Performs all duties required to fulfill and respond to simple, moderate, and complex release of information requests ensuring accuracy and completeness; complies with federal and state privacy laws according to Kaiser Permanente policies and procedures. Using specialty software keeps track of requests so that they are delivered within compliant turnaround times. Collects fees and reconciles cash drawer if appropriate. Process requests that originate from patients, insurance companies, third party requesters, attorneys, outside providers, regulatory agencies, and other parties who are authorized to obtain patient’s protected health information. Essential Responsibilities: Communicate by telephone, email and letter directly with patients, internal and external customers for authorization and other information required to process medical record requests. Advise patients of processing requirements, estimated time for completion, provider responsibilities, and other factors affecting the request. Meet compliance requirements by complying with all applicable Kaiser Permanente policies and procedures by applying the understanding of policies and using some judgment as to how to best respond to a specific request based on the authorization provided for the disclosure of protected health information. Identify appropriate release type from requests and complete or route as necessary. Recognize PHI requests that might lead to claims or actions against the organization and take appropriate action according to established policies and procedures. Identify and resolve problems in a timely manner and develop solutions and escalate appropriately. Follow protocols when information or clarification is needed from Compliance, Legal, Regional ROI, providers or requestors of ROI. Validate authorizations by consistently using the appropriate authorization checklists to ensure compliance with all applicable Kaiser Permanente policies, procedures and department guidelines. Process medical record requests for patients and other parties who are authorized to obtain patient’s protected health information. Process simple, moderate, and complex forms requests by abstracting appropriate documentation from the medical record onto the requested form and forwarding to the provider for review if required, according to department procedures. Save requested information to PDF Software, according to established policies and procedures and departmental guidelines, and burn CD or flash drive using software (if requested). Log all appropriate requests in the Kaiser Permanente Health Connect-Release of Information tracking system and use detailed remarks in the comment field to track progress of request from beginning to end, based on department guidelines. Run daily incomplete reports to monitor and ensure compliant turnaround time. Copy all appropriate requests and follow department guidelines for scanning to medical record. Email, mail or fax completed forms per the preference of the requester or established guidelines. Close requests in tracking system per department guidelines. Prioritize release of information requests in order to process requests in a timely and accurate manner. Send requests to provider for approval/signature; in basket providers for approval to sign. Follow up with providers to ensure the return of requested information. Interact with patients, third party requesters, physicians and insurance companies and provide education regarding release of information requirements according to Kaiser Permanente Guidelines. Clarify request and obtain additional authorization when needed. Track physician completion of forms. KPHC in basket message responses, and requests for clinical answers to ensure timeliness of completion. Request charts and abstract data from charts or Kaiser Permanente Health Connect when necessary to complete miscellaneous forms, legal requests deemed appropriate for ROMI dept., patient requests or comply with continuity of care and third-party requests. Interpret conflicting documentation in KPHC records according to guidelines and conferring with provider when clarity is lacking for certain release types and documents in comments accordingly. Review archived paper records, KPHC, Digital Images and Diagnostic Imaging, and other legacy electronic records systems in order to produce a complete and accurate legal record set. Included and not limited to point access, Livermore scan, Stentor MainFrame, Center, SFT, PEMR, and Scan on Demand. Process release of mental health and chemical dependency information based on department and regional procedures. Produce records or information in the correct format for the release, including encounter dates, report selection, save to file and ROI letters. Compile daily, weekly and monthly statistics and monitoring reports consistently and accurately in accordance with regional guidelines. Collect and record the appropriate fee from requesters, maintain the appropriate cash balance and reconcile the cash drawer at the end of the day. Complete required annual training courses; apply knowledge learned and stay current on knowledge regarding Kaiser Permanente policies and procedures, federal and state privacy laws and compliance issues. Complete self-assessment of release of information requests. Review all work for completeness and/or signatures as may be required. Copy all requests and scan documents as appropriate. Contact patient for pick up and payment if appropriate. Perform other ROMI Specialist duties as assigned. Perform other duties as assigned.
About Kaiser Permanente
Kaiser Permanente Kaiser Permanente is an integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser Permanente is made up of three distinct but interdependent groups of entities: the Kaiser Foundation Health Plan, Inc. (KFHP) and its regional operating subsidiaries; Kaiser Foundation Hospitals; and the regional Permanente Medical Groups. As of 2017, Kaiser Permanente operates in eight states (Hawaii, Washington, Oregon, California, Colorado, Maryland, Virginia, Georgia) and the District of Columbia, and is the largest managed care organization in the United States.