Why Insurance Companies Should Invest in Medical Record Retrieval

Why Insurance Companies Should Invest in Medical Record Retrieval

Insurance companies nationwide are flooded with day-to-day tasks that keep operations rolling. Settling claims, managing coverages, or handling legal liabilities takes up a substantial amount of time and energy — which means other essential tasks may get pushed to the wayside. One of these crucial processes is medical record retrieval.

There are three primary ways of spearheading document retrieval:

  1. In-house teams
  2. Sub-contracting overseas
  3. Outsourcing to a domestic team

All of these methods have their pros and cons, which means it’s up to insurance teams to decide which route best suits their interests and existing processes. However, some certainly have far more positives than negatives — which we’ll cover later on. It’s not uncommon for the price to pay a significant role. Who are we kidding? Money talks.

Whether you’re outsourcing to a dedicated medical record retrieval service for insurance companies or managing the process in-house, it’s an investment. We’re going to break down how these three avenues affect your insurance company’s process and overall success of medical record retrieval.

In-House Teams

If you’re considering an in-house operation or you already have an existing one — here are some important components to consider.

Pros: In-House

One of the biggest reasons why so many insurance companies employ in-house teams is communication and control. You may be able to solve issues quicker with a stroll down the hall. You’re also able to dictate time-management — as your team reports directly to you.

Cons: In-House

While in-house operations for medical record retrieval processes may seem like a sure-fire way to get the job done, there are some downsides. In-house teams are expensive and require a significant amount of work to ensure proper practices are in order. Staffing becomes a primary concern, as your medical record retrieval is only as good as your in-house team.

You may also end up pulling key players away from core competencies. Medical record retrieval is a time-consuming and detail-oriented endeavor, which means that your team needs to be on the ball. You’ll spend a great deal on resources and management to ensure that your processes are going smoothly. Whether it’s ensuring HIPAA compliance, implementing encryption safeguards, or simply making sure deadlines are hit — in-house operations can be a significant undertaking.

The final con is outdated methodologies. As technologies continue to advance, it’s not uncommon for in-house teams to fall behind the curve. For most insurance companies, medical record retrieval isn’t at the focus, which means advanced technology or effective practices get overstepped by more core processes.

Sub-Contracting Overseas

When looking to outsource medical record retrieval, the first options you’ll find will most likely be sub-contracted overseas. Many insurance companies may opt-in for these options due to their attractive price-points.

Pros: Sub-Contracting Overseas

There’s really only one positive to outsourcing overseas, and that’s the price. When sifting through various vendors, the cost will play a major role in the final decision. So, if your only concern is the price — you can certainly find a cheap option with sub-contracting to foreign vendors. Compared to hiring and training an in-house team, implementing software, and managing the whole process — it’s certainly a more cost-effective method.

Cons: Sub-Contracting Overseas

While it’s certainly the cheaper option, sub-contracting overseas comes with some glaring downsides. The first issue is that you’re getting what you pay for. You know the saying: “If something is too good to be true, it probably is.” Outsourcing is no exception. If they’re able to cut costs to such a degree, it means they’re falling short somewhere in operation. Whether it’s inexperienced team members or cutting corners with accuracy, you’re likely to experience some issues here.

Another issue is support. Now, we’re not talking about the language barriers that may make communication difficult — but the time differences. Dealing with time-sensitive and time-consuming insurance processes like medical record retrieval means that each second matters.

This issue intensifies when we look at follow-ups. Managing the retrieval process means constant follow-ups and relationships with record custodians and providers. The same issues that make communication difficult with your organization get exponentiated when we look at the big picture. This is where you may deal with delay after delay as your overseas sub-contractors struggle to properly communicate and relay information accordingly.

Outsourcing to a Domestic Team

Our last and final option is outsourcing to a domestic team that specializes in insurance medical record retrieval. Not only do you get the benefits of outsourcing, but you’ll also receive specialization that pertains to your industry.

Pros: Outsourcing to a Domestic Team

We’ve actually covered a great deal of this in-depth in our Why Insurance Companies Should Outsource article, but we’ll go over some of the key touchpoints here.

  • Speed plays a big role for insurance companies trying to get the most out of their medical record retrieval. Specialized companies that focus on insurance company’s needs know how this goes and can make the process faster from the start. Much of this speed comes from relationships they’ve built over the years with record custodians and providers — making the follow-up process seamless.
  • Accuracy is where things can come to a screeching halt if they’re not handled correctly. Errors in the request phase can cause your team to restart the process entirely, leaving you waiting. It’s not uncommon for errors to occur, but it’s how these are handled that make all the difference. If your team isn’t well-versed in how to manage the process from start to finish, you risk stoppages — which can cause your company time and money.
  • Cost-Effectiveness is obviously top-of-mind for any enterprise, and insurance companies are stranger to budgeting. However, it may come as a surprise that outsourcing can actually be more cost-effective down the road. Time and energy spent on managing an in-house team aren’t free, in fact, it costs several salaries worth, and that’s not including continuous training to keep up with changing standards.
  • Innovative technology is innate with these companies. With their sole focus being on their medical record retrieval customers, they need every edge they can get to make the process faster and more efficient. This means that your dedicated retrieval partner will have the latest and greatest in digital portals, technical safeguards, HIPAA compliant systems, and more.


Cons: Outsourcing to a Domestic Team

While we may be slightly biased, there really aren’t many cons to outsourcing to a trusted domestic partner for your medical record retrieval needs. One negative could be letting go of the reigns, as many insurance companies want to oversee operations internally. We can certainly understand why this could be an issue, but it really comes down to how responsive, or customizable an outsourcing partner’s support staff is.

Another issue may be convincing the boss to give it a shot. While you may see obvious oversights or issues with the current medical record retrieval process, they may not. Convincing them of the benefits could be a downside, depending on your relationship.

Your Investment Reflects Results

If you want to get the most out of your medical record retrieval processes, you’ll need to invest in it. Whether it’s managing the process in-house or outsourcing — what you put into record retrieval is what you’ll get out of it.

Insurance companies rely on medical record retrieval for their claims, coverages, and liabilities — so why not make it easier?