Pinehurst Medical Clinic
Managing release-of-information (RoI) requests can be inherently complex and costly, due in large part to the current federal and state regulatory environment. Other factors, such as the technical nature of the requests, staff training and customer service requirements add to the challenges of processing these requests efficiently.
By 2005, the process had become so sufficiently complex and resource-intensive that we began to explore outside solutions to help our staff better manage the growing RoI demands. As a 50-physician multi-specialty group, our primary goal was to reduce costs, lower risks and provide better customer service to our patients.
We began an informal selection process. Our top criterion for vendors was for them to be able to provide a turnkey solution that was flexible and highly automated, and would in turn, allow us to provide superior service to our customers. After evaluating several RoI processing vendors, we determined that King of Prussia, Pa.-based, MRO Corporation best met all of our criteria and would deliver the required results.
MRO’s shared-services process is designed to allow healthcare providers to outsource this time-consuming and potentially costly function, without losing revenue or relinquishing control. Furthermore, the solution met other key requirements of our medical clinic by operating well within firewalls, being fully HIPAA compliant and remaining current with evolving laws and regulations.
Other solutions not as robust
Prior to using the vendor’s solution, we attempted to perform the task of RoI processing on our own. But requiring various staff members to manage bits and pieces of the job, in addition to their regular duties, proved to be a fragmented and time-consuming process. Considering that we receive numerous requests daily from other providers, insurance companies, lawyers and even patients directly, this task was not the best use of our resources – personnel and otherwise. Adding to the task of fulfilling the requests alone, a number of questions began to arise from both a legal and regulatory perspective. On a routine basis, these questions are fairly straightforward, however, they can become sticky and complicated if a dedicated staff member does not stay on top of getting them resolved.
Our next attempt to manage our RoI processing was to enter into an arrangement with a service vendor. In this scenario, the vendor brought personnel on-site to perform the copying, preparation and mailing of the requested documents. With this particular process, we encountered a number of challenges including: scheduling inconsistencies with the vendor’s on-site employees, staff turnover with the vendor’s employees, and sub-optimal communication. Overall, the process was not efficient, and from a cost perspective, was not as attractive as the current arrangement with our shared-services vendor.
Automated system, knowledgeable staff create effective solution
Essentially, the shared-services model works by requiring that our staff take responsibility for the ‘front-end’ tasks such as logging the requests upon receipt, locating the relevant records, determining what information to release and scanning or sending the information electronically to the ROI Online system.
Once forwarded, the ‘back office’ functions are completed through the system’s secure Web-based workflow, which includes validation, tracking, requester relations/communications, the physical distribution of the requested information, receipt of telephone inquiries, billing and collections. The vendor’s system is very thorough and accurate in assigning the fees for RoI fulfillment. The fulfillment step is handled via printing or media creation and mailing or emailing. The vendor is then able to distribute the records in whatever format the customer requests – paper, CD-ROM or Web portal.
After only a few months of evaluating the market and selecting MRO, we went live and were up and running by the end of 2005. Although our medical clinic did encounter some small challenges in learning the software and processes, becoming familiar with the vendor’s support personnel and informing our customers about the change in vendors, we found MRO to be very responsive to all of our needs. A training representative spent one full day onsite with both our lead medical record personnel and a member of our information systems department to provide one-on-one training. The company’s support staff demonstrated patience and good humor in working through the change processes our group experienced.
Upfront costs with a shared-services vendor can be minimal, and the company charges a small monthly maintenance fee and shares half of the RoI fees it collects. Over the past two years, we have been able to accommodate an increase in the number of RoI requests without any increase in staff costs related to this function.
From an administrative perspective, the system’s real-time management reports help me monitor productivity quickly and easily. My staff can now focus on more productive tasks and spend less time handling telephone inquiries and paperwork related to RoI requests. Furthermore, the vendor quality checks our work to ensure that the records requested are indeed the correct ones being transmitted. This value-added service further instills confidence in our process and helps to ensure that our RoI requests are being handled correctly and efficiently.
Because the ROI Online system is a Web-based solution, we have continuous access to the information and can receive real-time updates on the precise status of any transaction request. We are still in control of what is happening and can dictate the terms under which these transactions are processed, but we did not have to build the infrastructure to do it – the vendor has already taken care of that.
I have also found MRO to be very accommodating to our billing practices. For example, if we encounter a situation in which we decide not to bill a company or individual for the release of a record – for instance, the patient was unhappy about some aspect of his or her care – we simply contact our vendor contact and instruct them not to bill the requester. There is enough flexibility built into the ROI Online system to allow us to continue to deliver the service the way we want to deliver it, in order to ultimately keep our patients happy.
We have been very pleased with the overall results. The MRO system has helped us to improve our customer service and satisfaction by allowing us to respond to RoI requests in a more timely and efficient manner. The highly automated and effective solution, coupled with the expert knowledge base of the vendor’s staff, is a big plus. From a legal and compliance perspective, we now have a platform within which we have a much stronger audit trail and protection. And, thanks to the shared-services RoI model, we’re managing our risks more effectively.