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How to Improve Patient Experience in the ROI Process


Patient satisfaction is one of the most critical aspects of the release of information (ROI) process. Patients deserve respectful and trustworthy customer service to ensure the best possible patient experience. Especially during this time of unprecedented crisis and uncertainty, empathy at every level of patient interaction is critical.

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HIM Workforce Training Webinar Recap

How to Improve Patient Experience in the ROI Process

As part of the MRO webinar series this year, I recently presented HIM Workforce Training: Developing an Engaged Team. During this presentation, I discussed best practices for training and retaining your employees based on the evolving health information management (HIM) landscape which demands new skill sets and coping with the new normal for the workforce.




Health Information Management: New Hire Checklist

Since the first step of an employee’s journey with a company is the onboarding process, using a new-hire checklist is critical. This document should include facility orientation topics, a job description, policies and procedures, systems, and any important forms. Other areas of consideration throughout the employee’s entire journey with the company are HIPAA, compliance, customer service, department functions and record lifecycles.

Lesson Plans Through Video and Slides

Creating lesson plans based on specific employee roles is an easy way to stay organized and keep a record of what employees are learning. For example, a lesson plan on “The Medical Record” designed to cover topics such as encounters, common documents, corrections and amendments, confidentiality and legal issues, and legal health record versus designated record set can be a good start for an overview of HIM topics. Switching it up with slides, documents, and videos across categories helps to keep the employees engaged and interested in the content. When confronted with a decision about how to teach a topic, always choose a video because people enjoy them the most. Also, don’t forget to quiz your employees along the way to make sure they retain what they are learning.

Training Video Content on HIM and ROI

I encourage you and your staff members to create your own videos. If you have an employee expert on a topic, engage them to produce a video for you. It engages the team and they will feel connected through their coworker. Other organizations, such as OCR and AHIOS, provide excellent video content. It’s a good idea to continually check such sites for updated training videos that you can use for your own workforce. Many videos covering HIM topics, especially customer service, are available on YouTube.

Create Relatable Stories for More Memorable Lessons

When teaching employees about important topics, telling a story that is easily remembered can be helpful. For example, to drive the point about HIPAA and confidentiality, talk about finding out your neighbor had a baby. If your neighbor’s husband tells you she had a baby, you can tell the world, because her husband told you directly. If you find out your neighbor had a baby because you see her name on the hospital admissions list, then you cannot share that information because you learned it through your job, making it confidential per HIPAA. I find that employees are more likely to remember a simple yet impactful story.

Mixing up the trainings with games, quizzes, and anything fun is a good way to engage employees to enjoy learning. For example, have employees play a security game where a hacker is trying to get to an unsecured computer before they do, or perhaps play HIPAA Jeopardy.

Stronger Training Programs for Stronger Future Leaders

As employees continue to work for your organization, it is important to create training programs that further develop their skills. These programs will vary depending on specific job functions. Create plans, especially leadership development plans, to grow your future leaders.

During the webinar presentation, I provided valuable videos and resources that can be used for employee development and engagement activities. To get the most from these valuable resources, I encourage you to request the playback along with the slides.

To learn more about developing an engaged workforce, complete the form below to request playback.

Request webinar playback for HIM Workforce Training: Developing an Engaged Team

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Step Up in Crisis

How to Improve Patient Experience in the ROI Process

There are times in a person’s life where resilience is tested.  As I reflect upon this pandemic, I feel hopeful.  I say this because time and time again, we Americans have risen to challenges such as natural disasters, 9/11, the Great Depression, rationing during wars, etc.  I remember the extraordinary story of people forming a human chain into the ocean to rescue someone drowning.  I remember how I was assisted after Hurricane Katrina and we recently saw volunteers lined up in Nashville to assist tornado victims.  One of my city leaders said, “We have to face this with storm coming mentality.  That’s when we check on our neighbors and make sure they have a plan, especially elderly neighbors.  Let’s make sure they have groceries or whatever they need to stay home and stay safe.”  I love this sentiment- that in a crisis, we band together where the fate of us all matters more than the individual.  Surrender the ME to WE!

