How to Ensure Proper PHI Disclosure Management in the Business Office
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.