Medical Proof: Procuring Your Medical Records For Your Personal Injury Case
If you have been injured in a car wreck and it was not your fault, you may be considering filing a personal injury case, if you have not done so already. While the at-fault driver's insurance company may cover your medical expenses and wrecked car, it won't address your pain and suffering or the wages you lost dealing with the after-effects of the accident. To prove your personal injury case, you must access your medical records, since the dollar amount of this expense is key in determining your pain and suffering compensation.
HIPAA Rules and Rights
Before the government stepped in and created the Health Insurance Portability and Accountability Act of 1996 (HIPAA), consumers faced considerable hurdles when attempting to access their own medical records. With the passing of this act, medical facilities were required to provide records to consumers within 30 days of the request, or to inform the consumer in writing of the reason for the delay or denial. This act also set limits on the amount the medical facilities could charge for making copies of the records.
Requesting Your Medical Records
The HIPPA act stopped short of specifying the exact manner in which medical records are to be requested, so it's left up to the consumer to contact each facility for that information. Many offices provide fill-in-the-blank forms, but some take a more casual approach in which you must create your own request letter. No matter the form of request you use, be sure to include the following information to increase the chances of a successful, complete and timely records request fulfillment experience.
- Name, address, phone number, email address
- Your date of birth
- Range of dates requested (you only want records pertaining the accident, so be careful with the dates)
Note: Keep in mind when making your list of facilities to contact that many places out-source lab work and treatments. Look back over your receipts to ensure that you have not missed any facilities or doctors. For example, if your medical treatment included a hospital stay you may have encountered any number of doctors and lab tests, some of which were billed separately.
When the Medical Facility Doesn't Comply
You will likely need to follow up after the allotted 30-day period by making phone calls to the non-compliant facilities. Most medical facilities are very well-informed about HIPAA provisions and make a well-intentioned effort to comply, but often requests fall through the cracks and are never addressed properly. Sometimes a reminder call is sufficient, but if not you may need to take action by contacting your state medical board and filing a formal complaint with the Department of Health and Human Services.
Discuss the importance of your medical records with your personal injury attorney.