen to two call samples that match my patient profile?
• What is the average client tenure in months?
• How many clients are in my size and specialty, and what results have they seen?

First 30-Day Onboarding Plan

Use a simple four-week plan so your assistant grows into the role instead of being thrown into the deep end.

Week 1 – Setup and Shadowing

• System access and account setup
• HIPAA refresher training
• Review scripts and SOPs
• Shadow live calls and portal workflows
• Do benefits verification in a sandbox mode (practice environment or test cases)

Daily huddles: Confirm logins, answer questions, and review two sandbox verifications with real (but de-identified) payer portals.

Week 2 – Low-Complexity Live Work

• Handle low-complexity calls live (e.g., new patient scheduling, simple questions)
• Verify insurance and document benefits using your template
• Log every exception in an exceptions log

Keep daily huddles and clear escalation rules.

Week 3 – Add One Higher-Complexity Lane

• Add prior authorizations or basic claims follow-up
• Introduce a denial tracker
• QA at least two calls per day

Review the denial tracker every other day, and coach on tone, empathy, and clarity.

Week 4 – Move Toward Steady State

• Expand to full scheduling or a well-defined RCM lane
• Move huddles to twice per week
• Finalize SOPs and documentation templates
• Confirm target metrics and schedule a short monthly review meeting

Bringing It All Together

If you follow this framework:

• You know exactly what you’re buying
• Your patients’ trust and privacy are protected
• You see improvements in access and cash flow within the first one to two months