There are many reasons why you’d need a copy of your older adult’s medical records. You might need them to have a complete medical history, file insurance claims, share information with another doctor, and more. But what happens when a doctor or hospital won’t release the records? The Dollar Stretcher shares useful resources, tips, and personal stories from readers in their community.
– Question –
Trapped Medical Record Madness
I filled out the correct medical record request form and submitted it to the correct office six months ago. I have since kicked and screamed because they have not fulfilled my request, telling me that my request is pending.
I have complained to the CEO of the hospital, the director of the department, and I have gone to the office several times, but they just keep stalling. What else can I use to motivate them?
– Answers –
Submit a Second Request
Is the medical record department responsible for release of information or do they outsource?
By law, depending on what state you live in, they have 10 to 15 days to fulfill your request. I would submit a second request along with a copy to the administration and then continue to complain to administration.
The release of information department will charge copy fees. It might be that they cannot find your record or lost the original request.
– Allison, Registered Health Information Technician
See the Patient Advocate
Most hospitals have a Patient Advocate or an Ombudsman who can miraculously get things straightened out when nothing else seems to work. Another person might be the hospital’s social worker.
Your Protection under HIPAA
HIPAA, the Health Insurance Portability and Accessibility Act, requires that a request for copies of one’s medical records be fulfilled within 30 days of the request. Under HIPAA, if the process takes more than 30 days, you must be given a reason.
Your state law may give you the right to receive your records more quickly. In California, for example, you should be able to see your medical records within 5 days and get a copy within 15 days. For more on your rights to access under state laws, see https://www.hhs.gov/hipaa/for-professionals/faq/preemption-of-state-law/index.html.
HIPAA sets the national standard, meaning that states can give you greater rights to access your medical information, but state laws cannot take away the fundamental access rights you have under HIPAA. A link to a fact sheet that explains HIPAA is https://www.privacyrights.org/consumer-guides/hipaa-privacy-rule-patients-rights.
The easiest way to deal with any problems in a hospital is to contact the risk management department. They are the people who deal with and prevent lawsuits, and trust me, more than the CEO, patient relations, medical records or any other department, they wish to prevent problems. When they talk, all of us jump.
– RN Who Knows
Have Your Doctor Request
I had this problem myself, and my son is even a nurse at the hospital I was trying to get the records released from! He talked to the Director of Medical Records and she said to have my doctor send in a request for the same records, and mark it “Urgent.” I had my records in eight!
Go to Your State’s Department of Health
I wanted to respond to the person having difficulty getting copies of their medical records. Your medical records are really yours and you have a right to look at them and have copies.
I used to work for the NY State Department of Health. They regulate doctor’s offices, hospitals, hospices, home health agencies, and nursing homes to name a few. They give them their licenses to work as a doctor, or to operate their facility. They also can take those licenses away or suspend them, and even have the power to shut down an office at any given moment if they refuse to comply with requests for information. (These events are unusual however.) It was amazing how nervous staff would get when I would make a phone call just to do something like verify their address and phone number, executive director, etc. when I identified who I was and why I was calling.
In NY anyway, it’s against the law to refuse to provide copies of medical records within a reasonable amount of time, and against the law to charge prohibitive copying costs. I suggest you call your local Department of Health (State, not County). They should be listed in the local government section in the front of your white pages. Call the “Office of Professional Misconduct” with the information about the doctor’s office, when and how many times you’ve called, etc. Give them as much information as you can. Often, it will take just a phone call from the DOH requesting to know what’s going on to get them to comply. You can also go online by the way. There’s information there on where the offices are, phone numbers, the departments, and complaint forms. And, it’s all free. Doctor’s offices don’t tell you about these things probably because they don’t want you to know. They’d rather you complain to them.
Six months is most definitely not a reasonable amount of time. I find myself suspicious that there’s either something wrong or maybe they have lost them. I hope I’m wrong.
By the way, the State Education Department regulates providers such as psychiatrists, Social Workers, Veterinarians, Dentists, Nurse Practitioners and Midwives. The process is much the same to file a complaint through them.
Basic Business Communication
I work in the legal field and have found that almost everything can be handled if you follow a few basic rules of business writing:
- State your situation. In this case, you should state that you want a copy of your medical records, that you requested them on a certain date by mail (presumably) and that since then you have communicated with whomever you communicated with. Be as specific as possible. Give names, dates, time of day, etc. Be sure to tell them what you were told and by whom.
- Check your state laws. In some states, the patients own medical records, and in other states, they belong to the medical practitioner. If you own them, make sure to cite the law.
