Rights to medical file?

SuperTech said:

Perhaps this is the wrong place to ask, but I have a question regarding access to my medical file.
According to nwjustice.org5930.htmlOpen ↗, I can request copies of my medical file where-
in the office can charge up to 69 cents per page to copy it. I take it then that I cannot request
the whole file and copy it myself? The reason I ask is that I have been dealing with bumbling
idiots at these doctor offices. I switched doctors and doctor's offices and none of my medical
history was transferred over to the new office. According to the new office, it is my
responsibility to make sure these are transferred. Well, before I left the old office, I told the
them to send them my medical history to the new office. And when I called the old office, they said
they did fax the medical file to them! So who's to blame?

Now the new office sends me to a specialist. I get the fax number of the specialist where I can
send my medical history for my problem and I call the new office to have them send that history
over to that fax number. I go to the office visit at the specialist and da...da...da: no medical
history! Zippo, zilch, nothing. Now I call my new office and request copies of ALL paperwork
regarding my specific problem. "Oh well, we can make a copy of the order we requested, but you had
the other work do at the other office, so you should request the paperwork directly from them".
Mind, you they HAVE this paperwork, but don't want to give it to me!

Call the old office (actually, it was another specialist). They won't mail me any of my medical
history until I write them a letter authorizing them to mail me the information. Amazing! I wonder
why they cannot send it to me in the first place? I mean, if someone else is living at my current
address, what difference would a letter make? None.

I went to the new office today and picked up a copy of the latest order and on the bottom it said
it was faxed to the new specialist on 12/09. I don't know who to believe anymore! So I'm going to
hand deliver the paperwork to the specialist's receptionist myself AND bring a copy on my person to
my next office visit so that if the doctor cannot find the paperwork, I'll have to be medical
archive and produce it for him!

That's my rant for today.

First off, I assume you're in the US. If not, then ignore the following....

You have a right to your medical files, but your doctors are required to obtain your written
authorization to mail them to you or anyone else. (Might sound silly, but it's federal law so
of course it's silly.) The bureaucratic runaround you're getting is a bit much, so what I would
do is this:

1. Call each office involved and ask to speak to the "privacy officer" (if they don't know what
you're talking about, call a lawyer).

2. Explain to this person that you're greatly concerned about the whereabouts of your records and
their apparent inability to keep track of them.

3. Suggest that promptly providing you with copies of your entire file at no charge would go a long
way toward satisfying you that they actually are in compliance with HIPAA and therefore there's
no need for you to file a complaint.

Do this and I predict you'll get the matter resolved promptly.

"SuperTech" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Perhaps this is the wrong place to ask, but I have a question regarding access to my medical file.
According to nwjustice.org5930.htmlOpen ↗, I can request copies of my medical file where-
in the office can charge up to 69 cents per page to copy it. I take it then that I cannot request
the whole file and copy it myself? The reason I ask is that I have been dealing with bumbling
idiots at these doctor offices. I switched doctors and doctor's offices and none of my medical
history was transferred over to the new office. According to the new office, it is my
responsibility to make sure these are transferred. Well, before I left the old office, I told the
them to send them my medical history to the new office. And when I called the old office, they
said they did fax the medical file to them! So who's to blame?

Now the new office sends me to a specialist. I get the fax number of the specialist where I can
send my medical history for my problem and I call the new office to have them send that history
over to that fax number. I go to the office visit at the specialist and da...da...da: no medical
history! Zippo, zilch, nothing. Now I call my new office and request copies of ALL paperwork
regarding my specific problem. "Oh well, we can make a copy of the order we requested, but you had
the other work do at the other office, so you should request the paperwork directly from them".
Mind, you they HAVE this paperwork, but don't want to give it to me!

Call the old office (actually, it was another specialist). They won't mail me any of my medical
history until I write them a letter authorizing them to mail me the information. Amazing! I wonder
why they cannot send it to me in the first place? I mean, if someone else is living at my current
address, what difference would a letter make? None.

