Improve Cash Flow, Reduce Receivables, & Improve Productivity with a Release of Information Provider
Friday, November 18, 2016
Posted by: Dan Bailey, BACTES Imaging Solutions, LLC
Responding to payer requirements for copies of medical information to adjudicate claims has a direct impact on cash flow and carries the same risk for wrongful disclosure or inappropriate accounting of patient information released. The risks and operating costs surrounding Release of Information (ROI) for the Billing Office (Patient Financial Services) is no less daunting than that of the Health Information Management department. A true ROI partner can help covered entities improve their DSO (collection experience) and mitigate their risk.
This is a story you may know all too well. There are typical challenges a Billing Office faces while processing claims (W/C & MVA). The Billing Office starts by processing the claim and submitting it to the payer. When collecting on the claims, the payer requests medical records to support the claim. An uncertified Billing Office employee pulls medical records and submits the medical information to the payer. During follow up calls, the payer denies receiving the medical records. The Billing Office has to rework the request and resubmit the medical information. Follow up calls continue.
The Billing Office is also faced with fulfilling requests for Billing Statements. The risk is just as great when fulfilling these requests (typically from attorneys) as they also contain Protected Health Information (PHI).
In addition to the typical challenges faced by the Billing Office, there are also business issues to take into consideration. Cash flow is a big problem. When payment of claims are delayed, the impact to receivables is often unnecessary, and potentially significant. There is a productivity loss managing delays and denials. And there is risk of breach by uncertified employees submitting PHI. If paper records are involved, the process is further exacerbated by having to chase down these records. There are denials, delays, rework, rework, and more rework. Not to mention the space used by these non-revenue generating employees.
Requests for Billing Statements from attorneys are also being released without screening for sensitive content.
A Release of Information service provider can improve this workflow by managing the claims process for fulfillment. A certified Release of Information specialist can abstract the corresponding medical information to support the encounter, screen for sensitive content, and submit the claim and medical record to the payer. If the Release of Information service provider has a secure portal, an electronic copy of the claim and medical information can be uploaded for the Billing Office staff to access. When the payer denies receiving records, the Billing Office employee can fax the supporting information directly from the portal immediately.
It’s plain to see how your cash flow can be improved, your receivables can be reduced and your productivity improved. The Billing Office staff can focus on the collection of claims and not the clerical support effort. The risk of a breach is mitigated, printing costs are eliminated, postage expense is reduced, and labor can be redeployed.
The same Release of Information service provider can support the requests for Billing Statements, thus eliminating the risk associated with this fulfillment process as well. And, all billing records are screened and fully tracked as required for Accounting of Disclosures.
Responding to payer requirements for copies of medical information doesn’t have to be so burdensome. Find a true Release of Information service partner, not just a vendor, who will work with you to streamline and protect this fulfillment process. A true ROI partner can help covered entities improve their collection experience while mitigating their risk and reducing operating costs.
About the Author
As Region President of BACTES Northeast, Dan Bailey services over 700 client locations in New England. Dan built the Northeast region from the ground up in late 2002. Working in the electronic capture and conversion businesses for nearly 30 years, Dan has owned two separate companies built to provide solutions surrounding the management of medical information. Performing in leadership roles throughout his career, Dan has consistently performed at the highest levels maximizing both top and bottom line results. Dan grew up in Northern Minnesota but has resided in Beverly, MA since 1988. He is married with three children.