The following is a HIM Scene guest blog post by Mariela Twiggs, MS, RHIA, CHIP, FAHIMA, National Director of Motivation & Development at MRO. This is the third blog in a three-part sponsored blog post series focused on the relationship between HIM departments and third-party payers. Each month, a different MRO expert will share insights on how to reduce payer-provider abrasion, protect information privacy and streamline the medical record release process during health plan or third-party commercial payer audits and reviews.
Millions of payer requests for medical records are sent to hospital business offices every day. Business office staff are often tasked with pulling, compiling and sending Protected Health Information (PHI) to meet these requests.
Many payer requests are part of treatment, payment and operations (TPO) according to HIPAA. Payer requests are the “P” in TPO. However, others such as Medicaid assistance applications and disability requests are not covered under TPO. Knowing the difference and managing each request with the upmost regard for patient privacy is the focus of this month’s HIM Scene post.