Information requests consume significant resources and represent a real area of risk for medical practices. Here are the top five actions you should take.
Requests for patient health information are a large and growing burden for physician practices. Healthcare providers must be familiar with the relevant laws and follow best practices in release to limit their risk exposure and optimize work flows. Here are some tips on how to minimize inefficiency, boost revenues, and serve as a responsible custodian of health information for your patients:
1. Be informed of your state’s administrative medical records statutes
Each state regulates the price a practice may charge for release of medical records. The charge is often dependent on the number of pages included in the disclosure, and the amount of staff time the disclosure takes. States, however, can vary drastically in how much financial value they ascribe to the release process. New York, for instance, allows doctors to charge only $0.75 a page, while neighboring state Pennsylvania includes a $21.33 search and retrieval fee, $1.44 per page fees for the first 20 pages, $1.06 for the next 40 pages, and $0.35 per page thereafter. Of course state statutes can change, so make sure to regularly update your understanding and check with an attorney to confirm that you are charging the appropriate amount. Maintaining an active Google alert on your state’s administrative medical records statute is also an excellent way to stay on top of relevant legislative changes.
2. Know your reimbursement rate under payer contracts
Payers include reimbursement parameters in their payment contracts for post-payment information requests. Many practices aren’t aware that they can collect a pre-designated fee from payers. In our experience, small practices in particular are often contracted for a flat fee on post-payment information requests. Check your payer contracts or contacts to inquire about any available reimbursements, or at least ask the requester when the request comes to your office.
3. Streamline the release of information process
The energy you commit to improving your staff’s release of information process will pay off. The disclosure process is highly regulated and it’s easy for staff members to forget efficiencies when they are concentrating on compliance. Focus on eliminating phone calls and misdirected faxes by putting information on how patients and third parties can request record and documentation requirements on your website and voicemail. Make sure staff understands the full release of information capability your EHR offers, and research potential electronic release of information solutions to eliminate manual authorization intake, billing, payments, disclosure tracking, and releases.
4. Track all disclosures and audit releases regularly
This may seem like additional busy work, but HIPAA mandates that a covered entity be able to provide a full account of disclosures for a period of six years preceding an accounting request. This account should list all instances when the practice shared an individual’s protected health information (PHI) with a person or organization outside of its own entity. Your practice must maintain records of all PHI disclosures for at least six years, often more depending on your state. Regular management audits of releases will minimize your risk of costly penalties and document that your practice is performing an industry best practice.
5. Educate your staff on your release of information process
Practices often forget that front-desk staff members have to manage a wide variety of complex disclosure scenarios. Make sure all of your front-desk staff know who to refer patients and third-party requestors to in making their request, and ensure that your staff is aware of compliance guidelines and release of information procedures at your office. For tips here, check out the American Health Information Management Association or other health information management organizations you trust for more information on compliance and disclosure guidelines.
Carly Stockdale is the CEO of ChartRequest. ChartRequest helps clinics and hospitals securely streamline the release of medical records and other information requests. Since inception, ChartRequest’s cloud-based solution has saved hospitals and physician practices’ time, increased their collections, and reduced their disclosure risk on over 30,000 requests for information. Email her at firstname.lastname@example.org.