Gold Nuggets to Manage Medical Records Workflow
Use these practical tips to help you get your practice running at maximum efficiency.
By Andrea Umbreit, MPA
Congratulations! You have a shiny new electronic health record (EHR) system. You carefully selected your EHR, trained your staff, and evaluated workflow and technology. Now you must keep up with ongoing medical records management. Although you probably cringe at the thought of doing it, it’s required to keep your practice running like a well-oiled machine. Here are some practical tips to help.
Don’t Be Penny Wise, Pound Foolish
Don’t try to make money or cut costs where it doesn’t make sense. For example, practices often bill patients who request their medical records (release of information), even though staff can’t handle the billing and tracking of these payments or state guidelines don’t allow reasonable compensation for this effort. Practices that pre-bill for release of information generally collect on only a small percentage of those requests. And the effort of the pre-billing actually represents 90 percent of the time and resources needed to fulfill the request. Avoid this pitfall by analyzing whether it makes sense for you to charge for this service in your state. If you’re averaging less than $8 per request, it’s not worth your time to bill.
Avoid HIPAA “Overkill”
The average practice cannot possibly keep up on thousands of pages of ever-changing Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations. Many practices lack the HIPAA expertise needed, while others go totally overboard.
If you feel you are over-documented, duplicating efforts, or spending too much time covering your electronic protected health information (ePHI), you probably are. Consult with your compliance specialist, attorneys, or EHR resources to be sure you are covering the requirements only. Unnecessary medical record documentation takes time away from your clinic and patients.
Plug Staffing Leaks
- Are you paying clinical staff to file, route, and appropriate documents that enter the EHR because you don’t have the administrative staff to do so?
- Is the practice administrator covering the phones and scheduling when the front desk staff are out?
- Do you have “down times” that aren’t filled with backup projects?
- Is your medical records staff running up against the 30-day HIPAA deadline a bit too often for comfort?
Analyze who is doing what, and when, and you’ll learn a lot about misused human resources. Redistribute tasks to match the skills and expertise of your trusted staff. Allow everyone to work at the top of his or her specialty and certification, and rearrange or outsource workflow from there.
Define Your Record Set
- Do you know when you’re allowed to send out medical records to attorneys?
- Should you allow your payers on site in your EHR during an insurance audit?
- Should records from other providers be included in your documentation?
The not-so-simple solution is to document these in your internal policies to be clear about what is and is not included in your designated record set, as well as the resources used to review your legal requests. Review your payer contracts annually and update them as needed.
Calculate Your True Costs
There are some super-organized folks out there who have a neat and tidy line item for medical records. As for the rest of us—dealing with more work, shrinking budgets, and information overload—we have a hunch as to what we spend keeping this workflow afloat.
If you have no idea what your medical records management really costs you, but you can come up with a number you believe is 85-90 percent within a reasonable range, start with that number and look for savings and efficiencies. Gather sample data, make educated assumptions, and start measuring and tracking from there.
Sign Business Associate Agreements, Pronto!
The latest HIPAA ruling has made several significant changes to strengthen policies. If you don’t have a business associate (BA) agreement in place with your vendors, do so immediately. Appropriate agreements allow you to transfer some HIPAA liability to your partners. If you don’t have an agreement written with your vendors, ask them to supply one. Keep yourself covered and limit your risk.
For more information on the implications of the new ruling, read the article “New Final Rule Changes HIPAA Provisions and HITECH Applicability” on page 56 of this issue of AAPC Cutting Edge; also check out this link from Forbes Law Group: www.datafiletechnologies.com/wp_aapc_content/uploads/2013/01/HIPAA-Final-Rule-Newsletter.pdf.
First, change your way of thinking and evaluate the opportunities technology and outsourcing have to offer. A few changes could save you or your department a few hours per week, or a few hundred dollars per payroll. More importantly, put stronger measures in place to prevent risks in your ePHI, while also employing your human resources to their maximum.
Andrea Umbreit, MPA, is director of business development for DataFile Technologies, a remote medical records management partner for healthcare groups of all sizes. You can contact Andrea at firstname.lastname@example.org.