new with some questions

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bubsykitty
Regular Member


Date Joined Jul 2008
Total Posts : 23
   Posted 7/11/2008 8:21 PM (GMT -7)   
 
This is my first post here.  I have been lurking on and off for a long time and finally decided to register today.
I'm in a lot of pain tonight and overall very aggravated .... it's just been one of those days ....
I had an appointment today with my new PM Dr and I'm hoping to be able to tweak my meds with him to relieve much of my pain.
 
Anyway ..... I have a question regarding medical records and hope to get some opinions.
Has anyone ever heard of a Dr's office refusing to give you a copy of your records because there is an outstanding balance of $$ owed??
Can they do this???  mad
I thought that they had to give you a copy of your records if asked, but can charge a fee for the copies.
Any input please????
TIA!!
 
Happy Friday and I hope everyone has a nice weekend!!!
 
:-)  

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/11/2008 9:40 PM (GMT -7)   
Hi, Bubskitty,
Welcome to the forum. Glad you decided to post with us, although sorry you need to.

Yes, doctors can have a policy of not giving you your records if there's an outstanding balance, but I'm not sure if this would stand up to strong legal tests. Maybe someone here can weigh in legally.

I don't know how much the balance is for, but you might try making a payment plan, and if you're current on that they may release them to you. Also, they may be more apt to release them to another doctor, although that doctor usually will not give you a copy of another doctor's records.

One thing you could do is try calling your insurance company. Doctors have contracts with insurance companies, and there may be stipulations in those contracts which could provide leverage for you.

Hope this helps some, and that others will also add input.

PaLady

Another thing - if this is their policy you should have been notified when you first started seeing the doctor. Yes, it may be in all the fine print that drives us all nuts, but you might politely (I'm suggesting polite only because getting angry will probably cause you more difficulties) ask them how you were informed of this policy. If they can't show you in writing, then I would definitely complain to the insurance company. Plus it makes any legal ground much weaker.

Post Edited (PAlady) : 7/12/2008 12:28:52 AM (GMT-6)


Lindaloo
Veteran Member


Date Joined Sep 2006
Total Posts : 1713
   Posted 7/11/2008 10:59 PM (GMT -7)   
I would think that they would have to give you your copies if you pay for them, but that's just my personal opinion. It makes me mad that they are giving you the run around.

As usual PAlady has given you excellent advice. Try the payment plan approach. They will probably work with you.

Thanks for posting with us and glad you joined the forum. It's so nice to see you here. Welcome and keep posting. You will find lots of great people here with lots of great input, I'm sure.

Gentle Hugs,

Lindaloo
Moderator Chronic Pain
 
Believe in yourself.  Be kind to fellow humans and animals.  Take time to smell the flowers and the coffee.
And by all means, when you are down, ask me for help.  I will be there.
 
Linda


bubsykitty
Regular Member


Date Joined Jul 2008
Total Posts : 23
   Posted 7/12/2008 1:14 PM (GMT -7)   
Thank you for the input. I am trying the nice approach right now .... we'll see how that goes ....
The balance is about $5K - for some reason the insurance did not pay the bill from them, so I am going to talk to the insurance company to find out why. The amount itself seems way too high - they did 3 series of facet something injections on me. $5K for that just seems outrageous!! No wonder the insurance co. did not pay!! LOL

I work in an attorney's office, so after trying the nice route, I may have to send them a letter on attorney letterhead to request the records .... maybe that itself could work - I can't imagine them refusing to gived an attorney a copy of medical records!!
Fingers crossed .....

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 7/12/2008 2:27 PM (GMT -7)   
Bubsykitty,
Yes, a letter from an attorney might help. But straightening out what happened witht the insurance might be even more productive. Why didn't the insurance pay the bill? If the services weren't properly authorized - which your doc's office should do in advance, as they have the procedure codes - the insurance could have denied it. Look on your EOB (explaination of benefits) for codes as to why payment was denied.

5K for the injections may not be high, especially with flouroscopy. Those high tech things are expensive. But what the doc's office bills and what the insurance pays can be two different amounts. Be sure your doc is a participating provider with your insurance, also. If not, that could be another problem, or if your insurance won't pay for these types of procedures regardless of authorization. Let us know what you find out. I may be able to give you more ideas. There are lots of things that could go wrong with billing, authorization, procedure codes, etc. between your doc and the insurance company.

Good luck!

PaLady

Dragoness Warrior
Regular Member


Date Joined Jun 2008
Total Posts : 96
   Posted 7/13/2008 9:32 AM (GMT -7)   

I'm just welcoming you to the forum!!  PALady has it covered, she ALWAYS has great advice!! Thank you PALady, for ALL your great advice!!  :-)

I've worked in Billing before, and the insurance could have not covered it for a variety of mistakes too, so I would definitely look into that!  Also, make sure that you didn't need to get a precertification!!  If the doc's office didn't tell you that, then that really isn't fair!  And the letter with the attorney heading would help too, if it comes to that, but I would check with the insurance first!

Good luck and welcome!!

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