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Five Takeways from the HFMA 2018 Conference

“Efficiency is doing things right; effectiveness is doing the right things.” Peter Drucker

Peter Drucker, world-renowned business management guru, reminds us to focus on both efficiency and effectiveness to improve long-standing processes, procedures or policies. Healthcare finance leaders and revenue cycle professionals were charged with the same goal—creating efficiencies and building effectiveness—during the recent HFMA 2018 Annual Conference held in Las Vegas, June 24-27, 2018.

For central business offices (CBOs) and patient financial services (PFS) departments, the need to address stubborn problems and improve performance is paramont to cut costs and reduce risk. One way to achieve these goals is by fostering innovation.

This blog shares HFMA’s call for innovation, summarizes four other takeaways from the 2018 event and lays out an important MRO strategy to improve business office efficiency and CBO effectiveness.

Foster Innovation for Business Office Efficiency and Better Outcomes

Kevin Brennan, FHFMA, CPA, the new chair of HFMA’s 2018-2019 board of directors and recently retired Executive VP, Finance and CFO at Geisinger Health System, welcomed attendees by discussing the importance of promoting experimentation and new ideas to bolster efficiency in revenue cycle workflow and operations. Brennan encouraged revenue cycle leaders to resist the fear of failing and build new business models to promote performance. As Brennan stated, a good new motto to follow might be “Never be fearful of making new mistakes.”

Build Collaboration through Better Tools and Workflows

By coupling innovation with collaboration, Brennan urged HFMA attendees to build new bridges with other departments, providers, payers, consumers and the government. The call for better collaboration was reiterated by Tuesday’s keynote speaker, Dr. Rubin Pillay, medical futurist, physician and professor.

With collaboration as the central theme of this year’s event, revenue cycle professionals were encouraged to “try new tools and make existing workflows work better” as one pathway to foster collaboration and improve business office efficiency within CBOs and PFS departments.

Go to a New Level in Healthcare Delivery

Dr. Pillay also discussed the role of artificial intelligence and technological innovation in spurring healthcare collaboration. Pillay provided examples of growing organs for corneal transplants and using robotics to help paraplegics walk as important ways healthcare organizations can take patient care to a new level. According to Pillay, “Technology and data, their convergence with policy, and provider and payer strategies are driving major trends to transform healthcare.”

Enhance the Patient’s Financial Experience

The final takeaway from the HFMA 2018 Conference was a continued cry to improve the patient’s financial experience. Best practices from HFMA’s 2017 MAP winners were referenced as innovative ways to make steady, incremental changes and improve performance. In reviewing these MAP winner strategies, we are reminded of the need to continually speed processes and streamline operations—this is especially true for CBOs.

Improve Business Office Efficiency by Reducing Biller Distractions

Consistent with HFMA’s themes of efficiency, effectiveness, innovation and collaboration, MRO is laser focused on improving business office performance. For most CBOs and PFS departments, biller distraction is an important issue—one we intend to reduce for MRO clients. We continue to hear from clients that billers and collectors become distracted with trying to process payer requests for medical records. Our latest service was discussed with HFMA attendees during the conference and received rave reviews.

Challenge:

Business office personnel release millions of medical records annually to commercial health plans and government payers to expedite payment of claims, appeal denials or fulfill auditor requests. However, it doesn’t make sense for these business office staff—billers or collectors—to handle payer requests for medical records when they should be focused on reimbursement. There are also HIPAA risks to consider when billers release Protected Health Information (PHI) versus having Health Information Management (HIM) professionals manage this task.

Receiving, processing and managing payer requests for health information is what MRO does best. So we’re applying this expertise to cut cost and reduce risk for CBOs and PFS departments.

Solution:

Instead of distracting billers and collectors from their core objective of collecting revenue, MRO disclosure management experts apply new workflows and HIM collaboration to the process of Release of Information (ROI) in the business office. Here is a high-level summary of how the new MRO service works.

