Solving the HIM Challenge of Managing Seasonal Spikes in Chart Requests

With shrinking budgets and limited resources, HIM teams are looking for ways to manage the daunting volumes of chart requests that come from payers during HEDIS^® and Medicare Risk Adjustment seasons. Payers are under pressure to collect complete, accurate data about their members in a timely manner to support quality improvement initiatives and optimize their risk.

The administrative strain and cost of providing accurate data to payers—especially the volume that comes with HEDIS and Medicare Risk Adjustment (MRA)—coupled with the existing financial burden at health organizations today presents a challenge with direct financial consequences.

Atrium Health, an integrated, nonprofit health system of 40+ hospitals, was recently faced with a similar challenge when a large payer asked for 30,000 charts to be processed with a two-week turnaround time.

Their existing manual processes weren’t going to be enough to deliver on time and Hannah Sorgius, HIM Director at Atrium, knew her department needed to consider a new way of approaching clinical data exchange.

Atrium faced three key challenges:

1. Keeping up with chart retrieval volume during HEDIS and MRA seasons took resources away from patient-centric initiatives.
   
   
2. Eliminating unnecessary release of information (ROI) requests and ensuring their teams were prioritizing the requests that needed to meet turnaround time obligations.
   
   
3. A frustrated staff who were spending too much time dealing with third-parties and were working overtime in the face of mounting workloads.

To solve the problem, Atrium partnered with Moxe to automate chart requests and digitize ROI to meet the 70,000+ HEDIS and MRA requests they needed to process.

Previously, Atrium’s manual ROI process required one staff member to pull 20 charts per hour. Integrated directly within their EHR, Moxe’s Digital ROI™ solution allowed Atrium to securely meet release of information restrictions while processing thousands of charts per hour.

Atrium’s HIM team was left enabled to better focus on patient and continuation of care requests. Sorgious explains, “Moxe reduced manual labor in several areas: pulling charts, answering phone calls, tracking down requests, sifting through faxes, and conducting call backs.”

Get a by-the-numbers break down and learn more about how Digital ROI helped Atrium Health by reading the case study.