Retrieval Nerds Put the “Order” in “Law and Order”
In October 2023, MTMP Magazine Editor-in-Chief Sara Stephens talked to Jay Jenkins, VP of Client Services for T-Scan—and a bonified “retrieval nerd.”
This is the kind of guy who can’t contain his excitement when he gets a particularly difficult record in the door. He gets equally bummed if a case settles before he pulled a record through.
“Back in the day when T-Scan started, it was just a few of us who would get excited about getting that record out of that hospital,” Jenkins said. “Through the years, we found a whole bunch of people who share our excitement. Basically, we are a bunch of nerds who like what we do. We think it is a service that helps people. We like serving the firms, and we like knowing that somewhere along the line, we helped someone resolve their case. It’s fun.”
MTMP: What are the biggest challenges law firms face in record retrieval?
JJ: I would say the biggest challenge is just how complex record retrieval has become. Those outside the retrieval industry, and even some within, have a misconception that retrieving records is a simple task. After all, we have a signed authorization, we send it to providers, and providers release the record. Piece of cake. These days, yeah, not so much.
MTMP: What’s changed?
JJ: Twenty-odd years ago when we began, the biggest reason for a firm to outsource was simply labor cost. But now, large volume or not, gone are the days when a single person in a firm could handle the request from beginning to end. It takes a team of people and a suite of software applications to efficiently request records. Record retrieval has become a complex task requiring a high degree of accuracy and performed within an increasingly complicated and volatile landscape.
MTMP: So, which would you say is a greater factor in records retrieval—technology or people?
JJ: The biggest challenges in record retrieval are securing an experienced labor force with a thorough understanding of what is now required, and maintaining a robust, and expensive, technology platform.
Despite this massive technology requirements, the human element is more important now than ever. Legal medical record requests are last in line at a healthcare provider’s release of information desk. A record custodian’s focus is to ensure the patient’s care providers have access to needed records. Our job is to get the provider to pay attention to our request and release the record in a timely matter. This task takes diligent tracking, a working knowledge of HIPAA, HITECH and jurisdictional requirements, and exceptional communication skills.
Here in our post-pandemic world, several hospitals and other providers have severely cut staff. What remains is an overworked, and at times inexperienced, custodial staff. It is surprising how often we, as a retrieval service, are called on to educate the providers on their requirements for the patient. The retriever needs to be able to articulate the urgency, the requirements and the regulations surrounding requests to the provider.
In terms of technology, we have clients that have invested heavily in practice management solutions to accommodate a hybrid work environment while maintaining efficiency and office cohesiveness. We have had to do the same. Then, at the same time, release-of-information practices are changing almost daily due to legislation or technology. Tracking and understanding the various entities’ technologies associated with release of records is a job within itself.
The biggest challenge faced by law firms is assembling a team to handle a task that gets more and more complex.
MTMP: What do law firms look for in a retrieval company?
JJ: The first two questions a potential client asks—always—is “How much does it cost” and “Do you integrate with system “a”?”
Now, I have an accounting team in one ear and a tech team in the other. In one ear, the accounting team always—always—wants to make sure I emphasis our cost effectiveness, our accounting capabilities, our value. In the other ear, the tech team always—always—wants to make sure I talk about tech and how we can blend seamlessly into management platforms through our many integrations, our security, our provider access, etc.
Our tech and accounting teams are proud of what we provide to the firms—and rightfully so. So am I. So, we always—always—talk about it. And so does every other company. Absorbing retrieval tech costs and integrating with a firm’s software is mandatory at this point. Both those items, while certainly not easy, are the baseline to what a retrieval company needs to execute for the firm. To me, those pieces are only part of the equation. In my opinion, firms should demand and expect more.
MTMP: What are the other parts of the equation?
JJ: I always—always—want to emphasize, both internally and externally, are experience, training, and people.
