Top Reasons Not to Outsource ROI

By Cherry Spencer, Director of ROI Operations

After beginning my career in healthcare in health information management (HIM), when a release of information (ROI) position became available, I thought I’d try it out. Twenty five years later, I’m still working in ROI. Today, I am thrilled to lead the ROI services team at Moxe. 

I joined Moxe about two years ago because I was excited about how they were harnessing technology to automate ROI workflows, making them more efficient, secure, and accurate. I saw how technology was not replacing the need for people, but allowing skilled staff to focus more on things that benefit from a human touch and add value to an organization.

It’s an exciting time for ROI. We’re continuing to see technology transform processes and add value. Not all technology (or the teams who steward that technology) are created equally, however, and I understand that provider organizations still have many concerns when thinking about outsourcing ROI requests. While their concerns are valid, my tenure at Moxe and deep experience in ROI allows me to confidently say that Moxe does things differently. 

Top concerns from provider organizations

• We’ll lose transparency. This is a valid fear! It can be disconcerting to go from being very hands on with requests to outsourcing all or a portion of requests. Provider organizations worry: How will we know requests are being fulfilled in a timely manner? How will we know the right data, and nothing more, is being sent to the right people at the right time? 

Transparency is not just essential to our work at Moxe, it’s one of our core values. We offer state-of-the-art reporting that allows providers to pull up-to-date reports they want at any time. Whether they want to look at turnaround times, request volumes by timeframe, etc., our reporting platform allows providers flexibility to get the data they need in near real-time. 

In addition to our reporting platform, we ensure transparency in our communication with customers from the very start. When a customer decides to partner with Moxe, we do a deep dive to understand how they release medical records today, how they’d like each request type to be handled moving forward, etc. It’s essential for us to understand each customers’ current state and their future, ideal state so we can tailor our solution to best meet their needs. As our partnership with a customer continues, we pride ourselves on communicating transparently and often. 

• Our data will be sent offshore. While there is currently no published measurement that tells us exactly how many U.S.-based ROI service companies use offshore labor, it’s safe to say it’s upward of 60%, based on adoption rates in adjacent healthcare operations sectors. We agree that sending patient information offshore is a risky proposition. Not all countries share the U.S.’s stringent privacy laws. What happens if there is a data breach in a country that doesn’t have the same laws around protected health information (PHI)? If a breach does occur offshore, enforcement mechanisms are also more limited. In addition, offshore teams often show higher error rates and more issues with incorrect redaction. Ultimately, while using offshore workers may reduce the hourly labor cost, there are substantial risks, including HIPAA exposure, PHI mishandling, lower accuracy, and a higher need for rework. 

At Moxe, our entire ROI services team is U.S.-based, which means we never send patient data offshore. Being based in the United States is just a baseline qualification. I believe our ROI team has some of the best, brightest minds in the industry. Our team members have a very high work ethic, and they truly care about the patient. At the heart of excellence in ROI is an understanding that behind every request there is a patient. Our team not only understands that, they are truly committed to making sure the patient is taken care of.

At the heart of excellence in ROI is an understanding that behind every request there is a patient. Our team not only understands that, they are truly committed to making sure the patient is taken care of.

• It increases our security risk. It’s true that sharing patient data with third-party vendors can increase the risk that data is exposed. That’s why it’s so important to only trust vendors who place the utmost value on data security and have the certifications to prove it. 

How do you know a vendor values data security and has the technology, processes, and expertise in place to effectively safeguard it? We recommend requesting a copy of the vendor’s SOC 2 Type II certification to determine adherence to HIPAA and HITRUST. In addition, we use a number of tools to ensure what is happening on and through traffic in and out of our systems are all safe: Endpoint Detection and Response (EDR), continuous penetration testing through Sprocket, and security and incident management (SEIM) through Blumira. We also use Snyk to scan our code and third party applications in our environment to make sure that patches are applied quickly and that the code we deliver to our production environment is as safe and secure as possible. 

In short, we are obsessed with data security and protecting the patient information with which we are entrusted.

• We’ll lose revenue. If ROI requests are fulfilled in-house, that’s part of your revenue stream. We recognize that healthcare organizations are operating on thin margins. Every dollar counts, and resources must be used effectively. 

Moxe’s FHIR-enabled technology allows us to process requests faster than the industry average. When staff use the best technology, the efficiencies gained allow Moxe to reduce our cost, or in many cases, offer our customers a revenue share.

This allows health systems to continue to realize the revenue while freeing up your staff to focus on other high priority initiatives. It’s also worthwhile noting that our quality rating is 99.999%!

This was the case for one regional medical center that recently shared how partnering with Moxe delivered tangible value over the course of a year. While you can read the full case study here, some of the outcomes include responding to over 27,000 requests, saving 5,647 manual hours, and reducing the average request turnaround time from 7-8 to 1.5 days. 

As I mentioned before, all of these concerns are valid. When considering partnering with a third-party organization for ROI services, it’s important to understand how they proactively work to derisk each of your concerns. 

What’s next for Moxe’s ROI services team

Over the past two years, it’s been humbling to see our ROI services sector grow more than 7x! More and more provider organizations are placing their trust in our ROI experts and tech-forward solutions. It’s a testament to the great work our services team is doing and how our technology is informed by a deep understanding of ROI workflows and the importance of trust and transparency in data exchange. 

As I think about what’s next for ROI and what I hope we can give providers, I’d like to see even more manual processes become automated. We recently went live with automating fax ingestion, a big win. We’re working towards automating more quality checking, which would allow us to do even more with less resources. 

It’s a gift to be in a position where I get to witness what happens when powerful technology is placed in the hands of committed, experienced ROI experts who are personally invested in the success of their customers. It’s an honor to lead the ROI team, and I look forward to helping them continue to exceed expectations. 

Are you interested in learning more about Moxe’s ROI services? Please reach out, and we’ll be in touch soon!