Medical Records Retrieval for Law Firms

• MODERN MEDICAL RECORDS RETRIEVAL SERVICE – AUTOMATION, COMPLIANCE, SAVINGS

The modern Medical Records Retrieval (MRR) service is a combination of modern web-based technology and a rules-compliant outsource solution. Historically lawyers and their staff would have to set aside a portion of their time, often a lot of time, to capture necessary information for cases that involved medical records. It’s not that the process is complex. Quite the contrary, every attorney, paralegal, and litigation-support person knows exactly what needs to be done.

It may appear simple, but it is a very manually intensive process. Someone at the firm must acknowledge the need for the records. Necessary forms must be completed to ensure compliance with a myriad of laws (including HIPAA), which the firm and often the patient (who may or may not be the firm’s client) would need to initiate a request. Then, the firm must track the progress of the request, and eventually receive, review, and organize the results, or note that there were no medical records available related to the matter.

To support the business of running a law practice, sophisticated and affordable software tools include new client/business intake, workflow automation, and conflicts management. Vendors who provide early case assessment tools and e-discovery-based technology-assisted review have begun to offer solutions for small firm and solo practitioners. In this article, we will show you how you can improve productivity, lower costs, and better manage billing for MRR expenses.

How Medical Records Retrieval Services Work

Here’s how a typical MRR service works for a small firm/solo practice. One of the firm’s employees logs into a secure, encrypted website. He or she then submits an order outlining the patient’s information, the records being requested, and any other data necessary to complete the request. What happens next is truly a game-changing activity. Instead of the firm’s billable resources chasing record requests from hospitals, doctors, and other healthcare providers, they go back to doing other, productive work, while the MRR process self-executes, and eventually provides you with the requested information and documents or informs you that there were no responsive documents.

Questions Regarding MRR Services

The availability of MRR services presents all attorneys, but especially solo and small firms, with the following important questions:

• How do you start with an MRR service?

• How are the record requests processed?

• Is this process HIPAA-compliant?

• When and how am I alerted to the status of my requests?

• How do I distribute the costs/fees associated with outsourcing medical records retrieval?

Choosing Your MRR Provider

To reduce the risk of choosing the wrong MRR service, consider the following best practices:

1) Ensure that the MRR service can prove secure access to its website (and your records) via a login and password.

2) Understand the MRR service’s processes to ensure protection of privacy.

3) Understand its service level agreements, which explain their process and anticipated turnaround time.

4) Verify that the MRR service has experience with expediting record requests by requesting a list of reference clients.

5) Review the process by which you and/or your staff are notified of updates, including record availability or notice of “no record found.”

6) Ask for the MRR service’s price schedule, preferably in a format that will permit you to do an apples-to-apples comparison of the fees of other MRR services.

When possible, a dedicated MRR service is a better choice than a firm that offers a multitude of legal practice services of which records retrieval is only a small subset of their overall business.

Getting Started with the MRR Provider

Upon choosing your MRR provider, the steps to starting to work with the provider are straightforward and similar to those when signing up with any on-line type of service:

• The firm identifies the approved personnel who are authorized to access the secure system.

• A unique user ID is created for the firm at this time, with a strong password required for all future access.

• Often, this is also the time that billing information is provided, and thus a financial account with the firm and MRR is created for future invoicing.

• Each authorized person completes a new user profile and sign-on request. The user must provide email and phone contact information.

• It is the responsibility of the law firm to notify the MRR as soon as possible in the event that an existing authorized user should be removed from the access control. The MRR should remedy and respond as soon as the user access has been removed.

• While the use of the MRR site should be quite easy for most users with minimal training, additional site support generally is available from the MRR’s services personnel via phone or email request.

Safeguarding Privacy

No matter how beneficial the technology, the firm must ensure compliance of federal and state HIPAA guidelines and any ethical rules about maintaining client confidences. Therefore, they must ensure that the MRR service collects, hosts, and provides access to client(s) records while maintaining compliance with privacy guidelines. Note: This should be part of your due diligence when selecting a provider.

The MRR Service should comply with Federal and state privacy laws. MRR services should keep up to date with changing rules of privacy such as the HITECH Act.

MRR agreements should expressly state that no personally identifiable health information (PHI) can ever be used for non-business related activities such as marketing and/or sales lead generation.

Record Processing

Once you have chosen an MRR service and set up your account, obtaining medical records is relatively straight-forward:

• After you enter a request into the system, the MRR service creates an MRR record request connected to the unique ID of the requester (the specific user at your firm), and confirms receipt of the request via an email.

