How to Cost-Compare Medical Record Retrieval vs In-House Staff

20 Jul How to Cost-Compare Medical Record Retrieval vs In-House Staff

No matter how you look at it, retrieving medical records will cost your organization money. Whether you handle record retrieval in-house or entrust the process to a third-party vendor, it will be a line item in your budget.

Because medical record retrieval is an inevitable part of legal and insurance proceedings, the primary question is which retrieval option is the most cost-effective. 

Looking to learn how to cost-compare medical record retrieval vs. in-house staff? To answer this question, you’ll need to understand the costs of in-house and  third-party retrieval, then weigh the pros, cons, and economics of both options. This guide will help you determine which retrieval model best suits your organization.

Understanding the Two Retrieval Models

In-house and outsourced medical record retrieval processes have the same goal: To obtain and store patient medical information for use in a court case or insurance claim. But the way these models operate — and their advantages and challenges — can differ.

In-House Record Retrieval

Organizations that opt for in-house retrieval rely on employees to manage all aspects of the process. From submitting record requests to organizing and storing files, 100% of the responsibility falls on the staff.

Naturally, there are benefits to in-house retrieval. When you handle record retrieval internally, you maintain control over the process from start-to-finish. You establish workflows, choose technologies, and manage relationships with healthcare facilities.

However, these advantages also come with drawbacks. Medical record retrieval is a complex, time-intensive process with little room for error. Unless you have a dedicated admin team handling retrievals, your staff will have to fit record management into their busy schedules.

Outsourced Record Retrieval

Organizations that outsource the process hire a trusted third party to provide medical record retrieval services. The vendor fields all requests for medical information, acting as a liaison between the healthcare facility and the law firm or insurance company.

There are several benefits to outsourcing record retrieval. Instead of relying on employees with diverse job duties to handle this compliance-heavy task, organizations can partner with record retrieval specialists. These experts already have working relationships with healthcare providers, as well as proven, secure, and efficient processes.

Of course, selecting the right record retrieval partner requires careful evaluation. Comparing providers, assessing their capabilities, and validating their track record takes time and effort. However, the right partner can streamline the record retrieval process, improve efficiency, and help reduce the administrative burden on internal staff.

Calculating In-House Staffing Costs

The cost of in-house record retrieval is layered, and it’s not always easy to calculate the money spent or the ROI it brings. The first step is determining which expenses are related to managing medical records. Associated line items include:

• Employee salaries – Every hour spent managing medical records is an hour that could otherwise be spent on revenue-generating activities. If employees need several hours each week for retrieval, the salary costs can add up quickly.
• Benefits – Expenses related to health insurance, retirement plans, and paid time off for internal staff should also be accounted for when tallying up retrieval costs.
• Administrative expenses – No calculation is complete without including the salaries of the HR and management teams who oversee the staff, as well as the licensing fees for any retrieval tech.
• Training – The intricacies of record retrieval call for extensive (and oftentimes expensive) initial training. And because software and security best practices are constantly evolving, employees require ongoing professional development.

Evaluating Outsourced Retrieval Costs

Outsourced record retrieval comes with an entirely different list of costs. These include:

• Service fees – The most significant line item for outsourced services is the cost of the service itself. Depending on the provider’s pricing structure, you may have to pay for consulting fees, sign up for a monthly subscription, or agree to a pay-per-service model.
• Technology access – Each provider of medical record retrieval solutions uses software to manage the process. Some even have their own proprietary platforms. In any case, you’ll typically pay for access to these technologies.
• Vendor management expenses – Hiring a third party has initial and ongoing costs. Internal employees still have to onboard vendors, oversee their contracts, and monitor their performance. Vetting takes time, too. These internal labor costs should not be overlooked.

Comparing Productivity and Efficiency

When you’re comparing in-house and third-party retrieval costs, the price tag is only the beginning. Even if one option seems more cost-effective than the other on the surface, further investigation can prove the opposite.

That’s because the medical record retrieval process impacts the quality and efficiency of all the work around it. Upfront cost savings may seem appealing, but choosing the wrong solution can lead to bottlenecks and mistakes down the road.

With that in mind, there are three productivity and efficiency considerations to factor into any cost calculation.

Turnaround Times

Under HIPAA law, a healthcare facility must provide requested medical documents within 30 calendar days. However, it’s possible to obtain records much faster. That is, if you understand the nuances of the process.