  • Business office logs requests and attaches billing documents
  • MRO adds medical record documentation
  • MRO quality checks and releases billing and medical documentation to the payer
  • MRO sends documentation by payer-requested delivery method

Results:

MRO clients who are using this service from MRO are achieving both efficiency and effectiveness in their CBOs and PFS departments. Specific improvements include:

  • Heightened efficiency and cost savings
  • Minimized breaches and more compliant PHI exchange
  • Payer request trackability for analytics
  • Enhanced collaboration between HIM and the business office
  • Maximized production by keeping teams focused on what they do best
  • Improved visibility and transparency for both teams

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How to Improve PHI Disclosure Efficiency in the Business Office

PHI Disclosure

Releasing medical records from a healthcare organization’s business office can be accomplished in a more efficient and cost-effective method. Instead of distracting billers and collectors from their main duties of collecting revenue, business offices should consider the following options to improve efficiency and ensure proper tracking of Protected Health Information (PHI). I provide more detailed information in an HFMA blog “PHI Disclosure Management in the Business Office.”

Centralize all Requests for Records

If the business office wishes to continue to process using their staff, the function should be centralized and assigned to a core group of processors to fulfill all requests. This will help minimize administrative burden from the billers and collectors. Centralization also promotes consistent, standardized processes. These dedicated business office staff should be thoroughly trained in proper PHI disclosure management to maximize efficiency, eliminate redundancy and mitigate risk of HIPAA breach for requests that may fall outside of TPO such as itemized bills for outside attorney requests.

Transfer the Work to HIM

HIM staff are well trained in processing requests for information. They have the knowledge and skills to complete requests efficiently and in compliance with HIPAA guidelines. Nevertheless, some organizations fear delegating this function to HIM because of concerns regarding timeliness and payer deadlines. To reduce turnaround time fears, the following four best practices should be implemented:

  1. Ensure open and ongoing communication between the business office and HIM
  2. Optimize the use of EHR and PHI disclosure management technologies to route requests and share information
  3. Assign dedicated Release of Information (ROI) experts to support the business office and process requests
  4. Conduct regular meetings to discuss new trends in payer requests and proactively improve turnaround time through SFTP delivery

Outsource Business Office PHI Disclosures

A number of national firms, including MRO, provide Release of Information services to process payer requests. MRO’s services for business office disclosure management ensure timely delivery of information to payers, full compliance with HIPAA guidelines, and around-the-clock staffing to avoid backlogs or delays.

Careful and strategic tracking of information released, to whom and why, will make the PHI disclosure process more efficient. If your organization needs to improve this process, you should consider: centralization, delegating work to HIM or outsourcing PHI disclosure management. By implementing these alternative workflow options, your organization will be taking the right steps towards improving billing processes and decreasing denials.

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How to Lead Enterprise-Wide Projects: HIM Expert Advice

From encoders to Electronic Health Records (EHRs), Health Information Management (HIM) professionals are often tasked with enterprise-wide project management including new technologies, changing workflows and centralized operations. These massive projects require strong HIM skills, expanded partnerships and greater collaboration among vendors, HIM, IT and others. With leadership skills, specialized education, and peer-to-peer relationships, HIM professionals are perfectly positioned to promote collaboration among all stakeholders, secure executive support, ensure timelines are met and cover every detail of an enterprise-wide initiative.

A few months ago, I moderated a roundtable discussion with three HIM experts: consultant, Pat Biesboer, RHIA, MSS, PMP; Susan Carey, MHI, RHIT, PMP, FAHIMA, System Director of HIM for Norton Healthcare; and Emilie Sturm, MA, RHIA, CHPS, Senior Revenue Management Consultant for Trinity Health. They each discussed mapping out enterprise-wide projects, such as PHI disclosure management and how to meet milestones and resolve common challenges. You can find the full discussion, “Using HIM Skills to Lead Enterprise-Wide Projects: An Expert Roundtable,” in the February 2018 issue of Journal of AHIMA.

