The primary function of the hospital business office is to submit, process, and collect payment for healthcare claims. To complete these tasks effectively, millions of medical records are sent to third-party payers by business office personnel every year. These business office disclosures occur during the claims submission process or as part of retrospective payer reviews and audits.
According to most business office staff, pulling information and releasing medical record documentation to payers is a necessary evil to get claims paid and reduce accounts receivables. However, proactive revenue cycle professionals are beginning to discover a new silver lining in the onerous task of business office release of information (ROI): payer insights.