Breaking up is hard to do..PO Day 105

Leaving a doctor's practice is always difficult. If I like the doctor and the reasons have nothing to do with being dissatisfied, it might be sad but no one is mad. If there has been an "incident," or I feel the doctor or the staff have disappointed me, it's a bit harder to do. Or maybe not, if I feel righteously justified, it may not be hard at all. Whichever it is, you will have to request  your medical records.

I've had both situations arise in the last year. I took the path of least resistance in both cases; I had the new doctor's office request my medical records. I did have to sign a Release of Medical Records form that would be provided to my "old" doctor, but I could have created my own written request. HIPAA laws are plain: a medical facility is legally required to provide copies (not the originals) of medical records within 30 days. They may charge a reasonable fee for reproducing the copies and for mailing them but may not charge for searching for the records or for the time involved in the work involved. They are not required to provide the records to another doctor but are required to submit the records to the patient or the representative of the patient.

Not being a person to burn my bridges ahead of me, I made sure to have an appointment with the new doctor before notifying the old doctor that I was leaving his practice. The doctor whose practice I was leaving because he had moved too far was not surprised at my departure and understood when I explained I had made other arrangements. I was disappointed in the second doctor but didn't see the need to confront him, changing orthopods in mid stream sent enough of a message. The patient does not have to say why they are leaving the old doctor and does not have to reveal to what doctor they will be going. It isn't surprising that when the medical records are requested by an attorney, patients often feel as if they are met with some resistance. Nonetheless, the same rules apply and no one knows them better than a lawyer.

Can a doctor dismiss a patient? Yes! Generally, valid reasons would include not paying your bills, being noncompliant by failing to follow medical advice or not returning for follow up care, behaving in a rude or obnoxious manner and if the the doctor is retiring or if he no longer participates in the insurance the patient has. The doctor must give the patient 30 days notice of the dismissal and may not dismiss the patient in middle of ongoing treatment, like if a woman is pregnant or if a patient is undergoing active cancer treatment.

Tips for requesting medical records from the American Health Information Management Association   website if the patient is the one making the request for records:

Read online or call the facility’s HIM (Health Information Management) department for information specific to your request. This will give you time to collect the required information and documentation before you arrive. If you are requesting another person’s records, you can confirm in advance that you will have authorization.

Provide as much information as you can on the authorization form. This will speed up request processing by giving HIM professionals sufficient data to track down your records. If you have a common last name, provide extra information about yourself, such as your date of birth or the last four digits of your Social Security number.

Bring a valid government issued photo IDand all other required legal documents with you when you pick up a record request. HIM professionals by law must deny requests where the individual cannot prove his or her identity or his or her right to access the records.

Tell the HIM staff why you are requesting the record. HIM professionals can help ensure you receive the records you need—and not the ones you don’t. The set of records one should request for personal use, for example, can be different from the set of records sent to a doctor for continuing care. A person’s medical record can be hundreds of pages long, so requesting your entire record may be too much, especially if the facility charges a per-page fee for compiling and reproducing it.

Indicate if the request is urgent… Many facilities triage their record requests, putting the most time-sensitive and care-oriented requests first.

…but allow as much time as you can. Not all facilities honor rush requests, however; some fulfill orders in the order in which they were received. When possible, make your request well before you need  the documents (between five and 15 days out).

Don’t request your records before you leave the hospital. If you need records from your hospital stay sent to a physician for follow-on care, don’t request the transfer before you are discharged. This will ensure all of your records are sent, including the discharge summary.

So, to repeat myself a little: It is always easier to let the new doctor request records from the old doctor but the original doctor is not required to send the records to another physician or hospital group.  However, YOU are legally permitted to ask for and receive copies of  your records yourself or your legal representative may request and receive them.  Recent HIPAA laws make plain that the patient is entitled to copies of all their records but not the original documents. This has been the law for decades but patients did not always know it.

It's a good practice to always request copies of special tests' reports, like lab work and cat scans, when they are done and create your own record system. It will not only ensure you have copies of the tests but will also jog your memory of what and when.


http://youtu.be/XQD3At3E7TA




Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September