Business office personnel release millions of medical records annually to commercial health plans and government payers to expedite payment of claims, appeal denials, or fulfill auditor requests. Time spent by billers and collectors aggregating and sending this Protected Health Information represents a significant distraction and efficiency challenge for business office directors and revenue cycle leadership. The interference in workflow also reduces revenue-producing claims-processing time for uniquely skilled business office staff. Furthermore, a non-standardized process may increase the chance of patient privacy concerns. This presentation will detail current process gaps resulting in inefficiencies and privacy concerns, then review alternative workflow options for healthcare leaders looking to improve their billing processes, decrease denials, minimize access to protected health information and enhance overall compliance.
Participants will be able to:
- Discover the hidden culprits for business office inefficiency and PHI privacy when solely billers and collectors manage medical record release for claims submission in response to ADRs, or as part of retrospective audits.
- Recognize the benefits of HIM/business office collaboration for Release of Information requests including privacy compliance, cost reduction and collaboration improvements.
- Review optimal workflows and assess how your health system can re-engineer business office workflows for disclosure management including new processes to delegate, centralize, and automate.
In her role as Vice President of Privacy, Compliance and HIM Policy for MRO, Rita Bowen serves as the company’s Privacy and Compliance Officer (PCO), overseeing the company’s compliance with HIPAA and chairing the organization’s Data Protection Steering Committee. In addition, she ensures new and existing client HIM policies and procedures are to code. She has more than 40 years of experience in Health Information Management (HIM), holding a variety of HIM director and consulting roles. Prior to joining MRO, she was Senior Vice President and Privacy Officer for HealthPort, Inc., now known as CIOX Health. Bowen is an active member of the American Health Information Management Association (AHIMA), having served as its President and Board Chair, as a member of the Board of Directors, of the Council on Certification, and various focus and specialty groups, such as privacy. Additionally, Bowen is a former chair for the AHIMA Foundation. She has been honored with AHIMA’s Triumph Award in the mentor category; she is also the recipient of the Distinguished Member Award from AHIMA’s Quality Specialty Group and the Tennessee Health Information Management Association (THIMA). Bowen has served as President for both the Arizona Health Information Management Association (AzHIMA) and THIMA, and served in AHIMA’s House of Delegates. Bowen is an established author and speaker on HIM topics and has taught HIM studies at Chattanooga State and the University of Tennessee Memphis. Bowen holds a Bachelor of Medical Science degree with a focus in medical record administration and a Master’s degree in Health Information/ Informatics Management Technology.
In her role as Director of Revenue Cycle Services for MRO, Kim Charland is responsible for the development and expansion of MRO’s Protected Health Information (PHI) disclosure management solutions for hospital and health system business offices. She has almost 30 years of healthcare consulting experience in Revenue Cycle Management (RCM) and Health Information Management (HIM). Prior to joining MRO and for 25 years, she held multiple positions within Medical Learning (MedLearn), now known as Panacea Healthcare Solutions, which included Senior Vice President of Clinical Consulting Services, Senior Vice President of Clinical Innovation and Publisher of VBPmonitor. She also co-hosted ICD10monitor’s weekly internet broadcast, Talk-Ten-Tuesday. Charland is an active member of the American Health Information Management Association (AHIMA) and currently serves in AHIMA’s House of Delegates; she is the current Past-President of the New York Health Information Management Association (NYHIMA) and is a Past President of the District of Columbia Health Information Association (DCHIMA). Additionally, Charland is a member of the Healthcare Financial Management Association (HFMA) and the National Association for Healthcare Quality (NAHQ). Charland is an established speaker and author on RCM, HIM and hospital value based payment topics; she sits on the Wolters Kluwer MediRegs Product Advisory Board.Watch Now