Furthermore, the hospital refuses to release my medical records to me. They released them to my doctor, but claim they don't have to release them to me. I KNOW they must release my records to me, but don't know how to enforce it without hiring an attorney. Any ideas?

They must release your records according to US Federal Law HIPAA passed in 1996.

If they still refuse, you could go to the hospital (like you feel like it) and ask for the HIPAA Compliance Officer. Tell them you want to file a HIPAA grievance.

You fill out their grievance form and they have about 30 days (?)to respond to you. The hospital must respond and satisfy your grievance in some way.

If you're not satisfied with their response, then go to the US Dept. of Health and Human Services and file a complaint.

Or, if they tell you right off the bat that they refuse to process your complaint at the hospital, then immediately report them to the Federal Dept. of Health and Human Services. They are in violation of Federal Law.

They will be investigated and subject to fines.

Non-payment of a bill is not legal grounds to withhold records according to HIPAA.

They may charge a nominal copying fee.

Hope that helps. I know you've been through so much and glad you're still ALIVE!

------------------

As luck would have it, we have an appointment with our llmd coming up in April. He's just a few blocks from said hospital. Will call in advance to ask for copies of my records.

My LTD referred me for a neuropsychological eval last summer and I have been having lots of trouble getting a copy. Here how's things have gone:

Neuropsychologist said he didn't have to go by HIPAA as we did not have an established "treatment" relationship. He was hired to do an eval and only that.

The LTD says they will release it to my primary physician for review. But the primary physician generally does not release records they don't generate directly to a patient.

My LTD summary plan description actually says that I am entitled to get copies of any and all records they use in making eligibility dicisions on my claim. However, I have already reminded them of that and they said "doesn't matter, we have to comply with HIPAA". If, as the shrink said, this report is not covered by HIPAA in the first place, how can they say this?

I WANT A COPY OF THE REPORT. IT IS ABOUT ME AND I FEEL I HAVE THE RIGHT TO THIS INFORMATION!

How do I have the right to make sure info was reported correctly if I cannot see the report? Don't I have the right to respond to this info if I feel there are errors in the report, to add my addendums into the record per HIPAA?

Does anyone know what my rights are in an instance where an insurance company ordered an independent medical examination? Does anyone know what the HIPAA laws say about a situation like this?

Does the fact that this is a "psychological" report make a difference? Are the HIPPAA rules different for psychological reports versus medical reports?

Biting back, hope you don't think I took over your thread; I just thought this was an appropriate place to ask this question.

Regards...

Richard

I'm not in that situation yet, but for those that are, you can call the HIPAA folks directly or email them at http://www.hhs.gov/ocr/hipaa/ or call 1-866-627-7748; the phone call is free.

Mino has given you great advice. I hope that helps.

But I'll ask my husband about your situation later tonight. He works at an organization which has to enforce HIPAA.

I can't promise he'll know about your particular situation, but it sounds like they're possibly trying to side-step the issue.

It may be tomorrow before I can respond.

Take Care
Jan

Here are some suggestions. You know best what to do because you know the details of your situation better than I do.

My husband nor I are lawyers.

Suggestions Only:

You could file a HIPAA grievance with your primary physician who ordered the Testing.

And as far as the NeuroPsycho Evaluators go,
you can call them and tell them they are a "business associate" under HIPAA Law and that they are obligated by their contract with the Primary Physician to provide your test results/records.

If they don't have a SIGNED contractual agreement with the Primary Physician, then both the Primary physician and the NeuroPsych Evaluators are in violation of HIPAA Federal Law.

In that case, you have the right to contact the Dept of Health and Human Services, if they refuse to furnish your records.

Anyone providing medical care of any kind, is covered under HIPAA, either directly as a "covered entity" or indirectly as a "business associate."

If the doctor did not have a contract with the Neuro Evaluators, then both parties will in trouble under the HIPAA law.

It is an outright untruth for the Neuro/Psych Evaluators to tell you they don't have to supply your records under HIPAA.

If you contact, Dept of Health & Human Services there WILL be an investigation. You need to tell both the Evaluators and your Primary doctor this fact-------if that's how you choose to handle it.

[I'm sure you saw my first reply above to Biting Back.]

If needed, please feel free to ask more questions.

Sorry they're giving you the run-around. My blood boils when doctors or health care provides are supposedly there to help you----then make sick folks jump through hoops.

I just don't get it at all. Do they have no conscious whatsoever?

Let us know how we can help.

Take Care,
Jan

The problem is that my primary physician didn't order this. This was an IME, ordered by the LTD company. I asked the LTD to send it to my physician, and they did. But lots of doctor's offices have policies where they do not release info they did not generate. I don't think there is any way to get by a policy like that.

I think the problem is the IME neuropsychologist isn't providing "treatment" or "care". This is an independent eval the LTD carrier will try to use to say I am not disabled. It is a work product, I think, rather than medical records.

hwlatin,

I think you are right and the disability companies do things in a "just so" way to avoid having to provide this info. Until AFTER they cut you off. That seems unfair, as it gives you no time to head off a denial decision and therefore by the time you are denied, it is too late. Everyone knows that once the denial is there, it is extremely difficult to change.

I may be out of luck.

Unfortunately the LTD has also scheduled a FCE. So what they are doing is putting all their bogus info together and will cut me off.

The LTD or insurance companies are covered by HIPAA. The LTD is acting as your health care provider------so covered under HIPAA. The law was written mostly for insurance companies.

You definitely might want to consider contacting the Health and Human Services and find out. Let them handle it. They can probably do more for you.

Hope that helps.

I had to leave for a while & couldn't finish my post. I really do see the urgency of getting those records.

If it were me, I'd contact Dept. Health & Human Services and file a complaint. For sure they'll figure it out.

You could also consider hiring a good HIPAA lawyer. I don't know if it's within the realm of possibility, but maybe they'd take your case on a contingency basis; You only have to pay if you win your case. Just a thought.

Best of luck.

Richard, neuro psy testing I had done 12-04. I told psy upfront I wanted a copy of ALL my medical reports from him & individual testings done:

memory, intellignence, and that STUPID Minnesota multi-phasic index, MMPI, which is 567 true/false questions with many "if, and, or" comments making it hard to answer 1 way vs. other.

There was NO problem at all. When he got the test results done, we had to see a different guy since he was the "expert" on these tests. MMPI was so wrong about me. I had hubby go with. We disagreed with so much that was there.

He said he'd redo the results & I could read them over. I did but in the hallway so they couldn't charge me; testings & visits were $1,000 !!

Again I found errors. I took it home & hubby & I read together. I noted errors, and then called him. He changed a few but wouldn't on rest. "You'll have to take that up with Minn. MMPI folks."

What really made me mad was he stated I could NOT do any type of work but refused to put his comments in my written report!

Problem I had with them was they were to send copies to my lyme dr. & sleep apnea dr. but didn't without RELEASE OF INFO. Then they sent them.

I was also given copy of HIPPA rules and how it relates to their business...very comprehensive so bring your reading lenses! I didn't! I believe they have you sign a statement saying you have read HIPPA too!

Back to BB's question. Do you have BC/BS and what plan or other insurance?

out of network ... meaning out of state?

That's what BC/BS did for me for my IGENEX blood tests done in Calif. They sent it to BLUE CARD who handles ALL OUT OF STATE charges except for SD who is treated like Iowa.

Call your insurance co.; no use fretting over something you don't have to. I have found BC/BS office wonderful to work with me on my countless bills but they aren't as many as your endless MDs.

Call the hospital ahead of time so they have "sufficient" time to copy your records.