Mississippi Baptist Health System
Mississippi Baptist Health System is a 629-bed healthcare organization, which includes four hospitals and 22 clinics, and receives 43,000 Release of Information (ROI) requests annually, not including walk-in requests. The organization’s Health Information Management (HIM) department historically handled all ROI processing in-house, but looked to an outsourced solution with more sophisticated workflows and technology, as well as additional staff resources, to meet the challenges of an evolving HIM space, including the rising tide of government and commercial payer audits.
In November 2015, Patsy Raworth, RHIA, Director of HIM, RAC Coordinator and Privacy Officer for Mississippi Baptist, spearheaded a transition from in-house ROI processing to an outsourced, enterprise-wide Protected Health Information (PHI) disclosure management model. By outsourcing this function to MRO, Mississippi Baptist was able to standardize processes across their organization, increase efficiency and reduce risk.
“Leveraging an enterprise-wide solution allowed us to gain control of releases from outlying hospital departments and clinics, driving compliance with HIPAA and HITECH,” Raworth said.
In addition to adding MRO staff onsite to drive improved quality and productivity, Mississippi Baptist also benefitted from the support teams at MRO’s National Service Center, located in Valley Forge, Pennsylvania.
With the help of the National Service Center, MRO took on several functions for Mississippi Baptist, including invoicing and collections, generating correspondence and requester notifications, distribution, clerical duties and Quality Assurance (QA) processes. MRO’s redundant QA checks include the use of IdentiScan®, MRO’s record integrity application, which uses optical character recognition technology to “read” documents before release, helping catch and correct comingled records – driving Mississippi Baptist’s disclosure accuracy rates to 99.99 percent.
Raworth said that with MRO she gained a partner, an organization she could look to as an expert in the field. Through this trust and partnership, Mississippi Baptist gained efficiencies by outsourcing several key tasks to MRO, leading to an increase in time savings. For example, MRO handled nearly 5,500 patient and requester calls in 2016, allowing existing Mississippi Baptist staff to focus on patient-facing functions.
Additionally, due to MRO’s quality-infused workflows, Mississippi Baptist saw a dramatic drop in breach risk exposure – from an estimated $97,000 in potential breach costs, to just $39 annually with MRO’s multiple layers of QA in place. Technology-assisted record integrity checks constitute one such layer. In a one year timeframe, MRO’s IdentiScan assisted in catching and correcting 60 comingled records, preventing improper disclosures and mitigating Mississippi Baptist’s breach risk.
MRO’s services for remote handling of payer audits also contributed to financial savings. Payer Humana audited Mississippi Baptist, stating they never received claim documentation and were therefore denying payment. MRO’s Remote Services team was able to provide tracking information for the audited records, showing Humana did in fact receive the required documentation. Without MRO’s support and tracking ability, Mississippi Baptist would have been responsible for $180,000 in unpaid claims.
Finally, the decision to outsource has helped to improve Mississippi Baptist’s patient satisfaction. Of note is MRO’s Patient Advocate Program, which provides compassionate and empathetic assistance to patients experiencing difficulty or confusion with the medical record request process.