In wars, natural disasters, or pandemics, we are called upon to be our best selves.  It’s time for you to ask the question, “How can I be my best self in this pandemic?”  Staying calm and collected is important.  Anxiety about the future just inflames your immune system.  Live in the present.  The past is done, the future cannot be controlled, but the present is the state in which to live and appreciate the little things.  Minute by minute, hour by hour, day by day.  Preparation is important in a possible quarantine situation.  Yes, buy groceries for a couple of weeks, but don’t hoard.  I know someone who was worried about families who don’t have childcare, and she decided that she would volunteer to babysit.  How generous, she will make a difference and leave this world a better place.

Psychologist Gretchen Schmelzer wrote, “For most people worldwide, this virus is not about you. This is one of those times in life when your actions are about something greater, a greater good that you may never witness. A person you will save who you will never meet.  This isn’t like other illnesses and we don’t get to act like it is. It’s more contagious, it’s more fatal—and most importantly, even if manageable, it can’t be managed at a massive scale anywhere. We need this to move slowly enough for our medical systems to hold the very ill so that all can be cared for. There is still cancer, heart attacks, car accidents and complicated births. We need to be responsible because medical systems are made up of people and these amazing healthcare workers are a precious and limited resource. They will rise to this occasion and work to help you heal. They will work to save your mother, father, sibling, grandparent or baby. For that to happen, we have important work to do.  Yes, you need to wash your hands, stay home if you are sick and comply with all social distancing rules.  But the biggest work you can do is to expand your heart and your mind to see yourself and your family as part of a much bigger community that can have a massive impact on the lives of other people.”

I’ve already seen amazing stories happening- the patron who left a $3,000 tip at a restaurant for workers to split, people delivering groceries to those in need, stores dedicating hours for elderly shopping and many more.  Let’s share these stories to encourage others.  Imagine if we can make our response to this crisis our finest hour.  Hopefully, we can look back and tell stories of how we came together as a team in our community, our state, our nation and across the world. Your contribution to the finest hour may seem small—but every small act of kindness adds up exponentially to save lives.

At MRO, we have an incredible team and a culture we’re so proud of.  I recently shared with our team, that if they start to feel stressed, take a deep breath and practice mindfulness.  One thing that always works for me is to name 5 things for which I’m grateful for right in this moment.  It eases your anxiety.  Rely only upon reputable sources for information.  Unplug for a while to de-stress.  Now is a great time to journal your daily thoughts.  You’ll appreciate reading them in the future.

Interested in learning more? Request the playback of my recent webinar, Effective Leadership During COVID-19.

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MRO’s Everyday Heroes: A Motivational Initiative

How to Improve Patient Experience in the ROI Process

I have a fabulous job title: Senior Director of Motivation and Development. When I meet people, they often comment on my title, saying it’s intriguing and then ask what I do. The development aspect of my job at MRO Corp. includes managing all the training content—creating engaging lessons within our learning management system for our large, diverse workforce. But the truly heartwarming and rewarding part of my job is the motivation aspect. It is my responsibility to manage a program that inspires our workforce. I often joke that I get to play MROprah!

Creating Everyday Heroes

The biggest piece of our motivation plan is a program called Everyday Heroes, which celebrates team members who go above and beyond in their job performance. On a bimonthly basis, we produce an Everyday Heroes Newsletter that tells stories about how the actions of a team member touched someone’s life. The stories come from a variety of sources, but each one is about an MRO customer who received outstanding service and took the time to email an employee’s manager. Sometimes these happy customers send a gift of appreciation or call MRO to say they had a wonderful customer service experience. By far, most of these satisfied customers are patients whose lives have been touched.