Getting the job done takes an experienced retrieval team with excellent communication and critical thinking skills. That is something I never hear other companies talk about. Rarely do firms even ask about who is doing the work. Like I said, people want to think retrieval is easy. It isn’t. It never has been. If it was, companies like us would not even exist. Tech and price are just the starting gate. It takes expertise to get across the finish line, now more than ever.
MTMP: What does the people component look like at T-Scan?
JJ: On one of our whiteboards, written in permanent ink, is the phrase “make it simple.” Our whole job is to make it simple. We take responsibility for tech and labor functions and make it appear simple.
Each client here has:
- A single point of contact simplifying communication
- Procurement specialists simplifying provider communications
- A technology team simplifying record access to thousands of providers
- A quality control team simplifying the intake and delivery of millions of pages.
Hundreds of specialized employees gathering millions of pages from thousands of providers available to clients via one point of contact. Make it simple.
MTMP: What else should a law firm look for in a retrieval company?
JJ: After the cost and integration question, the next questions a law firm should ask are:
- Can I trust you to get every record available in a timely manner?
- How do you safeguard my client’s information?
- Can you scale to the demands of my caseload?
If you find a company that says they cannot safeguard the information, you may want to call T-Scan right away.
MTMP: What makes your record retrieval service particularly relevant to mass tort attorneys?
JJ: We have been doing Mass Tort work for over twenty years. I age myself when I tell you that my first Mass Tort work was in Fen-Phen—and I could tell stories about receiving eight bankers boxes of single- page authorizations and being told to have the authorizations in the providers hands within 24 hours, which we did—the majority by old school fax machine. Tech has changed, but two decades of Mass Tort work has not. With or without tech, we get records.
If a firm is looking for a partner to retrieve records to help the client resolve the case, we are the firm people call. We have core clients going back with us for 20 years not because our invoices have the lowest line items or our tech can make a PDF sing at this point but because we are the most cost-effective and most reliable service for their clients. We get the records. We help the cause. And we make it simple.
MTMP: How does T-Scan gear itself to adapt to changing technology and incorporate innovative new solutions?
JJ: This is such a great and timely question. Since our inception, we have always been forward looking, not only in terms of labor efficiencies but also technology. Historically, most technological innovations were between T-Scan and law firm clients or implemented to create internal T-Scan efficiencies. Today, nearly all our developments and adoptions are focused on the technology and processes that must interact with the patients, clients, and providers.
MTMP: What are some of the common risks attorneys face in record retrieval?
JJ: The most common risk is simply not getting the records. Retrieval is a task full of minute details. Missing one can delay records by weeks. For example, there is a state that requires authorizations to be at least 14-point font with providers who measure that font and will reject any authorization that do not measure up. A font error there just cost the client at least 3-4 weeks in retrieval time diagnosing a rejection and resubmitting a new request.
Now, I cannot say we do not run into issues. We do. But I can say nine out of 10 times, we recognize the issue before it becomes a problem, or we correct the problem with as little interruption as possible.
MTMP: Your website states that your customers can reduce records costs by 70%. How is this possible?
JJ: I was literally about to talk about this while managing to pat myself on my back for coming up with the process. In reality, there are several ways in which we mitigate costs for our clients.
We have HITECH, which is possible through a specialized form we developed. To be completely transparent, it is much easier with individual single accident events than Mass Torts. In the world of Mass Torts, EMR and HIE are the way to go, my friend.
In the EMR process, we simply log into the provider platform and download the records. HIE, we hit the networks and get the health data in hours. All three are money savers. Which one is the best to utilize depends on what type of case we are working on. I could talk about all of these for hours. This is where I really geek out.
MTMP: What’s the future of records retrieval?
JJ: As processes continue to evolve, the client and patient experience is going to be much different than what the industry standard has been for decades. It is not the “one size fits all” approach with the standard authorization that has operated for decades. These new processes take education and strategy to implement effectively. I would expect in the next two years, even the way things get done today will be a thing of the past. Internally, we are already anticipating those changes and advancements.
This article originally ran in MTMP Magazine’s Fall 2023 issue. The magazine is distributed at each MTMP conference in the fall and spring of each year in Las Vegas.