Internal employees who don’t specialize in record retrieval may not be able to speed up turnaround times. Third-party experts, on the other hand, know how and when to follow up, and with whom. At American Retrieval, we pride ourselves on having one of the fastest turnaround times in the industry.

The sooner your organization can receive a medical record, the sooner it can start strengthening the case or completing the claim. In other words, a slow turnaround time can cost you. Delays can lead to missed revenue opportunities and a loss of client trust.

Ultimately, choosing a fast and accurate retrieval option is a wise move, especially for organizations that handle large volumes of medical records.

Workload Management

The in-house vs. outsourced conversation would not be complete without factoring in productivity.

The truth is that medical record retrieval for lawyers and insurance professionals is complicated. It takes time. When you handle retrieval in-house, your employees have to dedicate hours each week to submitting requests and follow-ups.

Outsourcing allows you to offload this work onto another party. By reducing retrieval workloads, internal employees can focus on strategic case work, client service, and other revenue-generating activities. In many cases, the value gained outweighs the cost of outsourcing.

Scalability and Resource Flexibility

In-house retrieval may be fine when volume is minimal. But what happens when the need for medical records suddenly skyrockets?

The in-house model leaves little room for flexibility. As workloads increase, organizations must either hire additional staff, which can take months, or place additional demands on existing employees, which increases the risk of costly mistakes or non-compliant retrieval.

With a third-party provider, you can scale up and down to match your retrieval volume. External experts are ready to submit and manage any number of record requests, whether it’s 30 or 3,000.

This flexibility is invaluable, and it’s worth accounting for when comparing costs.

Compliance and Risk Considerations

There are also costs associated with maintaining compliance and data integrity. The extent of these expenses depends on whether you choose in-house retrieval or a third party.

Considerations include:

• Security – All records must be transferred and stored securely. This type of infrastructure requires a costly setup. If you opt for in-house retrieval, your organization has to foot the bill for hardware, software, and labor. If you partner with a third-party solution, the security infrastructure is already in place, potentially saving you tens of thousands of dollars.
• Regulatory requirements – Both in-house and outsourced record retrieval solutions can meet HIPAA and HITECH requirements when managed in compliance with applicable regulations. However, internal administrators may lack the nuanced experience needed to adhere to them. Working with a third party eliminates most of the costs of compliance training and consulting.
• Quality assurance costs – Ensuring data accuracy and completeness is another piece of the puzzle. Doing so in-house means completing time-consuming audits and implementing user controls. With a third-party provider, these functions are typically built into the service.

All these considerations influence the total cost of medical record retrieval. What’s more, security breaches and non-compliance can lead to significant penalties; a HIPAA violation can incur fines of more than $2 million.

Creating a Total Cost of Ownership Analysis

To compare internal and external record retrieval properly, consider analyzing the total cost of ownership (TCO). Simply tally up all the direct and indirect costs of both options, then use the results to make an informed decision.

A thorough TCO analysis should cover every cost, from start to end, including expenses related to:

• Onboarding
• Employee training
• Salaries and benefits
• Administration
• Software costs and subscription fees
• Data migration
• Maintenance and support
• Compliance and security requirements
• Data disposal
• Vendor relationship management

Once you assign a dollar value to each of these variables, your choice should be clear.

Choosing the Most Cost-Effective Retrieval Strategy

There is no single, straightforward answer in the in-house staff vs. medical record retrieval service debate. The best approach depends on an organization’s specific needs, resources, and priorities. For some, handling retrievals internally may make sense; for others, the exact opposite.

What’s important is making an informed decision. When you understand how to cost-compare both retrieval options, you can identify which one is right for your business. Remember to account for both the direct and indirect costs, as well as the opportunity costs associated with each.

If partnering with an external provider is the best option for your organization, consider American Retrieval. With more than 30 years of experience, we provide fast, reliable retrieval services at some of the most competitive rates in the industry.

Book your demo to discover how American Retrieval delivers cost-effective medical records retrieval solutions for organizations of all sizes.

Sources: 

U.S. Department of Health and Human Services. How timely must a covered entity be in responding to individuals’ requests for access to their PHI? https://www.hhs.gov/hipaa/for-professionals/faq/2050/how-timely-must-a-covered-entity-be/index.html

The HIPAA Journal. HIPAA Violation Fines. https://www.hipaajournal.com/hipaa-violation-fines/