Additionally, there are customers such as attorneys, insurance company representatives and our clients who write lovely letters to sing someone’s praises. Sometimes a staff member is asked to tell a noteworthy story about their own MRO coworker. Further, the newsletter features a section called “My Manager Cares” where an employee nominates a manager for excellent leadership and an inspirational skillset.

I recently shared with my daughter that one of my career accomplishments I’m most proud of is being able to touch one person’s heart. This is a privilege I treasure. As the Everyday Heroes program begins its fourth year this January, our CEO asked me how we find all the stories. I explained that inspiration is contagious, so team members and managers continue to send me great material.

I like to say, “We don’t just disclose health information, sometimes we save lives.”

Celebrating Great Customer Service at MRO Corp

Many ROI specialists who handle patient walk-in requests often say the most enjoyable part of their job is making a difference in a patient’s life. Our program celebrates these moments and gives people recognition for great customer service. When acknowledged as an Everyday Hero, honorees receive a gift box with a gift card, an MRO Hero frame containing their story, a candygram and a chance to enter a drawing for a big cash prize. Historically, we’ve had around 60 team members per year receive this honor. At the end of each year, we randomly draw three Everyday Heroes and one “My Manager Cares” for the big cash prize.

How We Make a Difference

As I reflect on all the newsletters I’ve written over the years, some memorable stories come to mind. In one case, a patient was in the middle of surgery when a report from an old chart was needed. Our staff member made the request a top priority and walked the report to the surgery area.

In another case, a husband came in to obtain his wife’s report, explaining that she was in the car because she had difficulty walking. To make things easier, our staff member walked to the requester’s car to obtain the patient’s signature on the authorization form.

Another story that comes to mind featured a manager who stayed at work in the Distribution Center during a blizzard because many employees were unable to get to work. It’s so great to hear, “I have been working for many years with many bosses, but I have never had a manager make a difference in my life the way my MRO Manager has done.” Heartwarming, inspirational, making a difference. We care!

Here are some photos of gifts that have been received by staff members:








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Stay updated on our heartwarming and inspirational "Every Heroes" by signing up to receive MRO's Newsletters.

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Using the CRIS Test to Evaluate ROI Competencies

Using AHIOS’s CRIS test to evaluate Release of Information competencies of their staff is a best practice that every healthcare provider organization should consider to protect patient privacy and mitigate risk. Mariela Twiggs, MS, RHIA, CHP, FAHIMA, Director of Motivation and Development for MRO, and Education Chair for AHIOS, discusses the importance of using this powerful tool.

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Training Business Office Staff on PHI Disclosure Management

How to Improve Patient Experience in the ROI Process

Millions of payer requests for medical records are sent to hospital business offices every day. Business office staff are often tasked with gathering and releasing Protected Health Information (PHI) to payers in a very short amount of time to get claims paid. During this rush to meet payer deadlines and expedite claims, human mistakes can be made. Critical steps of the Release of Information (ROI) process may be skipped or accidentally omitted. This increases PHI breach risk.

To ensure business office disclosures are kept safe and secure, organizations should train their staff on disclosure management using the same information, curriculum and courses presented to Health Information Management (HIM) teams. Below is a video where I discuss MRO’s unique approach for training and educating employees, as well as five PHI disclosure management topics to train your business office staff on.

PHI Disclosure Management Training/Education at MRO Corp.

Five PHI Disclosure Management Topics to Train Your Business Office Employees On

1) ROI and HIPAA Basics

Ensure employees understand the definition of HIPAA (Health Insurance Portability and Accountability Act), the privacy rule, ARRA HITECH Omnibus, PHI and differences between federal versus state law. This distinction is especially important for business offices that process requests for care locations across different states.

Another important topic to cover is the Health and Human Services (HHS) minimum necessary guidance under the HIPAA privacy rule. This guidance helps organizations determine what information can be used, disclosed or requested by payers for a specific purpose. Business office staff need to know which parts of the record to send to the payer. By training business office staff to fully understand and apply the minimum necessary guidance, organizations tighten privacy and mitigate breach risk.

