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Health Information Management (HIM) professionals face mounting challenges in response to the rising volume of release of information (ROI) requests made to business offices to support payment of claims. Business office personnel release millions of patient records annually to commercial health plans and government payers to expedite payment, validate appropriate level of care, authorize services, appeal denials, or fulfill auditor requests. The process of pulling and attaching records in the business office can require up to 40 to 45 percent of personnel time, taking them away from their core responsibilities. In addition to workflow inefficiencies and distracting business office staff from tasks directly related to revenue, navigating privacy and security in this environment raises HIPAA concerns and presents obstacles to compliance.

This article explores PHI disclosure management technologies and workflows for improving collaboration between HIM and the business office when fulfilling documentation and claim attachment requests. Two HIM leaders share their experiences and offer strategies to optimize business office workflows to achieve efficiencies, cost savings, and compliance.

Thirumalai "Raj" Rajagopal

As Senior VP, Payer Solutions for MRO, Raj is responsible for driving strategy, growth and operations of Payer Solutions. His focus is to develop Payer Solutions into a profitable line of business for MRO. Raj joins MRO from FIGmd, now an MRO company, where he was President of Payer and Enterprise Solutions. Raj is a senior healthcare executive with over 35 years of experience. Prior to FIGmd, Raj had experience building, operating and supporting the clients of the #1 KLAS-ranked claims clearinghouse at RealMed, an Availity company, for 13 years, which is where he pioneered early on, payer-provider relationships and alignment. His experience with large scale projects includes the launch of a nation-wide Mallperks Affinity program for the Simon Property Group, development and management of a worldwide imaging library for Jim Davis, the Garfield cartoonist and the launch of the Garfield store and being a key member of the initial launch of the computerization of the Indian Railway system. Raj received his Masters from IIT, Chennai (Madras) and Bachelors from IIT, Varanasi (Benares), both in India.

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