I went to the new office today and picked up a copy of the latest order and on the bottom it said
it was faxed to the new specialist on 12/09. I don't know who to believe anymore! So I'm going to
hand deliver the paperwork to the specialist's receptionist myself AND bring a copy on my person
to my next office visit so that if the doctor cannot find the paperwork, I'll have to be medical
archive and produce it for him!

That's my rant for today.

\

Good idea. I would always hand carry any xrays or other medical information documents. I wouldn't
rely on the sending doctor's office to handle it correctly, nor on the receiving doctor's office to
handle it correctly.

Medical records management has always been difficult, but HIPPA has made it into a nightmare.
Doctor's offices can get into big trouble with big fines for violating any of their arcane rules,
and if it's not HIPPA, then the patients can sue for breach of confidentiality. Your situation is
difficult because the records your second doctor received from the first cannot be re-released to
another doctor without your written permission again.

As to giving you the records to copy, that's impossible. The records belong to the doctor's office
and that office has complete responsibility for keeping them accurate and confidential.

I don't blame you for being frustrated. Be aware that your doctors' offices find the whole mess
incredibly frustrating too.

HMc

SuperTech said:

Perhaps this is the wrong place to ask, but I have a question regarding access to my medical file.
According to nwjustice.org5930.htmlOpen ↗, I can request copies of my medical file where-
in the office can charge up to 69 cents per page to copy it. I take it then that I cannot request
the whole file and copy it myself? The reason I ask is that I have been dealing with bumbling
idiots at these doctor offices. I switched doctors and doctor's offices and none of my medical
history was transferred over to the new office. According to the new office, it is my
responsibility to make sure these are transferred. Well, before I left the old office, I told the
them to send them my medical history to the new office. And when I called the old office, they
said they did fax the medical file to them! So who's to blame?

Now the new office sends me to a specialist. I get the fax number of the specialist where I can
send my medical history for my problem and I call the new office to have them send that history
over to that fax number. I go to the office visit at the specialist and da...da...da: no medical
history! Zippo, zilch, nothing. Now I call my new office and request copies of ALL paperwork
regarding my specific problem. "Oh well, we can make a copy of the order we requested, but you had
the other work do at the other office, so you should request the paperwork directly from them".
Mind, you they HAVE this paperwork, but don't want to give it to me!

Call the old office (actually, it was another specialist). They won't mail me any of my medical
history until I write them a letter authorizing them to mail me the information. Amazing! I wonder
why they cannot send it to me in the first place? I mean, if someone else is living at my current
address, what difference would a letter make? None.

I went to the new office today and picked up a copy of the latest order and on the bottom it said
it was faxed to the new specialist on 12/09. I don't know who to believe anymore! So I'm going to
hand deliver the paperwork to the specialist's receptionist myself AND bring a copy on my person
to my next office visit so that if the doctor cannot find the paperwork, I'll have to be medical
archive and produce it for him!

That's my rant for today.

SuperTech

Stuff with medical records is always a total pain, but your offices are actually mostly following
the rules:

1) They need written authorization to release records

2) They can only release records that are "theirs". What this means is that if office #1 has a
note from office #2 because you previously asked office #2 to make a copy for office #1,
office #1 usually cannot release that note to you. You need to go back to office #2 to get
additional copies.

It is definitely a good idea to get copies made for you so that you can then make your own copies
for whoever needs them. Also, it's then much easier to figure out which office is messing up, rather
than getting the runaround of one office insisting they sent the information and another office
insisting they never received it.

--
David Rind [email hidden]

BUT if the consulting specialist requests those records directly -- there
should be no need for any further authorization from the patient because:
a) the records are needed for care of a mutual patient b) the patient was REFERRED to the specialist
by the original doctor. If the *patient* is requesting that records be sent to somebody else,
THEN new authorization is needed.. If the consulting specialist picks up the phone and calls the
requesting doc and says, "hey, tell me about our mutual patient ms. Smith.. and oh, can you send
over the EKG you did last month" there should be no issue with HIPAA.

correct?

