Posted and filed under Coding, Compliance, Cybersecurity, Fraud, FWA, Healthcare.

This article is a continuation of Risky Retrievals.

Walk-Ins Welcome

Our medical record specialists are required to arrive at each facility with their equipment, as well as their ID badges and driver’s licenses. This is to ensure that their identities can be verified by office staff and reporting in the event of an incident. What we learned is that roughly 45% of the physicians on our roster did not ask to check identification before granting our specialists access to their computer systems or Electronic Health Record (EHR). Below is the sample of an exchange that was reported, and one that reflects the experiences of many of our retrievers.

ADVIZE STAFF: Good Morning. My name is [REDACTED] from Advize Health. I’m here to perform a medical record retrieval on behalf of [REDACTED].

PROVIDER OFFICE: Do you have the list of patients?

ADVIZE STAFF: Yes, we do.

PROVIDER OFFICE: Great, come on back.

As you can tell, there were no requests to check identification, or any other safety precautions put into place.

It wasn’t all troubling, however; as some physician offices asked our medical record specialists for their ID badges, driver’s licenses, and an email from Advize Health’s Compliance Officer before they were even allowed out of the waiting room. Of the 55% of physicians who requested verification, only 20% asked for more than one form of ID or authentication.

It is also important to note that an estimated 30% of providers provided medical record specialists with their own EHR credentials, writing usernames and passwords on a piece of paper and leaving it on the desk.

Intruder Alert

Medical record retrieval projects are not typically something for a provider office to look forward to. Records are often extracted onsite for attestation or audit purposes, meaning that the presence of a medical record specialist on site is unsavory to office staff. Couple that with the inconvenience of one extra body and one less computer in the office, and the provider is left busy and unsettled. While 75% of our retrievals only took one day, some cases involving large sums of records could take anywhere from 2-5 days. In the interest of time, our retrievers often pull from opening until closing time in order to maximize the number of records retrieved in a day.

In one instance, a retriever was performing a pull on 150+ charts while using a dated EHR. The office manager wanted to close the office early because there were no more patients for the day, and kicked our medical records specialist out – despite the fact that only 10 records still needed to be collected. This caused our staff to lose 3 hours of transit time to pull only 10 records.

If you’re thinking about executing a medical record retrieval project, or if you’re expected a retrieval in your office – it’s important to keep these kinds of hurdles in mind. Medical record retrieval specialists are not there to condemn providers, rather to collect records to ensure the cost of healthcare isn’t rising due to poor documentation or non-compliance.

Fly on the Wall

Medical record specialists are trained to get in and get out as efficiently as possible, an effort that contributes to our quick-turnaround promise. This requires our retrievers to act with the utmost professionalism as they enter each office with one goal in mind: collect all requested records. It’s not always easy to focus, especially when the nurses and administrative staff are loud, rude, or vulgar in the presence of patients or office guests. As shocking as it may be, some offices will be full of unconventional employees who may overshare with each other and patients, forgetting that there is a visitor working quietly in the corner. Training medical record specialists to tune out these behaviors is essential.

Lessons Learned

Record retrievals can be risky, and depending on how fastidious each provider is, the risk usually lies more with them than with us – at least where patient privacy is concerned…but that doesn’t mean we will stop doing our due diligence to ensure safe data transfer. Record retrievals may be seen as a nuisance to provider offices, but that’s not an excuse to behave unprofessionally. As healthcare professionals, it is important that all sides of the coin work together to ensure a positive patient experience, from initial exam to claims payment.