Manually filling out the release of information (ROI) requests in healthcare is expensive, time-consuming, and error-prone. An error in the transfer of protected health information (PHI) could result in heavy fines for those who ignore or overlook a critical piece of information.
What is Release of Information (ROI)?
Sharing protected health information (PHI) to an individual or entity authorized to receive it is known as the release of information. Electronic records regulate the procedure by both federal and state laws, making it more cumbersome.
Health treatment is also dependent on information being released. Both short-term goals (making sure patients get the care they need now) and long-term ones (uncovering insights that will improve the quality and lower the cost of healthcare) rely on it.
The Vital Role of ROI Services
The vast majority of requests for access to a patient’s medical records come from outside the patient’s immediate family. HIPAA and HITECH laws require specific procedures before transmitting these documents.
The first step is to secure the patient’s permission in most cases. Examine each page of the requested record to ensure that only personal health information that a patient has approved for sharing is given to outside parties.
For patients and health care providers, it’s clear that ROI work is necessary with precision. It’s a question of personal privacy and security for patients, and it’s a subject of observing the law and avoiding legal action for healthcare providers.
Only approximately half of healthcare firms do their ROI work in-house due to the necessary high skill and experience. For this reason, these companies supply both software and services to preserve patient privacy and ensure that people requesting medical records have access to the correct information on time.
How Is Release Of Information Evolving?
We’ve all been accustomed to requests for information that return a quick response and minimal effort. Those expectations have permeated the healthcare industry, particularly in release of information (ROI).
The ability to meet patient, requester, and provider expectations is made feasible by digital ROI—using technology to request and release PHI according to proper authorization.
How Can One Improve The Release Of Information Workflow Process?
Establishing a safe, efficient, and reliable ROI process is the first step.
● Log, track, and double-check record requests
● Check that medical records are comprehensive and that only authorized individuals have access to them
● Deliver a complete audit trail of all interactions, including reports on what, when, and to whom a release was provided
● Provide multiple distribution options, such as printing, exporting to CD/DVD, and encrypting data
● Create fulfillment letters and invoices automatically
The HIM department of your healthcare business may turn this process from a labor-intensive cost center to a streamlined profit center with these ROI process improvements.
The 5 Phases of ROI Process
Note that this is just a broad summary of the ROI process, and it’s essential to keep that in mind. A medical records release specialist must ensure that certain conditions are met before deciding what action to take next.
1. The first step is to document, track, and validate the service request
There is a medical release of information form and a mental health release of information form. The patient — not the requester — is the one who makes the request. But it can also be an interested party, such as an attorney, insurance firm, or medical research institution. The interested party must be authorized first if they aren’t the requester.
If you fill out the ROI form, your medical records can be released to a healthcare provider, such as your local hospital. As soon as the healthcare organization receives the ROI request, it is instantly recorded by the ROI department. In addition, they verify the legitimacy of the authorization.
2. Getting Your PHI Back
The medical record number is searched by an ROI professional. When the file has been located, they decide if it is in hard copy, microfilm or electronic. This includes on-site or off-site and whether it’s digitally stored. There are times when all three formats must be retrieved from all three different sites.
Your protected health information — PHI — is extracted from your medical records and then uploaded to the release of information software. If the tracking tool cannot locate your medical history, they will let you know.
3. Protecting Your Personal Data
It is the job of the ROI professional to scrutinize each image or page thoroughly. Any state or nationally protected health information that the healthcare institution has not been permitted to disseminate must be removed. In such situations, the application is rejected, and the tracking software is updated accordingly.
If it doesn’t, the ROI expert confirms that all of the pages and photographs in your file are yours, and not someone else’s, before continuing. Check the service dates are correct as well.
After that, they scan a copy of the request and authorization into the tracking program as a backup. The medical records set also check in any hard-copy documents and photos. After that, they put the hard copy chart back together and store it.
4. Releasing Your PHI
The ROI expert checks to see if the data is genuinely yours before disclosing it. They use your social security number and birthdate to confirm your identity in this process. They also use the diagnosis to ensure they’re delivering the correct treatment information.
The ROI department conducts a quality review to ensure that the correct PHI is included. Consequently, another ROI expert has verified that the records are of the correct type and date range. They also double-check that the documents are orientated in the right direction.
5. Finishing the Request and Putting Up an Invoice
The final step in the process is a thorough review of the data by the ROI professional. When calculating fees, they use state statute pricing. As soon as everything is ready, they’ll put it all in an envelope and mail it to you.
Alternatively, they can send you the documents via a safe and secure internet medium, like an email.
As we’ve seen, the process of releasing information is highly complicated. HIPAA compliance is a top priority for ROI departments, and that’s why an electronic health information exchange provider can be so helpful in determining ROI solutions.
For both patients and healthcare providers, they make the procedure considerably more efficient. On the other hand, such services are always protected by multiple cutting-edge security procedures. The result is that there is no risk of your PHI coming into the hands of an unauthorized person or being accessed by someone who should not have access to it.