"David Rind" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

SuperTech said:

Perhaps this is the wrong place to ask, but I have a question regarding access to my medical
file. According to nwjustice.org5930.htmlOpen ↗, I can request copies of my medical
file where-in the office can charge up to 69 cents per page to copy it. I take it then that I
cannot request the whole file and copy it myself? The reason I ask is that I have been dealing
with bumbling idiots at these doctor offices. I switched doctors and doctor's offices and none
of my medical history was transferred over to the new office. According to the new office, it is
my responsibility to make sure these are transferred. Well, before I left the old office, I told
the them to send them my medical history to the new office. And when I called the old office,
they said they did fax the medical file to them! So who's to blame?

Now the new office sends me to a specialist. I get the fax number of the specialist where I can
send my medical history for my problem and I call the new office to have them send that history
over to that fax number. I go to the office visit at the specialist and da...da...da: no medical
history! Zippo, zilch, nothing. Now I call my new office and request copies of ALL paperwork
regarding my specific problem. "Oh well, we can make a copy of the order we requested, but you
had the other work do at the other office, so you should request the paperwork directly from
them". Mind, you they HAVE this paperwork, but don't want to give it to me!

Call the old office (actually, it was another specialist). They won't mail me any of my medical
history until I write them a letter authorizing them to mail me the information. Amazing! I
wonder why they cannot send it to me in the first place? I mean, if someone else is living at my
current address, what difference would a letter make? None.

I went to the new office today and picked up a copy of the latest order and on the bottom it
said it was faxed to the new specialist on 12/09. I don't know who to believe anymore! So I'm
going to hand deliver the paperwork to the specialist's receptionist myself AND bring a copy on
my person to my next office visit so that if the doctor cannot find the paperwork, I'll have to
be medical archive and produce it for him!

That's my rant for today.

SuperTech

Stuff with medical records is always a total pain, but your offices are actually mostly following
the rules:

1) They need written authorization to release records

2) They can only release records that are "theirs". What this means is that if office #1 has a
note from office #2 because you previously asked office #2 to make a copy for office #1, office
#1 usually cannot release that note to you. You need to go back to office #2 to get additional
copies.

It is definitely a good idea to get copies made for you so that you can then make your own copies
for whoever needs them. Also, it's then much easier to figure out which office is messing up,
rather than getting the runaround of one office insisting they sent the information and another
office insisting they never received it.

--
David Rind [email hidden]

"Beachhouse" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

BUT if the consulting specialist requests those records directly -- there should be no need for
any further authorization from the patient because:
a) the records are needed for care of a mutual patient b) the patient was REFERRED to the
specialist by the original doctor. If the *patient* is requesting that records be sent to
somebody else, THEN new authorization is needed.. If the consulting specialist picks up the
phone and calls the requesting doc and says, "hey, tell me about our mutual patient ms. Smith..
and oh, can you send over the EKG you did last month" there should be no issue with HIPAA.

correct?

Correct, though it remains a "myth" that HIPAA restricts such warranted information exchange.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

Beachhouse said:

BUT if the consulting specialist requests those records directly -- there should be no need for
any further authorization from the patient because:
a) the records are needed for care of a mutual patient b) the patient was REFERRED to the
specialist by the original doctor. If the *patient* is requesting that records be sent to
somebody else, THEN new authorization is needed.. If the consulting specialist picks up the
phone and calls the requesting doc and says, "hey, tell me about our mutual patient ms. Smith..
and oh, can you send over the EKG you did last month" there should be no issue with HIPAA.

correct?

Under HIPAA, yes, protected health information may be released in this scenario. However, that may
not cover all the information in a given medical record. If Office A sent copies to Office B, and
office B referred the patient to Office C, when the request comes through from Office C to Office B
for records, they typically are not supposed to copy the copies they have from A and send them to C.
They are, of course, free to write a letter summarizing the information in those records and send
them to C. This is not a HIPAA restriction as far as I know -- it predated HIPAA and I don't think
was changed by HIPAA. It has something to do with the legal status of the keeper of records, but I
have no idea who this restriction is supposed to protect. It may even by specific to a given state
in the US.

