·Disclosure Management of Protected Health Information (PHI)
Review each component of an authorization to release medical records to ensure it meets HIPAA requirements. Coordinate the routine disclosure of copies of medical records adhering to 'minimum necessary' requirements to patients, families, legal guardians, insurance companies, third party payers, attorneys, etc. when a HIPAA compliant authorization has been obtained according to hospital policies and federal/state regulations. Process requests in an accurate and timely manner consistent with established department standards. Denies requests when appropriate per departmental policy and regulations. Process STAT requests from Primary Care Providers and Specialists when needed for immediate patient care, adhering to HIPAA Minimum Necessary guidelines. Coordinate obtaining required PHI from Billing, Ambulatory and other Outpatient departments as well as from off-site storage for release. Calculate and create an invoice, when needed, for records according to State regulations and departmental policy. Accurately credit appropriate requestors for balance due when records are picked up or mailed.
·Disclosure Management of PHI (continued)
Handle cash and credit card transactions in an appropriate manner. Continuously follow up on requests placed on hold to meet turn-around time requirements. Perform follow up on the Pre-paid list to ensure timely release of information. Assist patient/families/legal guardians with accounting of disclosure requests. In the absence of a HIPAA compliant authorization, disclose PHI in the course of any judicial or administrative proceeding: In response to an order of the court, disclose only the PHI expressly authorized on the order; in response to a subpoena, if CCHMC receives satisfactory assurance that the individual who is the subject of the PHI has been given notice of the request. Ability to identify requests that must be included in an Accounting of Disclosure. Applies education and training to daily work to enhance job knowledge and skills.
Provides meaningful and timely feedback in a professional manner to intradepartmental, organizational, and external customers. Prompt, courteous and professional telephone and in-person customer service. Work with requestors to facilitate the processing of requests/questions in a suitable timeframe according to established departmental standards. Provide timely feedback to requestors regarding the status of all requests (valid and invalid). Develop and maintain strong effective working relationships with medical center staff in order to facilitate obtaining medical record documentation from decentralized shadow medical records.
·Productivity and Quality Assessment
Performs secondary HIPAA compliance validation of all authorizations for Release of PHI. Performs quality review of data entered into the Epic HIM ROI module by HIM Documentation Integrity Technicians. Reviews scanned images reproduced for release to ensure image quality and that all documents belong to the patient whose records are being released. Notifies appropriate HIM personnel regarding issues found. Maintains productivity and measurement statistics. Consistently meets department productivity and quality standards. Maintains a neat and functional work space that is organized, safe, accessible, and that provides an effective and efficient environment for employees, patients, and families.
Participate in the analysis and testing of software, hardware and process changes. Utilize knowledge to maneuver through a variety of documentation systems used throughout the medical center for the purpose of obtaining information for disclosure. Accurately, and in a timely manner, track all requests for copies of medical records and subsequent communication related to requests via the Epic HIM ROI module. Assist in problem resolution regarding issues with disclosing protected health information out of multiple electronic systems. Electronically transfer PHI to the Social Security Administration and Hamilton County Jobs & Family Services via secure web site. Scan x-ray films into the Radiology Digitizer, and upload images into the PACS Computer application. Utilize knowledge of electronic health record (EHR) maintained at the hospital to coordinate the disclosure of medical record copies from decentralized electronic systems and clinical departments within the medical center. Differentiate between the types and content of patient health records such as paper-based, electronic health records, personal health records, etc. Ability to operate a multi-line telephone, copier/printer/fax machines, and microfilm reader/printer.
·Serve as a Resource
Serve as a resource to customers regarding disclosure rules and policies. Maintain currency in the field through continuing education, literature, and seminars. Implement this knowledge into daily processes. Participate in project management for performance improvement teams, departmental planning sessions, as well as other organizational meetings as requested. Function as a team member in the Release of Information area in relation to process improvement, performing new procedures, collecting data and providing input to department discussions.
Provides leadership and guidance to HIM Documentation Integrity Technicians. Assists patients/families with accessing their PHI through use of the Epic MyChart patient portal. Troubleshoots advanced issues, including but not limited to issues with equipment and locating medical record documentation. Performs third level troubleshooting in response to inability to locate needed records, failure of technical equipment, engaging additional resources as appropriate. Oversee HIM student interns and volunteers as assigned.
Actively participates in departmental and/or organizational Performance Improvement projects as assigned. Function as a team member in the Release of Information area working collaboratively to improve processes, perform new procedures, collect data and provide input to department discussions. Participate in project management for performance improvement teams, departmental planning sessions, as well as other organizational meetings as requested.
Maintain currency of all State, Federal (HIPAA and HITECH Acts) rules/regulations, CCHMC and HIM department policies procedures related to disclosure of PHI. Apply this knowledge into daily processes. Review learning needs with direct manager to set individual education and learning goals annually.
·Work Flow - Basic
Basic understanding of work flow
Working cooperatively with others to achieve group goals; proactively adjusting one's style and efforts to complement those of others on the team; being pleasant, agreeable, and easy to work with; valuing group success as much or more than individual success
·Communication - Advanced
Excellent verbal, written and/or interpersonal communication skills. Understanding of medical terminology. Excellent phone etiquette including listening skills and situational problem solving skills
Possess strong organization skills and attention to detail
·Independence and Teamwork
Ability to work both independently and in a team environment. Participates collaboratively in staff meetings, committees, projects and teams to resolve conflicts and/or meet institutional goals. Is recognized as an informed participant or committee member by peers and HIM management
Proficiency in basic computer applications such as Microsoft Office, e-mail and internet. Ability to use multiple electronic medical record solutions utilized at CCHMC to store the official medical record. Ability to differentiate between primary and secondary systems and data bases
·Analysis - Advanced
This position requires a complete understanding and awareness of the rules of confidentiality and the State and Federal Laws pertaining to release of protected health information. Ability to analyze data to make judgments and recommendations e.g. understanding language contained in subpoenas and court orders to determine appropriate action for release of PHI
Being open to change and considerable variety in work activities; effortlessly adjusting to new or changing situations and unexpected events; altering one's approach to tasks and projects with minimal loss of efficiency. High level of adaptability
Critical thinking skills, with ready understanding of complex concepts and legalities regarding healthcare issues. Ability to independently work through details of a problem under stressful and rapidly changing conditions to reach a positive solution. Ability to act quickly to analyze discrepancies in often real-time patient care and safety situations
Expressing oneself verbally in an accurate, understandable, and succinct manner to individuals or groups; using appropriate non-verbal signals to emphasize spoken words; adapting communication style and tone to fit the situation and audience; demonstrating poise during group discussions or formal presentations; holding others' attention; responding clearly and tactfully to questions
Demonstrates an independent work initiative, sound judgment, diplomacy, tact and professional demeanor
·Cust Service/Conflict Res
Able to handle sensitive issues and defuse frustrated and/or angry individuals both in person, and on the telephone, while recognizing when to escalate to an HIM Manager
Demonstrates the ability to work with a diverse group of people. Understanding and showing respect and appreciation for the uniqueness of all individuals; leveraging differences in others' perspectives and ideas; appreciating cultural differences and adjusting one's approach to successfully integrate with others who are different from oneself