During the roundtable, all three HIM experts provided their main lessons learned from their experiences as enterprise-wide project managers. If you are an HIM professional, you may benefit from reviewing the lessons below:

    1. Provide concise, timely, and honest communication. Keep people motivated by injecting fun into your discussions. Keep the current status in front of stakeholders according to a regular schedule, providing the degree of detail they need.
    2. Have realistic expectations and transparency. If difficulties are expected, prepare the team ahead of time. This will help build trust.
    3. Follow stated goals. Guide your team toward the goals you established. When you run into blockers, review your options. Objectively provide the background, options, rationale and a recommended direction to maintain forward progress.
    4. Avoid bringing assumptions to the table. Remain open-minded and validate your expectations. Susan Carey reflected, “When I was the project manager for our EHR’s operating room, nursing and HIM modules, I mistakenly assumed that IT resources understood HIM. Looking back, I should have educated my peers who were managing other parts of the project regarding the tenets of HIM. This would have facilitated HIM operations leaders’ attempts to maintain decision-making regarding the electronic record configurations and policy.”
    5. Conduct reference calls with organizations using any technology you are considering. HIM needs differ from those of other departments. Current users can suggest ways to configure applications to best meet your needs and save valuable implementation time and resources.
    6. Perform as a project manager with HIM knowledge. Project managers are valuable when they have subject matter expertise and can develop subsidiary plans within the overall project management plan.
    7. Have the right stakeholders at the table when starting a project. Due diligence should be conducted to map out all areas of the project and determine vested parties. Having the right team on board provides for a productive group of multidisciplinary professionals with varying expertise.
    8. Identify lessons learned during each phase of a multiphase project. With a multiphase project, such as a system rollout, identify lessons learned during each phase. When possible, incorporate those lessons into the next phase for a stronger outcome. As your timeline allows, be flexible and don’t hesitate to post-pone a go-live if critical goals are not yet achieved.
    9. Communicate often with your project team and stakeholders. For HIM-driven projects, it’s critical that the local HIM director communicates with key constituents or peers. Establish regular meetings over the course of each project or expand your schedule if necessary. Disseminate project management tools such as timelines and meeting minutes to the project team. Regularly review the project plan to monitor progress compared with the overall timelines.

    Though HIM professionals have always managed projects, enterprise-wide endeavors raise the bar for communication, organization and leadership. HIM professionals have unique abilities to manage enterprise-wide projects. More importantly, HIM professionals can help team members solve problems, achieve their goals and enjoy the journey.

    If you are interested in learning more about this topic, come join me and Emilie Sturm, MA, RHIA, CHPS, Senior Revenue Management Consultant for Trinity Health, at the 2018 AHIMA National Convention in Miami, for our presentation titled “Project Management in Enterprise-Wide HIM Implementations.”

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How to Ensure Proper PHI Disclosure across your Healthcare Enterprise

PHI Disclosure

When it comes to Protected Health Information (PHI), one of the main duties of Health Information Management (HIM) departments is to protect their patients’ privacy and ensure proper disclosure. HIM departments have had a long-held reputation of being the top disclosers of PHI within a healthcare enterprise. However, recent trends in PHI disclosure management are changing things around. Combined requests from other areas such as radiology, business offices, and physician practices are matching, if not exceeding, the PHI disclosure volumes in HIM. This combination of departments managing PHI disclosure causes high volumes of records and increases risk. Below are a few best practices, as outlined in a Journal of AHIMA article, for how HIM professionals can ensure proper disclosure and mitigate breach.

Know the Risky Spots: Audit your Points of PHI Disclosure

A practical first step is to conduct an enterprise-wide audit of all disclosure points. An audit of all PHI disclosure points should be conducted and updated yearly as part of your organization’s privacy compliance assessment. Auditing your enterprise helps HIM leaders become aware of the risks, which they can then work to mitigate. HIM professionals should audit non-HIM PHI disclosure areas to ensure compliance with relevant laws. During the audit, HIM leaders should review a list of items for disclosures which includes date received, date delivered and more.

Train and Educate Based on Needs

Training is essential for safe and compliant enterprise-wide Release of Information. This goes for the HIM department as well as any other employees that release PHI. Well-trained ROI staff keep the flow of information running smoothly. Based on the individual department’s most common requests, ROI training should be focused on accuracy, include all HIPAA privacy basics, and include the following six PHI disclosure management fundamentals:

  1. Track and monitor each type of request being received.
  2. Define each type of request.
  3. Emphasize accuracy.
  4. Reiterate minimum necessary.
  5. Coach personnel on patient requests.
  6. Direct requests to HIM.