--
David Rind [email hidden]

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Correct, though it remains a "myth" that HIPAA restricts such warranted information exchange.

There are many myths surrounding HIPPA, what it takes to be in compliance and the penalties for not
being in compliance. It has to be one of the most misunderstood, misinterpreted pieces of health
care legislation that ever hit the books.

HMc

Howard McCollister said:

There are many myths surrounding HIPPA, what it takes to be in compliance and the penalties for not
being in compliance. It has to be one of the most misunderstood, misinterpreted pieces of health
care legislation that ever hit the books.

Absolutely. I think it will settle down within a year or so and all the panic and myths will wear
off just like OSHA regulations regarding "universal precautions" did with HIV in the 1980s.

But I can't stand it any longer....

It's HIPAA! Not HIPPA!! ;-)

"Carey Gregory" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

But I can't stand it any longer....

It's HIPAA! Not HIPPA!! ;-)

OK...

HMc

"David Rind" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Beachhouse said:

BUT if the consulting specialist requests those records directly --

there

Quoted message said:

Quoted message said:

should be no need for any further authorization from the patient

because:

Quoted message said:

Quoted message said:

a) the records are needed for care of a mutual patient b) the patient

was

Quoted message said:

Quoted message said:

REFERRED to the specialist by the original doctor. If the *patient* is requesting that records
be sent to somebody else, THEN new authorization

is

Quoted message said:

Quoted message said:

needed.. If the consulting specialist picks up the phone and calls the requesting doc and says,
"hey, tell me about our mutual patient ms.

Smith..

Quoted message said:

Quoted message said:

and oh, can you send over the EKG you did last month" there should be no issue with HIPAA.

correct?

Under HIPAA, yes, protected health information may be released in this scenario. However, that may
not cover all the information in a given medical record. If Office A sent copies to Office B, and
office B referred the patient to Office C, when the request comes through from Office C to Office
B for records, they typically are not supposed to copy the copies they have from A and send them
to C. They are, of course, free to write a letter summarizing the information in those records and
send them to C. This is not a HIPAA restriction as far as I know -- it predated HIPAA and I don't
think was changed by HIPAA. It has something to do with the legal status of the keeper of records,
but I have no idea who this restriction is supposed to protect. It may even by specific to a given
state in the US.

--
David Rind [email hidden]

but that scenario is frankly a set-up for horrific malpractice. the entire issue is making sure
that you have accurate, complete documentation for the care of a mutual patient. as long as the
records are needed for patient care, there should be no need for incessant authorizations from
various offices. relying on a letter summarizing the information is totally inadequate. we've not
run across this problem yet -- thank goodness. if a patient saw a cardiologist a year ago and
copies of ECG's, stress test were sent to the patient's primary physician -- then any subsequent
internist/cardiologists/consultant should be able to receive the patient's comprehensive record
from their primary doc --without having to track down the previous cardiologist who "is on
vacation.. " 'we can't find the chart" "it's in a warehouse." i don't want a summary of the ECG --
i want the ECG!

Beachhouse said:

but that scenario is frankly a set-up for horrific malpractice. the entire issue is making sure
that you have accurate, complete documentation for the care of a mutual patient. as long as the
records are needed for patient care, there should be no need for incessant authorizations from
various offices. relying on a letter summarizing the information is totally inadequate. we've not
run across this problem yet -- thank goodness. if a patient saw a cardiologist a year ago and
copies of ECG's, stress test were sent to the patient's primary physician -- then any subsequent
internist/cardiologists/consultant should be able to receive the patient's comprehensive record
from their primary doc --without having to track down the previous cardiologist who "is on
vacation.. " 'we can't find the chart" "it's in a warehouse." i don't want a summary of the ECG --
i want the ECG!

I don't disagree, but a lot of the privacy laws around medical records tend to be written as if
privacy rather than good medical care was the paramount concern of most patients.

--
David Rind [email hidden]