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Record Abandonment -Identify RIM Provider Alternatives?

Who pays the bill when the company declares bankruptcy? When a practitioner retires and/or meets an untimely death–who pays the RIM service invoice?  What about the outstanding invoices when a practitioner closes a “single practitioner” office and joins a large consortium practice or medical school? As an example, who pays the invoice for those boxes of records sitting on a shelf in the record center (when he indicates he no longer needs them)? These records have outlasted their usefulness for the physician.  However, based on the state Medical Board requirements, the RIM provider understands he continues to be responsible for managing clinical patient records for the duration of the retention period.  So goes the potential standoff!

Throughout the RIM industry, providers at one time or the other have had to consider similar examples.  Getting the invoice paid may not be as difficult as finalizing the disposition of abandoned records that are deemed confidential due to the nature of the content. Inheriting boxes or media containing current, historical business or health care records can be a major business challenge. Every RIM service provider will face that possibility.  It is just a matter of when and how many boxes or tapes you will have in your custody.  Knowing and understanding State regulatory and accrediting body standards is a key element to a RIM provider’s action plan and best business practices.   Be prepared to act rather than react!

I-Sigma will soon release the latest version of an industry Service Provider Contract.  Three specific forms of Record Abandonment are referenced in the document:

Abandonment by Non-Payment – Client’s non-payment of account after and/within a designated period-of time (as stipulated in the client/provider contract) becomes the responsibility of the client owners, partners, etc.; to include expenses of removal and disposal of materials

Abandonment by Absentia – RIM provider is unable to locate the client or responsible parties; after documented reasonable attempts, the client then agrees the RIM provider will not be responsible for the consequences of the removal and disposal of materials.

Regulatory Obligations – The client concurs that their abandonment of personal data is a violation of current data/privacy protection laws and regulations; Client, owners, partners et al., are subject to all implications of the laws and regulations. Responsibility for regulations of the disposition of abandoned materials and/or required retention expectations will remain those of the client, et al.

Options for Recourse

Legal agents for bankruptcy and estates provide for the dissolution of outstanding debt as it relates to abandoned records and collections. Management of the physical data over the balance of a retention period may not be an agent’s specialty.  RIM service providers are challenged with the responsibility of providing cost estimates for long term management, removal, and ultimately confidential disposal. Perimeters must be based on documented regulatory and industry-specific retention and privacy. standards.   Depending on the type and archival value of the data within a record, RIM providers may be asked to provide costs estimates for services to include long-term management of authorized file request, scan on-demand of documents to entities per requests and related data access as defined by the type of data within a record. Just as with any controlled access to a client inventory, a well-described internal process for management of these types of requests is critical.  Long-term management services may be proposed for the balance of the retention period with reimbursement based on an “all in, one-time” payment by the agent managing a client bankruptcy or estate.  This reimbursement method may allow the client agent to proceed with closing out the bankruptcy and/or estate case file.

Health and Mental Health Aspects of Abandoned Records

Fortunately for the RIM industry, the American Medical Association, individual medical associations, and related Professional Associations in the health care and mental health realm do not look kindly on those who abandon records. State, regulatory and accrediting body standards ensure that professionals accept responsibility for maintaining and safeguarding patient/client records.   Individual state professional licensure organizations provide on-line references to ensure an understanding of practitioner requirements and responsibilities for the management of both physical and electronic records.  As stated above, RIM professionals may be asked to provide long-term management services of data from an Electronic Health Record (EHR) or a hard copy record. Various states have passed legislation defining when a governmental agency may also take possession or custody of patient records that have been deemed “abandoned”.  Knowing respective state standards enables the RIM provider to navigate the process more efficiently.

Legal Course of Action

As in all business transactions, a legal course of action to resolve abandonment of records and/or related collection issues is always an option.  Minimizing exposure to such occurrences is the first step in a pro-active plan. A RIM provider action plan must include well-documented processes with clearly defined standard operation procedures (SOPs) for account management by Operations and Accounting. Timely debt collections and receivables tracking ensures focus on those clients who have the greatest potential for default or abandonment of records. Well designed, legally binding service provider contracts are the essential element of good business practices.  The depth of a binding contract is instrumental in a RIM provider’s ultimate success when addressing abandoned record scenarios.

By Gail W. Bisbee, RN, BSN; PRISM SME