Establish HIM as the Enterprise-wide PHI Gatekeepers

Annual HIM reviews and continuous communication with other departments that release information are essential to mitigate breach risk, expedite payer reimbursement, and prevent a requester dissatisfaction crisis. Non-HIM staff are focused on their core competency areas and are rarely trained in proper PHI disclosure management. The result is often hasty PHI processing and increased risk of breach. To mitigate risk while also ensuring the appropriate ROI, HIM departments should maintain oversight of PHI disclosure management across the entire enterprise—not just within HIM.

Complete the form below to download MRO’s eBook “Breach Risk in Release of Information: Don’t Leave Risk to Chance” and learn strategic, enterprise-wide approaches to PHI disclosure management and mitigating breach risk.

DOWNLOAD MRO’S EBOOK “BREACH RISK IN RELEASE OF INFORMATION: DON’T LEAVE RISK TO CHANCE.”

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Two Private Eyes on Your ROI: Quality Assurance in Release of Information

Quality Assurance in Release of Information

Small scale privacy breaches, like those caused by errors in the Release of Information process, can be just as damaging to healthcare organizations as larger breaches. The repercussions include both monetary penalties and reputational harm. With the stakes this high, it is important to ensure the highest levels of quality when disclosing Protected Health Information (PHI).

The Cost of PHI Breach

Although small breaches, affecting less than 500 patients per incident, are not usually broadcasted as widely as a large cyberattack, the financial impact is real.

• Each breach can cost between $8,000 to $300,000, not including HIPAA violation civil penalties.

• Penalties are rising to as much as $50,000 per breach with a maximum of $1.5 million annually for repeated occurrences.

• As many as 10 states now consider HIPAA to be the “relevant standard of care for state privacy violation claims brought by individuals.”

Release of Information – Risky Business

Criminal attacks and lost or stolen devices were the root cause of most PHI data breaches in recent years, but almost as many—40 percent—were due to “unintentional employee action,” according to 2015 survey results from the Ponemon Institute.

Unintentional employee actions include more than using the wrong fax number or mailing address when disclosing PHI. There are multiple points in the ROI process that can result in breaches.

• With typical ROI workflows, 20 to 30 percent of all submitted authorizations are initially found to be invalid. MRO’s research shows there are around 100 types of authorization errors.

• Five percent or more of patient data in Electronic Medical Records (EMRs) have integrity issues, including comingling of patient records.

• Well-trained ROI specialists will catch the majority of mixed records; however, with just one level of quality control, up to 0.7 percent will contain mixed patient data.

Additionally, in the typical ROI workflow, requests for health information come into a facility and are logged by onsite ROI staff that also handle many other responsibilities, such as: requester calls, support and issue resolutions, record retrieval, invoicing and collections, producing copies, and delivering records. There is no “second set of eyes” for Quality Assurance. This approach results in inefficiencies, distractions and increased errors.

Closing the Quality Assurance Gap in ROI

At MRO, we believe the best practice is to ensure “second set of eyes” Quality Assurance measures are taken across multiple steps of the ROI process. Not one, but two teams should check each ROI authorization for accuracy, in addition to checking PHI multiple times for accuracy, e.g. ensuring there are no comingled records.

Sophisticated ROI vendors will offer technologies to assist with this process – like MRO’s IdentiScan® record integrity application that uses optical character recognition to scan for mixed patient data. Technology, such as barcoding systems, can also be used to maintain shipping integrity.

Introducing MRO’s Two Private Eyes on Your ROI

If you subscribe to the Journal of AHIMA, or have visited MRO’s website or social media pages recently, you may have noticed our new campaign called Two Private Eyes on Your ROI. This theme was developed by the creative team at MRO. The idea was born while brainstorming ad concepts that could be tied into a Miami theme, with the 2018 annual AHIMA Convention being hosted in Miami Beach. What started as a Miami Vice theme quickly turned to a private investigator theme when the idea of “Two Private Eyes on your ROI” – a play on MRO’s “second set of eyes” redundant quality checks within our Release of Information workflow – was bounced around. Since the Miami Vice detectives were with the police force and not PI’s, we looked at famous private eyes over history and developed the characters Magnum PHI and SureLook Holmes.

