Patient Billing Records – the thorn in your side…

Common reaction to chasing billing records

Are Missing Patient Billing Records Ruining Your Day?

Stress no more.  MEDRECS will take care of it for you:

MEDRECS Inc. has a handle on the dizzying vicissitudes of the patient billing record industry.  We call this an “industry” because the recent proliferation of outsourced billing companies has snowballed into BIG business, on a national scale.  There is now a nationwide labyrinth of billing services, hospitals, ER departments, and parent medical systems, with requirements so complicated it will make your head spin.  The most immediate and perplexing consequence of this is that clinics and hospitals are less and less likely to maintain their own patient billing records, and often times they do not have correct information regarding how to retrieve the billing records.  Below we provide some very valuable information to help illuminate some of these recent changes for you:

EPBS Intermedix is an emergency physician billing service in Oklahoma which maintains patient billing records for no less than 6 Washington State providers.  As of recently, EPBS now requires the “emergency/medical group” name on the patient authorization –  i.e. they will no longer accept just the Hospital name on the authorization.  Below are the Hospital names with the corresponding group names that must be on the authorization. 

Capital Medical Center – Thurston Emergency Group 

Valley General – Northsound Emergency Medicine 

Swedish Medical First Hill – Seattle Emergency Physicians 

Auburn Regional – Cascade Emergency Physicians 

Holy Family – Emergency Physicians Services

Similar requirements are now in place for our local facilities in Washington: 

Association of University Physicians now requires the authorization to list not only the Hospital but the exact medical group, clinic, or emergency physicians for which you desire billing records.  

Similarly, Swedish Cancer Institute requires us to request patient billing records from 3 separate contact fax/phone numbers depending on which services were provided.

It is critical to be aware of these requirements in advance so you can plan accordingly and prepare the necessary request information.   MEDRECS is here to help you and your law firm navigate the challenging world of medical and billing record retrieval.  Please leave a comment or let us know if you have any questions.  We are always happy to help!

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HIPAA tightens its grip…

In the ever-stricter world of protected health information (PHI) and HIPAA compliance, nothing can be left to chance.  Healthcare facilities are no longer interested in inferring anything from the authorizing documents.  All requests must be explicit and direct.   Interpretation is out of the question: if there is even the slightest ambiguity on the stipulation, authorization, or subpoena nowadays, the request will likely result in a rejection.  This level of scrutiny is vastly more stringent than it was even one or two years ago.  Here are a couple important tips to remember:

If you require billing records from a particular organization, you must (1) determine where the billing is done and (2) include the specific billing department’s name and location on the stipulation/authorization.  Many hospital billing departments are now off-site and/or outsourced.  This is true for hospitals such as University of Washington and Harborview Medical Center.  In the past, it was sufficient to state on the stipulation that you require medical records and billing records from University of Washington Medical Center, or Harborview Medical Center.  Now, if you require billings in addition to the medical records, you must list the billing departments separately from the medical records departments.  So for Harborview, you must indicate “Association of University Physicians” billings (and include the address), as well as “Hospital Collections” billings.  Furthermore, you must indicate whether you seek billings generated by a UWMC Doctor or department, or a Harborview Doctor.  Yes, this is much more detailed than it was a year ago.  But it is useful to be aware of these nuances in advance as requests will be processed more quickly and achieve a higher level of success if copious information is provided at the outset.  If you have any questions about this, please contact MEDRECS.  If you are unsure of the exact wording or address for a billing facility, please contact MEDRECS.  Note – citing incorrect address, name, or facility information on a stipulation may result in a rejection from the facility.  Therefore, it is advisable to cross-check all information with MEDRECS before proceeding.

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MEDRECS L&I Update

Hello MEDRECS friends!  Springtime litigation is heating up and there is a regular need for record retrieval from the Washington State Department of Labor & Industries.  Please take notice: Washington State L&I has been cracking down lately on their acceptance of patient signed authorizations to comply with the State RCW 51.28.070.  In order to authorize the release of L&I records, the Stipulation or authorization form must specifically indicate it intends “to release Labor and Industries records” or “to release workers’ compensation records.” The Department of L&I has informed us that wording such as “any and all medical records” will compel the release of “medical records” from L&I, but not the entire L&I file.

MEDRECS – Group Health Authorization Form

In the interest of thoroughness and stringent commitment to the confidentiality of patient health information, Group Health all but requires the use of their own particular authorization form in order to release protected health information (PHI).  If you attempt to request records from Group Health with something other than the Group Health Legal Release Form, your chances of gaining compliance to your request are rare indeed.  For this reason, it is highly recommended that you utilize the Group Health Legal Release Form for any medical records requests made to Group Health.  The Group Health form is updated periodically and MEDRECS keeps a keen eye out for any updates to the form to ensure that the forms we provide access to contain all the most recent verbiage.  The most recent Group Health form includes authorization language for sensitive information.  This form, and dozens of other facility-specific authorization forms, can be found in a reliable and up-to-date format on MEDRECS website.

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Medical Record Retrieval – Tips for a Successful Retrieval Effort

Welcome Back to the MEDRECS Blog!  Please consider this a forum for all things Record Retrieval.  Medical Record Retrieval is the core expertise of MEDRECS, Inc. and we want to share our knowledge and experience with you in hopes of improving the record retrieval experience for all parties involved: attorneys, patients, clients, adjusters, and healthcare professionals.  Medical Record Retrieval is difficult enough even with all of the resources, skills, knowledge and support of a company like MEDRECS, but it can prove to be extremely cumbersome and perplexing if you jump into it without equipping yourself with the tools and knowledge necessary for a successful retrieval campaign.

Now enter the birth of the MEDRECS blog: the intent of this blog is to fill a much needed space where information and discussion relating to medical record retrieval can flow.  This means that we would love to hear from all of you!  Please feel free to post comments relating to your strategies and successes in your record retrieval effort.

Let us initiate this new Blog with a few key things to remember when preparing for a record retrieval effort:

1)      Specific Authorization Forms

Not all facilities were created equal – i.e. some accept multiple forms of authorization, while others reject all forms of authorization except their own.  It is always a good idea to check your facility list with MEDRECS up front in order to determine whether any facilities will require their own specific authorizations.  This can save a significant amount of time in the long run!  To see a list of facility specific authorizations please visit http://medrecs.com/Resource/FormsDownload

2)      Reconcile the medical records with the billing records

This will determine if anything crucial is missing from the record set.  This falls under the “record collection best practices” category.  It is a reality in the industry that healthcare Providers do not always release all information in their possession, as is explicitly requested in the authorization.  There are many reasons for this, not least of which is accidental non-disclosure of all information.  The record retrieval service will sometimes notice that key information is missing from a record.  But it is best practice to review the records carefully to ensure that all requested information is contained within.