Let’s face it, the retrieval of medical records can be a frustrating process with rules and complexities that can leave you uncertain as to when or if you will receive the records you need. That uncertainty is the reason most firms turn to experts like MRC to collect complete and accurate records in a timely manner.
Medical records are the linchpin to any case involving complex medical issues so having a complete set of records is not an option, it’s a must.
If you are tasked with collecting medical records, how successful you are will primarily depend on how well you understand the state statutes and the rules set by the health care provider’s custodian of the records as well as the Health Insurance Portability and Accountability Act (HIPAA).
Here are some of the questions you should ask the records custodian to ensure the fastest turnaround time:
1. Am I sending my record request to the correct custodian of records?
Make sure you know exactly who to send the record request to by first calling the medical provider and asking them who handles medical record requests and where should they be sent. Never assume a request sent to the street address or billing department will be forwarded to the custodian.
2. Does the record request have the right information?
Certain parts of a record request are universal and should be included no matter where the request is being sent such as the correct social security number, birth date, and any signed authorizations for release of information. In some cases, it is also necessary to include the treating physician, referring physician, and the specific dates the service was rendered. Checking with the custodian beforehand can help prevent deadline-shattering denials later.
3. What kind of medical record release form do I need?
The process in which a custodian can release medical records first begins with submitting a medical record release form. Because all medical release forms need to adhere to HIPAA compliance, some medical providers require their facility’s approved release form be used. Be sure to use a HIPPA-compliant release form or ask the custodian if they require use of their medical record release form.
4. What are the custodian compliance requirements for releasing records?
By asking the records custodian if they are familiar with the laws regarding the retention and release of medical records, you send the message that you know the rules exist. Take the time to familiarize yourself with the requirements and be sure to include in the record request a firm date in which the custodian must respond to meet compliance.
5. How can I securely receive the records?
Determine what is the best way for your team to store and handle records and ask the custodian if they can securely produce and send the records in the format you need. Today, most custodians can produce records in a variety of formats including paper, electronic, and CD/DVD. If you don’t specify format type, you may find yourself spending more time transferring the records to a different format.
6. What happens if I’m denied or all the records are not present?
Normally, the custodian will include the exact reason as to why the record request was denied and what, if anything, can be done to remedy the denial. If you are uncertain as to their instructions, contact the custodian immediately and try to get clarification. Never attempt to guess what the custodian’s denial letter says if it is not clear.