- Give them a deadline, such as two weeks from the date of your letter, to send you a complete copy of your medical records.
- Always, even in a first request, get a way to track the letter. At a minimum, send it certified mail. Federal Express and UPS, while more expensive, allow real-time tracking of your letter until it is signed for. If this letter is going cross-country, it’s valuable to know it sometimes. You also will know who signed for it.
- Copy the right people. In this case, I would send the letter to the CEO, but be sure to copy the General Counsel of the hospital (or any other staff lawyer). It’s amazing how fast they will respond. Trust me, I’m one of them! Also copy the patient advocate (if the hospital has one) and the head of the records department. Receptionists or lower level people will often give this information if you’re polite and friendly. If not, try the Internet, corporate listings, etc. Attorneys are often corporate secretaries as well. Another thing to ask about is the structure of the system and how your request is processed. Maybe you can find out where the bottleneck is and that can be quite helpful.
- Include your name, phone number(s), fax, and email (they should be able to contact you directly).
- You don’t mention why you want these records. If they are just for your files, state that. If you’re considering a lawsuit, do not.
- Follow up with a phone call within three days of your due date. If you get no response, start complaining to the appropriate people: the American Medical Association, the Better Business Bureau, governmental agencies, etc. Don’t expect fast results, but at least this shows diligence and a paper trail on your side. Continue calling and keeping records of the conversations, including full names of people, titles, time and date of calls, what was promised (if anything), etc.
Under no circumstances:
- Say you have a lawyer or threaten a lawsuit unless you mean it. Nothing will shut down communication faster. Some companies (including hospitals) have a policy of refusing to speak to the customer once they state they have a lawyer and will only speak to the attorney from then on.
- Don’t ever be anything but professional and courteous. Do not yell, curse, raise your voice, or do anything else that makes you seem irrational or erratic.
Ask Specific Questions
Have you ever heard of the Health Insurance Portability and Accountability Act (HIPAA) of 1996? HIPAA is responsible for the privacy notices you read and sign every time you visit your doctor or other providers. Because of HIPAA, it can be very difficult to have PHI (Protected Health Information) released. You may need to sign a special HIPAA release form from the hospital, especially if you’re requesting that the information be faxed.
You might also ask your current doctor to require the medical records instead of doing it yourself. Sometimes a request from a doctor’s office may be considered more important than one from an individual.
Also, some providers charge a fee (I have paid $8 or so in the past) for a copy of medical records. If the hospital you used doesn’t, they may not consider it a priority as it may cost them money to have the records pulled (as you’ll see below).
These scenarios would still not explain why the office keeps telling you that your request is “pending.” I have learned that, especially with older records, medical information may be kept offsite (my employer does this). The information is stored by a separate company that specializes in record storage, and sometimes is sent to another state! Hard copies may be stored or scanned in and destroyed so that only electronic copies are kept. It can take a long time for records to be found and returned to the provider’s office, and it costs the provider money. A scary thought is that the records may have been lost or destroyed inadvertently. You might just ask this question directly. Hospitals will not usually volunteer information, but I’ve found that specific questions get specific answers.
I suggest that you try to have your current doctor get a copy of the records first. If this doesn’t get results, check to see if there is a board of directors over the hospital. A CEO has to answer to someone; he or she is not the owner of the hospital. I would also inquire as to whether the records are stored offsite (and if so, get the company’s name), and ask what the usual procedure and time period is for pulling past medical records. Ask for details. Find out why there is a delay.
If they continue to stall, and you really need your records badly, it might be time to hire a lawyer or contact a local news station. In my area, one of our news stations has a segment where consumers can contact them and they will do an “investigation” of the problem. They will report their findings on the news, and most hospitals and providers don’t want this kind of negative publicity.
This even raises a question. Why are you asking that the records be provided? Are you considering a malpractice suit, or do you have a complaint? If they know this, they might put you on hold indefinitely. This is where a request from a doctor’s office, or even the lawyer, will come in handy. The less they know in this type of situation, the better. Finally, get everything you can in writing!
– Melissa in Texas
Recommended for you:
- 7 Tips for Helping Seniors at the Doctor: Being a Health Advocate
- Avoid Conflict When Helping Seniors at Doctor’s Appointments
- 4 Ways to Know If Seniors Need to Return to the Hospital
Guest contributor: Gary Foreman is the editor of The Dollar Stretcher.com – a site dedicated to “Living Better…for Less” since 1996. You’ll find an active section addressing the financial issues of baby boomers. Visit today!
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