Update on oral surgery thread

[Ed62]

If you don't know about the other thread, here it is http://www.bt3central.com/showthread.php?t=41201 .

Last week, my wife was basically through with follow-ups with the oral surgeon. I asked him for all medical records. He told me he would have them ready for me Thursday (yesterday). I called the office, but there was no answer. Today I told the receptionist I'd like to pick up the records. She had me talk to the surgeon. He told me he would have the records for me next week, but in order for him to release them, we would have to sign a release of responsibility for him. He said he was not connected in any way with the anesthesia company in question. (They finally cashed the check he told me he would get back for us) Hmmmmmm, that makes me a little more suspicious than I already was. I refused to sign a release, and told him I would talk to my nephew (a personal injury lawyer) for advisement.

Although he did a good surgical job, something is not right about the whole thing. I think he's a little worried now.

Ed

[crokett]

Hopefully Germdoc or Paul (haven't seen him around in a while???) will be along to comment but I think if you ask for your records you are supposed to be able to get them. I've never had a problem getting mine or either of my daughters'.

My take is, if he wanted you to sign a release he knows he screwed up and is trying to weasel his way out and put it all on the anesthesiologist.

I am glad your wife came out of this ok. You seem to be taking this better than I would. I admire you for it.

[jking]

If you haven't already done so, I'd definitely talk to an attorney. If for no other reason than to find out who is legally responsible for the decisions made. Unfortunately, unless there is something in writing from the surgeon stating the personal physician requested the anthesiologist, it's probably tough to prove much.

I'm pretty sure the doctor has no right to refuse you copies of your medical records. If you request them to send copies somewhere, they will likely ask you to sign a release form stating that you made the request. They might also charge you a fee for making the copies.

Just because a surgeon has a majority of his/her patients supporting the work done, it doesn't mean much. We have a ENT in the area currently doing time for insurance fraud. Most the patients interviewed talked about how great of a doctor he was, but, he was convicted of overbilling & ordering unnecessary procedures to make money.

[Ed62]

My take is, if he wanted you to sign a release he knows he screwed up and is trying to weasel his way out and put it all on the anesthesiologist.

My thoughts exactly. I've been able to get numerous records from other places with no problem at all.

I'm also wondering if he owns all or part of the anesthesia company.

If you haven't already done so, I'd definitely talk to an attorney.

I have a call in to my nephew, who is a personal injury attorney. He is aware that I'm not interested in making money from this. But I do want the records, which I'll get one way or another. He has no right to withhold the records.

Ed

[cgallery]

But I do want the records, which I'll get one way or another. He has no right to withhold the records.

Ed

He's probably busy changing the records.

Have your nephew take care of it.

The nerve to tell you you'd have to sign a release...

[Greg in Maryland]

Ed

The medical records are owned by the dentist. Weird that a medical professional owns records on you, but that is the way it is. However, HIPPA gives you specific rights regarding access to your records. Please see this site for more specific information:

http://www.hhs.gov/ocr/hipaa/

According to the HIPPA regulations, your dentist must comply with your request within 30 days unless they request an additional 30 days (with a reason). Also, they are permitted to charge you a nominal page charge.

You can file a complaint, but you only have 180 days to file. There is a provision for another 180 days that you can petition for, but it is far from certain so I would not count on it.

Here is the link to investigate filing a complaint:

http://www.hhs.gov/ocr/privacyhowtofile.htm

This is what I would do:

1) Document everything relating to your request to get your wife's records -- dates and times you contacted the dentist's office, who you spoke to, what they told you, what you said/did, etc., etc. Keep very detail notes made at the time -- don't try to recreate them all the time. Obviously, there will be some recreating at 1st, but that's probably ok. Notes like this are quite important in documenting actions.

2) Write a letter to the dentist stating the date you originally requested the records, the time (s) you contacted his office regarding the records, who you spoke to, and the responses you were given. Send it registered mail, return receipt and signature required.

Indicate in the letter that there is no way that you will sign a release of liability for what happened to your wife to access the records as is your right under HIPPA. Kindly remind him of his obligation under HIPPA, and that withholding the records because of your refusal to sign a release is illegal and is a basis for a complaint to the Office for Civil Rights at the Department of Health and Human Services.

Tell him that this no doubt a simple mix up and confusion on his part and that you expect to pick up the records at his office on MM/DD/YYYY at HH:MM an/pm (within the 30 day request period, and at a date/time that his office is open).

I would not threaten or intimidate him with a HIPPA complaint in the letter. Be cordial, pleasant and friendly. Treat it like a normal everyday letter

3) If he does not give the records, send him another letter via the same delivery method stating that the records were not provided at the appointed hour, even though you were there. Again, do not mention a HIPPA complaint. Just the facts.

4) Collect all your notes and documents and file a complaint. Here is the regional office you should turn to to help and/or guidance, as well as file the complaint:

Office for Civil Rights
U.S. Department of Health & Human Services
233 N. Michigan Ave. - Suite 240
Chicago, IL 60601
(312) 886-2359; (312) 353-5693 (TDD)
(312) 886-1807 FAX

The point of all the above is to document your actions, his actions and to ensure that any complaint against him will withstand scrutiny and questioning by a overpaid lawyer.

