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requests completely online. A growing number of ROI service companies are adopting this automated platform to dramatically reduce their existing cost of operation, improve disclosure reporting, and enable their Provider clients to enjoy real-time oversight of the ROI process.
In conclusion, the traditional “free service” marketing model used by many ROI service companies is likely to become less viable in the near future. The inevitable paradigm shift from “free outsourcing service” to “fee for outsourcing service” will, for the very first time, shift the financial burden for ROI fulfillment processing onto the Provider. ABT Medical’s ROI+ platform represents an opportunity for practices and hospitals to manage their own ROI request processing, while capturing the total ROI-based fee revenue allowed by state statutes, and to easily meet all HIPAA compliance reporting requirements. In addition, ABT’s ROI+ service company affiliates will be able to offer “fee for outsourcing service” to Providers at rates far less than other outsource ROI service companies.
Article adapted from Steven W. Kaeppel’s NBW Healthcare Resources blog:
Steven W. Kaeppel is COO of NBW Healthcare Resources, a Fort Worth-based medical service consultancy for specialized medical practices, clinics, and hospitals.
Additional ROI reading: ”The Changing Face of ROI” by Cassi Birnbaum, MS, RHIA, CPHQ in For The Record, December 2012.
ROI Fee Confusion: Overview
There is mounting concern in the healthcare industry as to whether the HITECH Act takes precedence over state statutes when it comes to ROI fulfillment fees. To date, there has been no definitive legal precedent established by a court ruling in this matter, although class action lawsuits have been filed against Providers and their ROI outsource service companies.
In light of this ominous potential legal burden, Providers in various parts of the country have chosen to avoid becoming embroiled in lawsuits by structuring their own ROI fees or adhering to HITECH fee specifications, while ignoring state fee statutes.
A large 22-hospital chain in the Northwest has discontinued charging for all requests for patient medical records, with the sole exception being requests from Disability Determination Services. Similarly, one of the largest hospitals in the Southeast is charging less than eight cents per page for billable requests specifically to avoid any exposure to ROI fee-based litigation.
What we see is a more fundamental question at issue here. It isn’t the amount of the fees themselves that is causing such turmoil; rather, we are witnessing a classic case of federal versus state jurisdiction. At this moment, the fear factor over ROI is rooted predominantly in large hospitals, which are more exposed to community pressures than smaller Providers, such as physicians and clinics.
ROI outsource service companies will be greatly impacted. As Providers continue to mandate “low/no fee charges” for ROI fulfillments, the service companies will need to compete against each other based on who will do the work on a “lowest cost” fee basis, without the substantive ROI fee income that they enjoy in today’s market.
Recent ABT Medical ROI+ Affiliate Successes (continued)
Seton Medical Management:
Seton Medical Management manages Providence Health System’s physician network, which has thirteen practices and more than 70 physicians offering primary and specialty physician services in southwest Alabama and southeast Mississippi. Seton Medical Management is the area's largest non- profit health system, serving patients through their many health facilities in Mobile and surrounding areas.
Version 2.0
Coming in April 2016
ROI+ is being completely redesigned to improve processing efficiency as well as to simplify system performance, the tracking of medical records requests, and compliance reporting. Real-time, concise activity consoles will replace the traditional reporting features. For instance, with a single click of a mouse, users will be able to view request fulfillment status for the last eight weeks.
A new user interface will greatly improve feature/function navigation within the platform. Request processing will be divided into three clear and easy steps, and users will be able to exit and re-enter each request right where they left off. Version 2.0 will also support both in-line and batch request processing.
A vastly improved Account Receivables module will make tracking unpaid invoices much easier and more effective.
Angela Ford
aford@abtmedinc.com
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