Be sure to check out the “premier episode” of Two Private Eyes on Your ROI by visiting our microsite.

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Training Business Office Staff on PHI Disclosure Management

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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How Providers Can Prepare for a HEDIS Review: A Proactive Approach

Three major types of payer record reviews are conducted every year: Healthcare Effectiveness Data and Information Set (HEDIS), Medicare Risk Adjustment, and Commercial Risk Adjustment. A HEDIS Review, in particular, is performed by a payer or health plan to measure the quality and effectiveness of care delivered to their covered patient populations. They are the smallest of the three major payer reviews and occur every year from January to mid-May.

As the volume of payer and health plan reviews continues to sky rocket, millions of patient records are requested. From 2016 to 2017, payer review requests to MRO clients increased by 14%, with HEDIS Review requests increasing from 2% to 3% of the total Release of Information requests processed by MRO nationally.

A recent article in HIM Briefings about HEDIS Reviews details benefits, lessons learned, and what to expect. Below are three important tips that are outlined for providers to prepare for the upcoming HEDIS Review season.

Tips for Managing Payer Requests During the Upcoming HEDIS Review Season

In working with payer record reviews, several practical strategies have emerged to minimize payer-provider abrasion and reduce operational costs. Providers should take a proactive approach and follow these three tips:

1) Engage early.
The National Committee for Quality Assurance (NCQA) is proactive in announcing which quality measures will be targeted for review in the year ahead. For example, the 2018 NCQA quality measures are now published and available to both providers and payers. Proactive providers should reach out to their contracted payers and health plans in December or January to discuss the upcoming HEDIS Review season. With the potential for thousands of medical records to be requested between January and May, two conversations are critical: expected volumes and reimbursement for the provider’s efforts. Keep in mind this dialogue sets the tone for the relationship.

2) Determine expected volumes.
The most important conversation that should occur between payer and provider is about determining the number of record requests that will be received. Be sure to plan ahead for the increased staff workload needed to produce the required medical record documentation. The number of requests depends on the size of the hospital or the healthcare system. Each payer has a designated HEDIS Review team responsible for the program. Contact the team lead or local health plan representative to schedule this conversation during the HEDIS Review planning period in December or January.

3) Set rate for records.
The initial perception in the industry suggested that providers could not charge payers for the time, manpower, and mailing costs associated with producing records for a HEDIS Review. However, this is not the case. Payers understand the tremendous staff burden on providers and are willing to reimburse them for their efforts.

How Your Release of Information Vendor Can Help

At MRO, we utilize our industry knowledge and “easy to work with” approach to create partnerships with payers and their vendors to streamline the processing of HEDIS Review, Medicare Risk Adjustment and Commercial Risk Adjustment projects. This process includes establishing a rate per chart for these projects, as payers are willing to pay for review requests regardless of the language in the managed care contracts. We have found that most payers are reasonable and understand the cost associated with producing these high-volume requests. Hence, why they are willing to pay for them. MRO ensures that the cost of producing these records is not a burden on our clients.
Watch the below video interview to learn more about reducing payer-provider abrasion, and what MRO is doing to help providers handle these payer review requests.

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A Thanksgiving Message from the CEO of MRO

As I reflect during this year’s Thanksgiving season, I find it both gratifying and humbling to see the progress that MRO has made since our humble beginnings in 2002. We formed MRO on the premise that a better platform for Release of Information (ROI) could be built, and we continue to evolve and meet the demands of our changing industry.

This year marked the company’s 15th anniversary, and as a co-founder of the company, I have had the great honor and privilege of watching the organization evolve and grow. There have been both exciting and interesting times throughout MRO’s history, including major milestones that helped transform the organization into the industry-recognized leader for Protected Health Information (PHI) disclosure management. I would like to take a moment to thank all our clients, employees and partners for the company’s continued growth and success.

