In this Business Profile, Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.

Brian Grazzini, CFO, HealthPortTell me a little about your organization.

With a national footprint, HealthPort is the leading provider of release of information (ROI) services as well as audit management and tracking technology. In fact, established almost 40 years ago, we are the nation’s first ROI company and have really driven development of this segment of the industry. In the United States, we currently partner with more than 13,500 hospitals, health systems, physician practices, and clinics to process and fulfill medical record requests and maintain compliance related to the release of medical information to all types of requesters.

We process 25 million requests per year. Given our expertise, we also provide thought leadership on HIPAA compliance, governance, and guidance pertaining to audit management and release of information through webinars, seminars, our national user meeting, and presentations at state healthcare associations. Because we work with so many organizations, we feel a sense of responsibility for disseminating best practices in release of information services, so that organizations can successfully adapt to changing practices.

What are most healthcare organizations seeing today with respect to requests for audits?

The volume of requests has increased tremendously, which has caught many by surprise and created an overwhelming paperwork burden. In fact, for many, the number of requests has doubled over the past few years. And it’s not going to slow down in the years to come. HIPAA, the Affordable Care Act, increasing costs of health care, and changing demographics relating to utilization are just a few of the factors that will continue to drive an increasing number of requests.

There are the government audits (e.g., RAC, MAC, MIC) as well as the health plan audits, such as HEDIS, Medicare risk adjustment, and new this year, a STARS program for all the plans that participated in the healthcare insurance exchanges. The problem is that because organizations’ healthcare information services are increasingly tied up with responding to this volume of letters, calls, and administrative work, they don’t have the time they need to contribute at a mission-critical level in their organizations. Instead of sending records to attorneys, they need to be actively involved in sharing data insights to better guide patient care.

In fact, years ago, healthcare information management (HIM) services used to be housed under a variety of functions and departments in organizations, ranging from operations to compliance. But increasingly, we are seeing HIM reporting to the CFO as part of the revenue cycle due to the cost of IT, desire for interoperability, and importance of Meaningful Use in electronic health record technology. I believe it’s a trend that will continue to accelerate over the next decade. Because HIM is so critical to the success of organizations in this new era, we simply can’t tie up these essential resources with responding to audit requests.

HealthPort: A provider of release of information services, audit management and tracking technologyHow can HealthPort’s solutions address these kinds of challenges?

HealthPort Audit Relief manages audit requests securely and efficiently to eliminate this administrative burden. By serving as the “honest broker” between providers and health plans, we help everybody win. For example, for providers, we advocate to negotiate deadline extensions when needed. For health plans, we offer complete automation of the request and direct delivery of medical records to drive efficiency. By improving audit request turnaround time, we reduce the natural friction that occurs there. Providers can focus their resources elsewhere to improve patient satisfaction, while health plans receive records faster.

Another way we aid both parties is that we are experts at increasing HIPAA compliance while reducing the risk of improper disclosure of health information. Each year, all HealthPort employees complete mandatory HIPAA training. In short, we protect revenue, decrease costs, and improve patient, staff, and requester satisfaction.

What are some key considerations when choosing a partner to manage audit requests?

Size and scale matter. It’s important to assess whether the company you are considering partnering with has the relationships to manage the volume to get the job done efficiently and effectively. A solid track record of experience also is important. Should something go wrong, will they make it right? Also, focus on security. Do they use defined practices to ensure they are compliant with HIPAA? How will they keep privileged and confidential patient data safe? Are they SOC-certified? Do they undergo penetration testing and rigorously enforce security measures?

Next, assess whether there is seamless integration of technology. It’s important not to piece together a number of different technologies to support information exchange, as that increases the risk of security exposures. Ask: Do they have a centralized intake process? Centralization offers a distinct advantage in terms of efficiency for processing requests. In fact, we work with one California facility where staff find that it is faster to request internal records from us directly than to walk down to their mail room to procure them. This is as it should be.

And finally, choose a partner that understands both sides of the medical record request—the provider and the health plan perspective. The healthcare landscape has dramatically shifted with the implementation of the Affordable Care Act. Collaboration with business partners is critical to success, so it’s important to identify suppliers who bring that mind-set, experience, and capability.

Where can readers learn more about HealthPort’s services?

Join us for a HIMSS webinar, "Three Ways to Strengthen the Provider-Plan Relationship," at 1 p.m. EDT, April 2. Learn more about HealthPort's Audit Relief services or call (800) 737-2585.

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Content for this Business Profile is supplied by HealthPort. This published piece is provided for advertisement purposes. HFMA does not endorse the published material or warrant or guarantee its accuracy. The statements and opinions of those profiled are those of the individual and not those of HFMA. References to commercial manufacturers, vendors, products, or services that appear do not constitute endorsement by HFMA.

Publication Date: Sunday, March 01, 2015