• A reviewer is assigned to assess the necessary actions to fulfill the request, and will notify the user of any questions regarding the record request. In some states, including California, an electronic request can be executed from the MRR service to the healthcare provider, eliminating the need for paper-based transaction.

• The provider then tracks the request, and conducts any follow-up communication by any means available, including email, telephone or in-person visits if necessary, to acquire clear copies of records requested.

• If the record is available and legible, it is scanned into the secure web-based system for access by the user. Otherwise, a “no record found” is annotated to the request, and communicated back to the user.

Communication Is Key

Nothing can be more frustrating to case management than waiting for needed information from a third party. The MRR service must not only forward the record request to the healthcare provider, but also must provide the firm an ongoing and timely response regarding status. Each record must be tracked in real-time with detailed notes from the MRR agents. The MRR service should send alerts if additional information is required, provide replies via email, and deliver the link to download and/or view completed requests as soon as the records become available. Again, during the selection process, you should ascertain the provider’s practices regarding communications, and include them in the contract.

Speed Is Critical Too

Obtaining the medical records timely is critical, whether to respond to discovery, to make or oppose a motion for summary judgment, to get an expert up to speed, or to settle a case. A reliable MRR service will offer a quick turnaround. They have the experience working with medical locations to obtain records faster than a law firm’s in-house staff. After all, a law firm staff member may encounter (or, in truth, may feel like they have gotten stuck with) the occasional medical record search, but the MRR service is a specialist in the process of collecting information, including “no records found.” So, the MRR service’s very job is obtaining medical records, and therefore will have the process down to a set of specific steps, and can support their clients via a web interface.

Relationships With Healthcare Providers

Sometimes hospitals, physicians’ offices, and other healthcare providers may treat the occasional request by an attorney for medical records as an inconvenience, not respond as quickly or perhaps as completely as the attorney or client would like. A smart MRR service will develop long-term relationships with healthcare providers and their staff to get the data needed promptly and efficiently. This will improve the quality of the document production, reduce its cost, and speed the process up.

Database Strength

Medical records often can be in a different location or city than the healthcare provider. For example, billing records for hospitals are usually in an offsite facility, sometimes in another state. With the advent of electronic records, more healthcare providers are centralizing their records offsite with the umbrella company of their medical group/hospital. Without the information on how and where to request records, in-house staff can waste valuable time sending requests to the wrong locations or having to spend the time to find out where to send the requests. A strong database on where and how to request records from healthcare providers therefore is key to save time, ensure complete result, and save money. MRR services have the incentive and the resources to develop such a database. Law firms, especially solos and small firms, do not.

In addition the importance on the database in requesting medical records, it is equally important on the production side. Virtually all medical records are produced in digital format. Records are typically available in PDF or TIFF file format, making them searchable by many document management systems – including on premise, cloud-based, web-based or hybrid systems. They are usually made available for download and/or viewing from virtually anywhere on any device that supports a secure micro-browser. The MRR service maintains the medical records for ongoing access by the user and any authorized personnel.

MRR Costs and other Considerations

The MRR service will charge you for their services. However, because the firm’s resources are freed up to work on activities that generate revenue for the firm, the costs of using an MRR service will be offset at least in part, and perhaps in full. In addition, depending on your fee arrangement with your client, the invoices from the MRR service may be directly billable back to the client or at least accounted for as a recoverable cost. (Many MRR services charge no monthly fees for having an account, and thus the firm only incur fees on a usage basis, which can then be charged to the cases for which they are required.)

Summary

While many firms may continue the “do-it-yourself” approach, solos and small firms should consider using an MRR service. In addition to the higher costs of installing and maintaining one’s own record management system, the soft costs and resource consumption make this a less favorable alternative. A qualified, experienced MRR service offers a cost effective, robust platform for processing, monitoring, and tracking medical records requests. Record management and processing is HIPAA-compliant, always available, and secure-which in-house processes may not be, with the attendant risks. Use of an MRR service does not require capital expense to leverage digitally filed and maintained medical records. Firm resources can be repurposed from tracking record requests to meaningful and fee-generating activities. Client satisfaction may improve as matters are able to be processed more efficiently, and firm business may increase. The results of using an MRR service are measureable and immediate. It’s literally a one-click quantum leap from manual, resource-heavy processes to a modern, digital, secure web based management for your practice.

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