2) Medical Record Components

Make sure to define the various components of the medical record to business office staff. These components include: common documents, various types of encounters, properly documented corrections and amendments.

3) Confidentiality and Legal Issues

Outline the legal health record concept and what it includes for your organization. Additionally, all the various confidentiality and legal issues should be explained in full detail.

4) Types of Requests

List all the various types of requests that might be received in the business office. For each category, differentiate which are part of Treatment, Payment and Healthcare operations (TPO) and which are not. Those that fall outside of TPO require a patient authorization and should be forwarded to HIM for processing. For a list of types of requests to discuss, read this article.

5) Sensitive Records and Special Situations

Identify and describe specific PHI disclosure management practices related to sensitive records. These cases can include information on genetics, HIV/AIDS, STDs, mental/behavioral health, substance abuse, deceased patients, minors and other sensitive issues. Federal and state legal issues may be involved with these and business office employees should be aware of them.

If you’re concerned about the ability of business office or other staff to properly and securely process requests, a centralized ROI model may be your organization’s safest approach.

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A Lesson in Staff Retention: 15 Reasons Why MRO’s Employees Stay

How to Improve Patient Experience in the ROI Process

On May 1, 2017, MRO celebrated our 15th anniversary. As the company continues to grow and evolve, we keep a focus on our “people” – hiring, training and retaining the best and brightest in the industry. Employee retention isn’t an easy feat in the Release of Information (ROI) industry – in fact, the average turnover rate for ROI staff is around 40 percent. At MRO, we keep our turnover at an impressively low 15 percent.

To celebrate our 15th anniversary, we collected a list, through a voluntary employee survey, of the top 15 reasons MRO employees love their release of information jobs. Any employer can learn a lesson or two from the results.

15 Reasons MRO Employees Love Their Release of Information Jobs

  1. Great managers – Managers are a huge indication of employee job satisfaction, and a major reason employees stay or go. At MRO, we have programs to develop enthusiastic managers who coach team members to be successful.
  2. Flexible scheduling – People cherish the ability to maintain work life balance.
  3. Enjoyable work – When work is fun and meaningful, employees tend to go the extra mile. I heard an anecdote that really encapsulates this idea. It goes like this: three people were crushing rocks side by side at a construction job, when they were asked, “What is your job?” The first person answered, “My job is to do whatever I am told so I can get a check.” The second person replied, “My job is to crush rocks.” The third person said, “My job is to build a temple.”  Ask yourself, which of these workers do you think is the happiest?
  4. Coworkers – They’re the best! At MRO, we treat coworkers with the same level of customer service as anyone else.
  5. Growing company – MRO has been listed on Inc. 5000’s fastest growing companies list for two years in a row. When a company is growing, not only is it exciting, but it’s an indication of stability.
  6. Fast-paced and exciting jobs – Fast-paced jobs make the day go by. Nobody wants to be bored with all the time we spend on the job!
  7. Making a difference – We are all in search of a clear and driving purpose for our lives, and want to contribute to something bigger than ourselves. At MRO, our work world offers a great opportunity for people to connect with a purpose. We make a difference in the lives of patients, requesters and our clients by getting the right PHI to the right requesters, on time. We remind our teams regularly that they are “everyday heroes.”
  8. Career advancement and promotion opportunities – Developing employees, and promoting within, support a positive culture. That’s our approach at MRO. We also encourage our credentialed health information management (HIM) staff to pursue their educational goals by contributing towards membership dues to the American Health Information Management Association (AHIMA).
  9. Team culture – When everyone is in harmony, working towards a team mission, employees tend to be fulfilled. At MRO, we take pride in our culture, which is based on MRO’s core values of passion, accountability, respect, trust, nurture, excellence and reputation.
  10. Valued ideas and opinions – Everyone wants to be heard, and employees with great ideas can make a huge impact on a company’s success, from improving efficiency with technology ideas, to enhancing quality and service through recommending adjustments to workflow.
  11. Leadership that cares – Leaders, from executive management to direct managers, can cheer staff to achieve their highest levels of excellence.
  12. Stability – When a company is stable, employees have one less thing to worry about. Employees can rest assure with job security, benefits, wages, etc.
  13. Great benefits – Employees don’t take these for granted! Healthcare insurance, personal time off, etc., all support an employee’s wellbeing, attitude and commitment to the company.
  14. Company reputation – MRO has been rated #1 by KLAS for four years in a row, and noted for having both the highest quality and fastest turnaround times in the ROI industry. It’s inspiring to be part of a company that is rated top in its field!
  15. Training programs – People want fun, interactive and easily accessible training – not a boring, old PowerPoint template that has been in use for ten years. MRO Academy is MRO’s primary training tool, offered via a web-based learning management system. Training is continuously updated and offered through the virtual platform.

