Medical records are a crucial component of many legal cases, especially because various practice areas depend on the information contained within them. Yet retrieving, organizing, and analyzing these records is no small task—and one can run into problems if it is done incorrectly. Fortunately, there are ways to make the record-retrieval process more efficient and effective. By adopting the following strategies, law firms can not only reduce costs and better manage the time and efforts spent by their attorneys and paralegal staff, but also ensure that critical evidence is obtained for successful case outcomes.
Obtain Proper Authorization
An important step in the record-retrieval process is obtaining patient permission to request the records. Because every provider will require a HIPAA (Health Insurance Portability and Accountability Act)-compliant authorization for release of information that is signed by the individual or their legal power of attorney, it is important to get a signed permission form from the plaintiff as soon as possible. However, a HIPAA authorization form may not be the only authorization needed. There are thousands of special authorizations in use, and medical-service providers often have their own rules and require their own authorizations. To streamline the process, obtain the appropriate authorization document at the beginning and save time.
Do Your Research
A common challenge with collecting records is ensuring that the record request is received by the correct custodian of records. Often, individuals will provide their attorneys the address that appears on their invoice as the destination of the record request, thinking that it is the address of where they received treatment. However, if a record request is sent to a billing department, there’s no guarantee that the billing department will forward the record request to the correct department within the provider facility—in fact, typically it won’t. This step in the research process is critical to ensure all required records are received. Thus, one should first research the correct department to send the record request to within the provider's facility, as well as the correct location, and then verify by phone before making the actual request.
Know the Scope of the Request
There’s a fine line between being too broad and being overly specific in the wording used in a record request. If the goal is to obtain a list of medications a person was treated with during a hospital stay, request this information along with the date of the hospital visit. If radiology records are all that is needed, be sure to specify this in the record request. Every record, as well as every record page, comes with a cost, so by specifying the scope of the record request, costs can be contained.
Know Your Medical Providers
There are hundreds of thousands of medical providers across the United States alone, and they often have their own unique method of managing records, as well as their own release-of-information authorization document and fee requirements. Because different facilities have different requirements, it is beneficial to learn as much as possible about each provider to work more effectively with them. The more you know about the provider requirements before submitting a records request, the less amount of time you will spend on questions and follow-up calls.
Track and Manage Every Request
Turnaround time varies depending on the location, type, and size of the facility, but the average time to fulfill records requests is around 30 days. However, several issues can arise that will halt progress. These include requests that become misplaced by the provider, those that have incorrect or incomplete authorization-document information, those missing the required payment, and those that are not managed with regularly scheduled follow-up calls to remind the custodian of records that the records requested have not yet been received. Tracking the request status, then, is crucial because it helps everyone stay informed and ensures that turnaround times are as short as possible. Tracking also ensures that case deadlines are not missed, saving the attorney from having to scramble for record information at the last minute.
A typical medical file includes many different records, such as billing information, patient history and physician orders, tests, and treatments, and sometimes there can be so many records in a file that it can be hard to distinguish one from another. Medical records, then, must be well organized to be used effectively. To present a coherent view of the medical history, organize the records to support your litigation needs. This makes it easier for the nurse, attorney, or expert to analyze. It also enables an attorney to quickly find information in the record relevant to the allegation of injury, which ultimately helps him or her more rapidly prepare and present the case.
Natalie Baker is a national account representative with Medical Research Consultants.