Highlights and Milestones for MRO in 2017 Include:

  • MRO was named the KLAS Category Leader in the Release of Information service category for the fourth year in a row. As the 2017 Category Leader, MRO was rated No. 1 for ROI with an overall performance score of 93.7 out of 100, an increase from 91.9 in the 2015/2016 Best in KLAS: Software & Services report. KLAS scores are weighted in the following key areas – sales and contracting, implementation and training, service and support, and general and overall services.
  • Our Patient Advocate program at MRO’s National Service Center won a Stevie®Award for innovation in customer service. The Patient Advocate program was initiated by MRO’s Client Support team in 2016 to elevate the PHI disclosure management company’s focus on patient satisfaction. The Patient Advocate team provides specialized support to patients requesting medical records from MRO’s client locations.
  • Philly.com named MRO the No. 34 midsize company on a list of Top Workplaces in Philadelphia. Out of 14,000 companies in the Philadelphia area, only 125 companies made this prestigious list.
  • Inc. magazine named MRO one of the fastest-growing private companies in the nation for the third year in a row. MRO’s appearance at No. 3988 on the annual list was a rare third showing after the company ranked No. 3903 in 2016, and 3290 in 2015.

We are proud to be recognized for our strong client and employee satisfaction scores as MRO grows, and we strive to continuously exceed expectations.

I’ll close with a note to our clients that it was great seeing so many of you at the recent AHIMA Convention in Los Angeles. Being at the convention this year only added to my sentiments as we had one of the larger booths in the exhibit hall. It doesn’t seem all that long ago that we were a first-time vendor with a small exhibit space and a handful of clients. I talk about MRO’s history exhibiting at the convention in the below video. Watch it to hear a funny story about our first time exhibiting!

2017 AHIMA Reflections Video: MRO’s History of Exhibiting

Our company’s success would not be possible without the contributions and support of so many people over the years, for which I am eternally grateful. Thank you, and Happy Thanksgiving!

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Outsourcing Release of Information: Henry Ford Health System Testimonial

Henry Ford Health System (HFHS) is one of the nation’s largest healthcare providers. The auto pioneer himself founded it in 1915 to serve Detroit autoworkers. The group has since grown into an integrated health system employing more than 30,000 full-time workers and handling millions of patient visits a year.

HFHS Partners with MRO for Release of Information

To better meet the needs of its patients, HFHS turned to MRO for outsourcing Release of Information (ROI) more than a decade ago. HFHS was one of MRO’s early clients, and we’re proud that they are still a client today. Over the years, we have continued to evolve our Protected Health Information (PHI) disclosure management services to meet the changing needs of our clients. A recent example is the implementation of MROeLink®, an interface between MRO’s ROI Online® platform and HFHS’s Epic medical records software. With the interface in place, our client has realized notable productivity improvements.

Watch the video below to hear Sheila Bowlds, Director of HIM and Hospital Coding at Henry Ford Health System, share why HFHS continues to partner with MRO, including some details around our MROeLink Epic integration.

Transcript

Hi, my name’s Sheila Bowlds, and I am the Director of HIM and Hospital Coding at Henry Ford Health System.

Henry Ford Health System is a large health system located with its main campus in Detroit, Michigan, with about an 800-bed hospital there. In addition to that, there are four other acute care hospitals located in the southeastern Michigan area, along with several clinics. In addition to that, there is a detox hospital and also a mental health hospital.

Henry Ford Health System has been with MRO for approximately 13 years. We were one of the initial customers, and I’ve only been at Henry Ford Health System for a year and a half. I’ve had very good experiences with MRO. We have a Shared Services relationship with MRO, where our staff do the inputting of the authorizations and then also the pushing out of the documents to MRO. Then, MRO does the rest of the release, handles anything in the call center, does all the billing and takes care of all that business for us.

I came from a health system where everything was done internally. So, working with MRO, when a patient has a question, they call MRO, and MRO handles it very positively. With any issues that come up, MRO is very attentive in taking care of any of those issues.

We did just initiate MROeLink. The MROeLink has been a really great success for our health system, and the MROeLink has improved the turnaround time because it’s the technology that can be used with that. And the request can be input more quickly because there is an interface with Epic that can pull across the demographic information; and then, also when they’re working on the releases, they can work on multiple releases at one time rather than having to wait. So, I think it’s just been a really good success.

Henry Ford Health System continues to partner with MRO because it’s been a long-standing relationship— a very positive relationship. It’s very collaborative, so whenever we have something that we need, we feel free to contact MRO. And, they’re always very attentive to anything that is needed.