Most likely you can also file a complaint with the state medical board or licensing authority. No doubt you can find this stuff out via the state's website.

Good luck and let us know how it turns out.

Greg

[MilDoc]

AFAIK, no doc in any state can refuse to release medical records on a patient's request. NOR can they attach any conditions to the release. They can, at most, charge a "reasonable" fee for the records (state's define "reasonable").

I would call the surgeon again and tell him that you want the records or you will report him to your state's medical board. I looked up Indiana's rules:

“On written request and reasonable notice, a provider shall supply to a patient the health records possessed by the provider concerning the patient.”

The fee to provide the records is:

$ 1 per page, pages 1-10
.50 per page, pages 11-50
.25 per page pages 51 and up

+ $10 if records are requested to be available in 2 days

+ $20 to "certify" the records (that's a new one on me)

IOW, he can not refuse to release the records, nor insist on any conditions for their release. Indiana law says the records are the property of the patient, period.

[MilDoc]

I just read Greg's response and certainly agree with keeping a record of everything. But IMHO I would first point out that In. law requires him to release the records, and that, failure to do so will result in an immediate complaint to the State Medical Board. That get's most doc's attention fast.

[cgallery]

I agree with Paul and Greg, but I'd still let my nephew handle it.

The guy is treating you like a chump. Give it to him between the eyes.

[MilDoc]

I agree with Paul and Greg, but I'd still let my nephew handle it.

The guy is treating you like a chump. Give it to him between the eyes.

Sorry, but I have to disagree with that. Most malpractice insurance companies require a doc to call them immediately if contacted by a lawyer. And that can open a whole bag of worms you really don't want to get in to.

Try again to handle this yourself. In. rules do specify a request in writing. Do that. Take it in person. Mention the state medical board rules, and HIPAA. Threaten a complaint to both if the records are not provided. Even better, have a complaint already typed up.

Then, if that doesn't work, get a lawyer involved.

[cgallery]

Sorry, but I have to disagree with that. Most malpractice insurance companies require a doc to call them immediately if contacted by a lawyer. And that can open a whole bag of worms you really don't want to get in to.

So far, Ed has been told the check would be returned. Now it has been cashed.

He has been told he'd get the medical records, then told he'd have to sign-off to get them.

From where I sit, Ed is running out of cheeks to turn.

He has given 'em two chances to be stand-up about this. I don't think they're going to start shedding their spots anytime soon.

I don't continue to deal with people that refuse to honor their word, and break the law.

So I guess we'll have to agree to disagree on whether the attorney should handle it.

[crokett]

What I'd do is call and say I am coming down in 1/2hr and I expect to leave with the records. If I don't get them then I have a complaint ready to mail to the medical board which I will fax as soon as I leave the doctor's office. I bet Ed gets the records then.

[Greg in Maryland]

Ed,

You are certainly getting a range of opinions here and a lively discussion .....

The basis for my suggestions are that they build a record of what happened that is quite difficult to dispute. Phone calls, visits and oral conversations are much harder to substantiate in a court or board of inquiry. Unless something is in writing, any oral conversations, communications, assertions, demands, etc, etc, between you and the good doctor boil down to your word against his. It is not impossible to substantiate these communications, but it is much harder. A paper trail is much easier to substantiate or conversely, dispute. I would avoid any conversations with him at all costs. If he calls, immediately tell him you will not talk to him and that he should put into writing anything he wishes to say for your consideration.

I completely agree with everyone that you should point out his responsibilities under state and federal statutes, and that you are prepared to file the necessary complaints if he does not comply as he is required to do.

I do not agree that you should go in breathing fire and brimstone. Depending on what you and your wife choose do to regarding this issue and the two doctors, you are in a chess match and you need to think far ahead to ensure that you come out where you want to be. My experience is that you will be much more credible and come from a stronger position if you maintain a reasonable, calm and professional demeanor.

At the end of the day, you have the 500 lb and 250lb beasts in your corner -- federal and state authorities. If you don't get what you want in a reasonable manner, let them do what they do best: bludgeon him into compliance. It will be a lot easier for them to do their job if you have documented you requests and interactions in writing.

Hopefully he will do what is right with a little nudging and this is all just a interesting discussion.

Greg

[Ed62]

I appreciate all the suggestions. I will talk with my nephew about the problem, but I expect to handle it myself. I have no desire to make money off this, although I do feel a reimbursement for anesthesia is warranted. But the bigger issue is the one I posted in the other thread. That bothers me a lot. He'll give me proper advice on getting records, and who to contact if I decide to do that.

Ed

[Pappy]

Forget everything you have read so far. Engage in a bit of 'Marine Diplomacy'.

Go to the office, demand the records. If he refuses, sucker punch him and then procede to hold close order drill on his chest cavity until comes around to your way of thinking!

If you follow my advice, retain a GOOD criminal lawyer first!