New York (CNN/Money) - If a tax preparer gets you an unexpected refund this year, you may have an accountant in India to thank.
That's because accounting firms are joining the outsourcing trend established years ago by cost-conscious American manufacturers.
In fact, companies in a number of unexpected industries are now sending work overseas. From scientific lab analysis to medical billing, the service-sector workforce has gone global.
CPA firms are just one example. In the 2002 tax year, accounting firms sent some 25,000 tax returns to be completed by accountants in India. This year, that number is expected to quadruple.
The reason lies in the numbers; accountants in the United States typically earn $4,000 a month. In places like India it's closer to $400, says David Wyle, CEO and founder of SurePrep, a tax-outsourcing firm based in southern California that's employed more than 200 accountants in Bombay and Ahmedabad, India.
"We've estimated firms will save between $40,000 to $50,000 for every 100 returns that are outsourced," adds Wyle, whose firm expects to do 35,000 returns in the coming year. That's up from 7,000 last year.
Xiptax, of Braintree, Mass., is another tax firm that's moved much work overseas for "a whole number of reasons," besides money, says CEO Mark Albrecht.
"Most CPAs do between 45 to 50 percent of their work in two months out of the year. It makes for an extremely stressful time," says Albrecht, who adds that accounting firms must then "strain" to find qualified staffers to help fill in during the crunch.
By hiring full-time staff in India, CPA firms like SurePrep and Xiptax don't have to worry about finding staff here.
Instead, they simply send tax information to a permanent team of qualified accountants in India. American accountants then review the returns before signing off on them.
"The real important part of returns isn't taking a number off a W-2 form and putting it in Box No. 1," notes Albrecht. "The real value is what's retained within the CPA firm -- the tax planning and the review."
Fighting cancer from afar
Cancer patients who seek treatment may soon find that when their tests are "sent to the lab" their medical work is scrutinized by pathologists who aren't just down the hall, but who are in a different country.
Since the mid-1980s, pathologists have been using robotic microscopes from offsite locations to peer at biopsy samples. But now, pathologists are using the newest generation of technology to enhance "telemedicine" opportunities.
Specifically, pathologists are accessing computer servers to look at digital images of lab slides, says Ronald Weinstein, director of the Arizona telemedicine project at University of Arizona College of Medicine.
The benefit isn't cost-cutting or accelerating how fast jobs are done, says Weinstein, but the power it has to bring the best and brightest medical minds together.
"Telemedicine will enable international group practices to form," he says. "You'll have a conference where three world experts can look at the slide at the same time."
To test potential uses for offshoring medicine, Weinstein's group at University of Arizona has teamed with the University of Panama School of Medicine in Panama City to work together on cancer cases.
"We're looking to have pathologists in different time zones to speed up the rate at which patients pass through clinics," he says. "Currently we're limited by time zones, not just by access to people but to a full range of expertise."
Data entry in New Delhi
Pathology isn't the only area in medicine that's looking abroad. Increasingly, medical billing is being done by clerical staff in India, too.
That's the case at Alpha Thought International, a Chicago-based medical billing firm that has workers both in the U.S. and opened a billing office two years ago in New Delhi where staff do data entry work needed to process insurance and other medical billing claims.
"The reason that came about is because it's difficult to find workers in different parts of the country who want to do data entry," says Alpha Thought COO Dave Jakielo. When staffers in the United States quit, the company replaces them with India-based workers.
Alpha Thought cuts costs by 25 percent, because Indian workers are paid less than the average $10 an hour an American makes. The company also taps into a better-educated workforce.
"To work in an office over there you must have a college degree," says Jakielo. "The office workers we hire here are usually high school graduates."
Even so, even offshoring has its limits.
Jakielo envisions a day when medical billing will be totally automated. When that happens, even workers in New Delhi will have to find another gig.