The top reasons I would recommend MRO is that we have a very collaborative relationship with MRO, and that we use the Shared Services model which our staff can still control what is being sent out to the patient or to the requester, and MRO will take care of all the back office business that’s needed for those releases. They take care of all the call centers, all the billing and all the mailing. There’s also the technology from them that they can push out in a different type of file or we wouldn’t have that type of capability.

We have a very good relationship with MRO. I do feel like it is a very team oriented type of a relationship, and that they’re very attentive. They provide education to my staff. They’re very up on any new Release of Information type of regulations that come up. And, they help guide us also in that type of release and making sure we’re up to date on everything.

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Reflections from AHIMACon17: Merger Mania and its Impact on Privacy and Health Information Management Systems

Merger Mania

At the 2017 AHIMA National Convention and Exhibit, MRO’s client Melissa Landry of Ochsner Health System and I co-presented a session titled “Merger Mania: Impact to Privacy and Health Information Management.” In this presentation, we discussed industry trends around mergers of healthcare organizations and the impact on privacy, Health Information Management (HIM) systems and Protected Health Information (PHI) disclosure management.

Melissa Landry shared how Ochsner successfully responded to challenges resulting from healthcare mergers. Audience members learned strategies for addressing these types of challenges. Below is a video interview where I recap the presentation.

Video Recap: Merger Mania and its Impact on Privacy and Health Information Management Systems


Video Transcript

Rita: I’m Rita Bowen, and I am with MRO. And, I am their Vice President for Privacy, Compliance and HIM Policy.

Question: Tell us about the presentation you gave at the AHIMA Convention about “Merger Mania.”

Rita: I had the opportunity to work with Melissa Landry from Ochsner on a discussion of Merger Mania, and that has been so important because there have been so many physician facilities that are actually merging, buying physician practices, and there needs to be a dedicated process in getting that done correctly. It’s not simply, “I’m going to buy you, and make you part of my team.” There are Information Governance components that have to be demonstrated to make it work correctly.

Question: What best practices did you discuss during your presentation?

Rita: During our presentation today, we talked about best practices for this process of Merger Mania, and we actually took each of the components of Information Governance and threaded that through the discussion; the project management skills required in that; and, actually, the workflow that has to be determined. Because, you often find that the workflow in a physician practice has never been discussed, and you may find that a physician never closes their record, and most of the records will not come into an electronic health record system that you may be trying to merge unless they have actually been closed, which means someone has signed off on those records.

Question: What is MRO doing to address Merger Mania?

Rita: At MRO, we’re doing many things to address Merger Mania—through our acquisition process when we’re bringing on and partnering with a new customer, through the implementation process. We have an assessment phase that helps us do a deeper dive into workflow, and helps analyze those workflow issues. Then, there’s the policy review, which I do, which helps identify policies that the facility may be missing and/or may be complementing policies that we have; or they may be more stringent; or we may perhaps have a policy that’s more stringent, so that sets the foundation for the framework for the implementation team as they go through their education process.

Question: What are some of the biggest trends and themes you’ve noticed at this year’s AHIMA Convention?

Rita: At this year’s convention, some of the biggest trends that I’ve noticed and observed, especially in the general sessions, is that there’s still a focus and discussion regarding Information Governance (IG). There’s still a disconnect from many members thinking they’re not in that IG space. I contend that everything that everybody does in HIM is IG. Everybody is in some kind of lane of IG. It’s not different; it’s not a different domain; it’s one in the same of Health Information Management. The other big thing is population management and how information has got to flow in a way that it can be used in a way that patient privacy is still protected but it actually helps the population management improve health and improvements can be seen—because we still have a way to go there in this country.

Question: What is your favorite part about AHIMA?

Rita: When you ask me what my favorite part about AHIMA is, that’s hard because this is my 43rd convention, so obviously I love to come here. But, my favorite part is seeing friends. Seeing and networking with all the colleagues who I’ve worked with over the years. And, then networking is an excellent way to learn. You stay engaged with someone that’s doing one niche, because you may be working in a different lane, so it helps you stay identifiable into the whole processes. But, the friendships that you’ve maintained through those years is just so vital.

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