It's not always that simple. I own a medical clinic & as a provider we always talk to reps in India regarding benefits for a patient's policy. If we have a problem with a claim, we talk to a rep in Jamaica. They only read what is on their computer screen & cannot interpret any of the information. If you ask a specific question, they just re-read the screen. At least insurance companies have realized that in order to entice employers/groups, they have to provide call centers in the USA for their policyholders. But that does not solve the problem for providers including doctors, hospitals, surgical facilities, diagnostic centers, etc.