Should a clinic hire a medical VA from the Philippines or Latin America?

Philippines vs Latin America at a glance

What does a medical VA cost from each region?

Only some providers publish a rate. These are the rates on their own pages on Oct 26, 2026; confirm them on a written quote, because prices and terms change.

On these numbers the regions overlap, so price alone does not settle the choice. We found no reliable public salary dataset for medical VAs in the Philippines or Latin America, so this page quotes no worker pay; an agency rate also covers recruiting, payroll and support, not only the assistant’s pay. For a US baseline, the BLS median for medical secretaries and administrative assistants was $45,930 a year in May 2025. Source: BLS Occupational Outlook Handbook: Secretaries and Administrative Assistants (pay, May 2025)

How much do US clinic hours overlap?

• Philippines: In Manila, 9:00 am to 5:00 pm in New York is 10:00 pm to 6:00 am the next day in January (US standard time) and 9:00 pm to 5:00 am the next day in July (US daylight saving time).IANA Time Zone Database
• Latin America: In Bogotá, 9:00 am to 5:00 pm in New York is 9:00 am to 5:00 pm in January (US standard time) and 8:00 am to 4:00 pm in July (US daylight saving time).IANA Time Zone Database
• Latin America: In Mexico City, 9:00 am to 5:00 pm in New York is 8:00 am to 4:00 pm in January (US standard time) and 7:00 am to 3:00 pm in July (US daylight saving time).IANA Time Zone Database
• Latin America: In São Paulo, 9:00 am to 5:00 pm in New York is 11:00 am to 7:00 pm in January (US standard time) and 10:00 am to 6:00 pm in July (US daylight saving time).IANA Time Zone Database

A Philippines-based assistant can cover your full day, but as a night shift. Hello Rache and MedicalVirtual both say their assistants work your US hours. Source: Hello Rache home · MedicalVirtual home Ask who covers holidays and absences, and whether the schedule is fixed in the contract.

Do your patients need Spanish?

About 44.9 million people age 5 and older spoke Spanish at home in the US in 2024, roughly 1 in 7, and 58.9% of them said they speak English very well. Source: USAFacts: How many people speak Spanish at home? (Census data, 2024) · US Census Bureau, 2024 ACS 1-year, table C16001: Language Spoken at Home

If a real share of your calls, reminders or intake happens in Spanish, Latin America is the simpler fit: MedicalVirtual offers bilingual English-Spanish assistants, Ask Velma lists a bilingual role, and Virtual Latinos offers English plus Spanish or Portuguese. Source: MedicalVirtual home · Ask Velma Careers · Virtual Latinos: Pricing For English-only phone and back-office work, both regions can fit. Whichever you pick, test the language you need in a live mock patient call before you sign.

HIPAA steps before an offshore assistant sees patient data

The rules are the same for Manila and Bogotá. Your practice stays responsible for its safeguards.

1. Sign a Business Associate Agreement before any patient data moves. HHS says the HIPAA Rules let a covered entity disclose PHI to a business associate only with satisfactory assurances, in a contract or other written arrangement (a BAA), that the business associate will safeguard it. An agency whose assistants handle your patients' records on your behalf is generally a business associate, and HHS says a business associate needs its own BAA with any subcontractor before sharing PHI. HHS publishes sample BAA provisions you can compare a provider's draft against. Source: HHS: Business Associates FAQs · HHS: Sample Business Associate Agreement Provisions
2. Put the assistant inside your Security Rule safeguards. HHS's Security Rule summary lists administrative, physical and technical safeguards: a risk analysis, a named security official, workforce training, access control, audit controls, authentication and transmission security. Give the assistant a unique login on your systems, keep patient data in those systems, and review access logs. Source: HHS: Summary of the HIPAA Security Rule
3. Give only the minimum necessary access. The Privacy Rule's minimum necessary standard requires covered entities to limit uses and disclosures of, and requests for, PHI to the minimum needed for the purpose. In practice, a scheduling assistant should not see full charts; set role-based access before day one. Source: HHS: Minimum Necessary Requirement · HHS: Summary of the HIPAA Security Rule
4. Weigh the location in your risk analysis. HHS's cloud guidance says the HIPAA Rules have no requirements specific to ePHI handled by a business associate outside the US, but that offshore risks can vary by location and should be taken into account in the Security Rule risk analysis. That applies to Manila and Bogotá alike. Source: HHS: Guidance on HIPAA and Cloud Computing (question 9, ePHI outside the US)
5. Check the training, then add your own procedures. HHS's Security Rule summary says a regulated entity, which includes a business associate, must train all workforce members on its security policies and procedures. Ask the provider how and when it trains, then walk the assistant through your practice's own procedures; HHS's training page links free material. Source: HHS: Summary of the HIPAA Security Rule · HHS: HIPAA training and resources

When neither makes sense, and when to hire locally

• The work is in person: rooming patients, vitals, front-desk check-in or anything hands-on. A remote assistant cannot do it.
• The task needs a US clinical license, such as clinical judgment by a nurse. Check the license rule for that desk before you hire anywhere.
• Your practice cannot yet give a remote worker a unique login, role-based access and audit logs, or no one owns the BAA and the risk analysis. Fix that first; the HIPAA steps above apply to any remote hire. Source: HHS: Summary of the HIPAA Security Rule
• You need more than one assistant can cover, or nobody has time to supervise. A managed agency or a local hire may fit better than a single remote assistant.
• Cost is the only reason, but patients want someone in the room. The BLS median for US medical secretaries and administrative assistants was $45,930 a year in May 2025 (receptionists $38,010). That is pay before benefits and payroll costs; weigh it against a written remote quote for the same hours rather than assuming offshore always wins. Source: BLS Occupational Outlook Handbook: Secretaries and Administrative Assistants (pay, May 2025)

Not sure which desk the work is? Compare the remote healthcare desks and their license rules first.

Which should you choose?

• Spanish-speaking patients or live daytime calls: Latin America.
• English-only back office on a fixed US shift: either region; compare written quotes.
• One provider for both regions: MEDVA or Ask Velma recruit in both.
• A BAA in writing from day one: ask every provider; Ask Velma and MedicalVirtual say they sign one.
• You want to hire directly and train the assistant yourself: post the role on RemoteNurse and point candidates to the free medical VA courses.

Candidate-side guides: medical VA work from the Philippines and medical VA work from Latin America. More providers compared: MEDVA alternatives.

Common questions