Page 19 - Company Newsletters

Consequences. While tradi/onal outsource service vendors in healthcare are evaluated and awarded contracts for their services through a Request for Quota/on (RFQ), ROI vendors are rarely, if ever, awarded outsourcing services based on cost and budgetary considera/ons. However, this will change in the very near future. ROI vendors will insist that Providers subsidize them for the difference between the average fees they were collec/ng based on state regula/ons versus what they can collect under the new OCR mandate. This transi/on from “free service” to “fee for service” will place a significant financial burden on Providers and their HIM department budgets, which are already stressed.
In light of this epic shi^ in fee structure, the emergence of the “lowest cost” ROI vendor will quickly determine the survivors and losers. ABT Medical's outsourcing partners that operate on our ROI+ plaaorm will most certainly be the “lowest cost” outsource op/on due to the high level of automa/on and HUB-free nature of ROI+. As for in-house processing, ABT’s ROI+ plaaorm is the only "zero cost" op/on in the industry.
The following communicaNon excerpt from the largest ROI outsource company in the industry foretells the near-term transformaNon from "free service" to "fee for service.”
What Is “Z ero Cost”?
“Zero Cost” is when the cost of ROI fulfillment labor and software is equal to or less than the amount of ROI fee revenue collected. “Zero Cost” is made possible by using a highly automated workflow software platform, such as ABT Medical’s ROI+ platform.
For Healthcare Providers who fulfill requests for medical records in-house, automating the ROI workflow reduces labor costs. Having a web portal for electronic PHI delivery to 95% of Requestors further reduces those labor costs and eliminates the cost of printing, mailing, and faxing.
“We will continue to lobby in Washington DC, with a goal of getting an Amendment to the existing HITECH Act that would limit the low 'cost based' fee structure to just patient and patient directive requests, where the records are being directed to a healthcare provider, family member, caregiver, or a patient's mobile health application. Even when we are successful on the lobbying side, we are only revising when the low cost based fee is applied, not whether it will exist at all.
This new rate (particularly for patient directive requests) is lower than our current pricing and will be a fairly material hit on the ROI business. As a result of this, we will no longer be able to subsidize the cost of delivering patient records for free. The OCR clariCication including patient directive requests, has caused a signiCicant decrease in our attorney (billable) request volume. The “patient directive” requests are being used by attorneys to avoid the regulated rate structure for attorney requests and is undermining the entire economics of the ROI industry.
Until we are successful in our lobbying efforts, and can limit the cost based fee, we can no longer afford to send all Patient requests at no charge to the Patient. This is due to the lower fees realized from attorneys requests, now treated as patient directive requests. We also understand the updated pricing structure is required to be implemented for all patient and patient directive requests by August 23, 2016, in conjunction with the implementation of the new guidance.
The revised pricing structure for all patient and patient directive requests is
listed below:
A Clat fee of $6.50 per patient request, plus
• $0.01- 0.02 per page for records that are stored in paper and scanned
• $0.05 per page for records that are printed and delivered in hard copy
• Actual postage for records that are delivered in hard copy
• If a records is stored electronically and delivered electronically (either CD, USB, website/download portal, etc) the charge would be $6.50. If the record is stored in paper and delivered electronically, it would be $6.50 plus $0.01-0.02 per page to scan the record (We are currently conducting a time study to verify the exact charge. This will be completed by Aug 23).
• If the record is stored in paper and delivered in paper, it would be $6.50 plus $0.01-0.02 to scan, plus $0.05 per page for the paper plus actual postage.
For all other 3rd party requests, we are currently charging the regulated rate.
Angela Ford
aford@abtmedinc.com
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