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headline reads: “local paper turns work day crappy”

October 24, 2007

i work as a medical practice manager at an ob-gyn office. every time some junk news story runs in a local news paper, on the local news or god-forbid on the today show, touching the subject of health care management, the next few days of my life suck.

last year the today show ran a little segment on “lowering your medical bills” and i spent three days unable to do anything productive because people kept calling me wanting discounts on co-insurance, deductibles and co-pays. money that insurance companies require patients to pay—-the money owed by patients is not “extra” money payed to a health care provider, it is a set amount or percentage that is deducted from the insurance payment. in the case of a deductible, no money is paid out from an insurance carrier, 100% of our income from these policies depends on the patient payment. please see my post here.

this week a little snippet on medical record fees from a local paper by has temporarily halted my productivity in the office:

Enfield Family Medicine could use a little refresher course on customer service.

Roberta Shanley of Manchester learned recently that doctors can charge a fee to copy your records if you switch physicians. Not only the medical records they generate, but any records you might have brought with you from your previous doctor.

She recently asked for all her medical records because she was planning to switch doctors. The office manager for Enfield Family Medicine told her she would have to pay about $30 for them – 45 cents a page.

Shanley said she could swallow paying for the six years’ worth of records written while she was there, but she was not about to pay for the previous 30 years’ worth of records that she hand-carried from her previous doctor, who did not charge her a copying fee.

She said she made several requests for the old records but was refused. One secretary, she said, even made fun of her request.

Shanley wrote to me and to the state attorney general’s office looking for help to obtain the records that she said were being held hostage.

“It’s a matter of principle,” she said.

The doctors refused to talk to me, but their attorney, Richard Tynan of Hartford, said the issue of charging for patient records is confusing to many doctors in Connecticut because of the way the state statute is written. The statute – which allows doctors to charge a copying fee – does not distinguish between records generated by the doctor and records the patient already had.

Eventually, Shanley got her old set of records without paying a fee. Apparently, the day before I called the doctors office, they changed their minds and released her records for free.

here is the article on the hartford courant’s website

enfield family medicine, gombossy and the attorney general’s office need to do a little more research on this subject. according to hippa medical records may be about a patient, but the records belong to the health care provider who produced the record. it is a violation to supply a patient with records transfered from a previous provider because those records are not the property of the office that houses them. also according to hippa a health care provider may choose to deny a records release request to an individual if the provider believes that the content of the record could cause the patient mental distress or cause the patient to harm themselves or others. i advise our patients to always make and keep a copy of their records from a previous office for themselves before they are handed over to us, because we can never give them back to the patient.

we charge 45 cents a page like enfield family medicine, and we do not make any profit from medical record transfers and copies. we use our time and labor, our paper, our copier, our fax machine or our stamps to transfer records. i wouldn’t be surprised if we loose money on records copying. if i didn’t have to spend so much time chasing down patient balances and insurance carrier payments maybe i would have more time to calculate our loss in this area.

medical record fees are not a “fleecing of america.” the state of connecticut passed this statute allowing health care provided to charge for the labor and supplies utilized in medical records because it would be a burden on doctor’s offices without the charge. the state of connecticut leaves a gap in the law that allows a patient to receive records at no cost if payment is not made within 30 days of notification of the fee, if more people would take the time to learn their rights and plan ahead patients could get away with records at no cost to them. i would not recommend attempting to take the “free” path if the patient ever plans on going back to the office, because the charge can still be collected if the patient stays in the practice.

the only reason why a patient in my office would get their records at no charge is if they are discharged from the office because they are such a pain we can’t wait to get rid of them (discharge is very rare at my office). i would guess that the only reason why roberta shanley received her records at no charge was because the $30 the office could have required was no longer worth the trouble.

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