Other reasons MRO employees listed for loving their jobs included competitive wages, educational opportunities, employee recognition, fun events and charity activities.

In an incredibly competitive business environment, hiring and retaining top talent can be challenging. However, if you listen carefully to what your employees say they love about working for your company – and continue to do more of that – chances are you’ll keep the best of the best working for your organization.

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Virtual Academy recap: Six Tips for Business Associate Compliance

How to Improve Patient Experience in the ROI Process


Businesspeople Sitting In A Conference Room Looking At Computer Screen

HIPAA compliance for Business Associates (BAs) was the topic of MRO’s AHIMA Virtual Privacy and Security Academy session this month. I presented alongside my colleagues Sara Goldstein, Esq., general counsel and Rita Bowen, MA, RHIA, CHPS, SSGB, vice president of privacy, HIM policy and education.

During this three-credit course, we discussed how BAs must now comply with the HIPAA Security Rule and certain provisions of both the HIPAA Privacy Rule and the HIPAA Breach Notification Rule. We emphasized that BAs can be held liable for violating these rules, as well as for violations by their subcontractors.

We also covered several best practices BAs can follow to stay HIPAA-compliant and avoid liability, which you can learn more about in Sara Goldstein’s recent post.

Although it’s difficult to summarize all of the valuable insight shared during our session, the six major tips offered by our experts included:

1. Check your insurance policy
Verify insurance coverage in the event of a HIPAA violation.

2. Conduct regular internal and third-party audits
Regular internal and third-party technical audits are the foundation of implementing Security Rule administrative, physical and technical safeguards.

3. Consider applying for Health Information Trust Alliance (HITRUST) certification
HITRUST provides an information security framework to harmonize standards and regulations.

4. Implement the right technologies
Utilizing technologies like encryption, access tracking software and record integrity applications, powered by optical character recognition (OCR) software, can also drive BA HIPAA compliance.

5. Document compliance programs
Business Associate Agreements (BAAs) can ensure HIPAA compliance, and hold subcontractors liable for potential violations.

6. Invest in training and education
Workforce members should undergo formal training at least once a year on privacy, security and compliance, as well as on federal and state disclosure laws, and the healthcare organization’s policies and procedures.

After covering these topics, the Virtual Academy session concluded with a fun, educational and impactful group activity where participants were assigned disclosure management case studies that explored how to identify HIPAA violations and breaches. Rita Bowen and I then tested the participants on their knowledge.

MRO’s team will delve more into the topic of BAs in the next session of AHIMA’s Virtual Privacy and Security Academy: “Advanced Business Associate and Subcontractor Management” on November 9, 2016. If you are interested in attending the session, please fill out the form below and you’ll receive MRO’s promo code for a 15 percent discount.

Receive a 15% Discount for AHIMA's Privacy and Security Academy

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