Requesting Medical Records: The Quest for Standardization

 In Medical Records, ROI

You want to focus on caring for the needs of your patients. It seems easy enough, right?

Not so fast; priorities can get lost in the shuffle when managing office systems, paperwork, and other administrative responsibilities. ROI management is one necessary task in the healthcare industry that can cause delays and backups with office staff members.

There’s no question that patient record requests and delivery is not going away anytime soon. Patients will always need access to their medical records files or share this information with other healthcare providers. So how are you managing this process in your office?

Unfortunately, there are many reasons why you can’t standardize or automate this process. Here are some of the issues that are hindering the standardization of ROI in the healthcare industry:

1. Various EMRs and Technology

Electronic Medical Record (EMR) systems are standard in our digital healthcare world. These software systems make tracking patient records and information easy without stacks of paperwork in filing cabinets. Many modern healthcare providers have invested in EMR/EHR systems. However, there is no one standard across the industries, causing a competitive market where each technology component conflict rather than cooperate. In addition, as with any technology improvement, the investment to adopt it deters some organizations.

2. Varying Types of Requests

Not every request is the same. Each submitted request is analyzed and reviewed to ensure the authorization and the requested information are accurate. This is a timely process. Without this expertise, complete records with thousands of pages can be delivered, causing significant delays. A few pages might be sufficient to fulfill the request depending on the request. Figuring out what information needs to go where is a skill not everyone in a healthcare organization can quickly learn.

3. Unique State Legislation

Not only do you need to stay compliant with federal HIPAA requirements, but there is no common legislature defining how records can or should be delivered to requesters in every state. Each state dictates this process, and it widely varies, making it challenging for organizations in multiple states.

4. State Fees

Like state medical record legislature, the fees that can be charged to deliver patient records are not standardized across states. Additionally, these fees are complex and can change frequently. Knowing these ever-changing guidelines is crucial to providing medical records compliantly.

5. Ambiguity with Process

When processing requests, there isn’t a cookie-cutter process or a “silver bullet” solution for healthcare organizations (or companies like us). Different methods of delivery are required, depending on how the requester wants to receive the information. Plus, every ROI requires personalized attention to review the requesting information and ensure the delivered pages match the request. There are other essential steps, such as verifying the validity of the request, maintaining privacy and security through delivery, and supporting patient satisfaction every step of the way.

6. Who Is Paying the Fees?

One necessary step in the ROI process is to define who is paying the fees for this service. These state-regulated fees (see above) cover the administrative costs of reviewing the files and sending the requested information. Unfortunately, there is a current ongoing debate about who should be paying these fees. Fortunately for you, the reader, this post does not get into the details of the discussion. Let’s say it’s a shade of gray needing experts and their experience to figure out.

7. Lack of Knowledge about ROI

Since the ROI process is so detailed and frequently changes, many organizations cannot keep up with training their staff members and maintain the continuity of patient care – this is where we come in. Without the knowledge, speed, and experience when processing requests, organizations are liable to make drastic mistakes and/or spend too long processing the request. With the current state of healthcare staffing, things continue to worsen in systemizing an ROI workflow.

RecordQuest Can Help

At RecordQuest, we are working hard to reduce the busy work in your office. If you are looking for a partner who will spend the required time to improve your ROI (or do it all for you), reach out to us at your convenience to >book a demo or have a chat.

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