The Role of ROI in Medical Record Processing
The Role of ROI in Medical Record Processing
The Release of Information (ROI) function is often an undervalued element of the Health Information Management (HIM) department. Release of Information and medical records processing includes logging, invoicing and responding to the entire medical record requests from patients, insurance payors, Attorneys, Government organizations and other authorities. Statistical reports of Association of Health Information Outsourcing Services (AHIOS) says, about 80% of the Release of information function is outsourced. The various regulations within the Health Insurance Portability and Accountability Act (HIPAA) play a prominent role in the procedures and rules for Medical Release of Information. The procedures, rules and regulations of this act set the parameters and dictate the way in which the Release of Information is completed. In fact, 2011 will see the enforcement of three key items which impact HIM departments and the ROI function.
1. Covered entities are required to track medical record disclosures for payments, treatment and operations. The use of an EMR software solution is the basis for this regulation which became effective in 2009. All entities, no matter what type of EMR deployment, will need to comply by 2014.
2. New patient rights will influence the EMRs design and process flow as it will have to track the timeframe and media at the time the medical record is requested and produced.
3. Within the extended HIPAA regulations a patient may also restrict disclosure of certain medical records to insurance companies if the patient pays for the services out of pocket. Few entities and EMR software applications are able to comply with this mandate at the current time.
The ROI service, from a qualified vendor such as ProTec Solutions, is rendered at very little or sometimes without any costs to the health care Facility. The services provided by an ROI company can range from a full service model, which completely manages all communication and processing for the ROI function, to a shared or even partial model which would provide only those services focused on logging, obtaining the records, invoicing and delivery to the requestor.
Due to government mandates, the implementation of EMR systems does have an effect on the ROI process. The software provides features such as e-prescribing, work flow tasking, communication and messaging. The medical records are maintained within these databases. The Release of information outsourcing decision can be a by- product of implementing an Electronic Medical Record and document management system. The Electronic Medical Record solution can assure considerable degree of patient safety, accuracy, reduced patient costs, data quality, and increased patient care. Oddly enough, the ROI process itself could actually become more complex depending on how much data was converted from the prior EMR or from back-scanned hard copy records (paper files). The ROI process may now include additional steps for access to multiple EMRs and even hard records which have not been scanned into the EMR.
Release of information is not for the faint of heart. Correctly fulfilling medical records requests, as submitted by patients or third party requestors, such as Attorneys and Insurance companies, requires a highly skilled individual. Medical Information processors need to be dedicated to following process guidelines, be knowledgeable in data privacy and security and focus on the correctness and quality of the information that is released.
For over 23 years, ProTec Solutions has been a leading provider for Release of Information, Medical Record process consulting and Document Management Solutions for the Healthcare Industry. ProTec Solutions combines experience and leading technology to assist you in improving efficiency, reducing costs and complying with the complexities of HIPAA regulations all while improving patient care.
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