Medical records play a significant role in a variety of civil cases, including personal injury actions and workers’ compensation claims. As a result, litigators rely on subpoenas to quickly and efficiently obtain the medical records they need to support or defend their clients’ claims.
However, just because a subpoena is served to a records custodian doesn’t mean the custodian will comply in a timely manner — or comply at all.
Delays in custodian responses can have a serious negative impact on a case, and in some situations can even bring a claim to a grinding halt. How can lawyers and claims adjusters manage delayed custodian responses without wasting valuable time, money and resources?
As the largest nationwide provider of records retrieval, subpoena services and document management for the legal and insurance industries, ABI has spent over 30 years developing innovative technology and processes that offer more efficient ways to manage, analyze, review and summarize records.
Here are our best tips for ensuring records requests are fulfilled swiftly.
Give the Medical Records Custodian the Right Information
One of the most important parts of a medical records request is making sure the request contains every piece of information the medical records custodian needs to fully comply.
ABI prepares subpoenas, ensuring our clients get the information and documents they need. Paralegals and insurance claims adjusters ordering records can help get records quickly by completely filling out the online order form with the following:
|If you subpoena:||The subpoena should include:|
|Insurance company||A policy or claim number, as well as the type of claim|
|Hospital||Patient’s date of birth and/or social security number|
|Medical billing company||Patient’s date of birth and/or social security number and date of service|
|Medical group||Name of the treating physician|
|Radiology group||Name of the referring physician|
|Ambulance/EMT company||Date and location of transport|
|Business for employment records||Employee’s social security number, approximate dates of employment. If the employer has multiple locations, they may want a store number or indication of specific location.|
Require a Specific Date for Compliance
In some cases, a medical records custodian may respond with a need for an extension of time to comply with a records request. Because the discovery process typically unfolds without the court’s intervention, litigators sometimes find themselves grappling with a reluctant or uncooperative medical records custodian – that’s where a third party service with well established custodian relationships can provide benefit.
As most attorneys know, the courts generally dislike being pulled into a discovery dispute. Fortunately, there are ways to avoid getting the court involved.
When confronted with a request for more time, lawyers should respond promptly to the medical records custodian with a firm date for compliance. If the medical records custodian gives an open-ended date for compliance, the entire case could be thrown into uncertainty, leaving the lawyer in the difficult and time-consuming position of monitoring the request and following up to determine if and when the medical records custodian plans to turn over the documents.
This is another area where ABI can help. We know the nuances of each custodian’s preferred formats, as well as each regional, state and local compliance requirement — factors that are very important when requesting records from multiple states or when working with insurance carriers that have offices nationwide.
Make Sure Requests for Protected Health Information Meet HIPAA Requirements
Any request for medical documents that qualify as “protected health information” under the Health Insurance Portability and Accountability Act (HIPAA) must include specific information, including assurances that the patient whose medical records are being subpoenaed has received notice of the request.
Under HIPAA, health care providers aren’t authorized to release protected health information without receiving satisfactory assurances that the patient has knowledge of the records request.
Per 45 C.F.R. 164.512(e)(1)(iii), the entity making the records request can give a medical records custodian adequate assurances that the patient has been notified of the request by including notice language in the subpoena, a written notice to the patient, complete information about the records being requested and adequate time for the patient to raise and resolve any objections to the request. In practice, this type of assurance usually takes the form of a written release signed by the patient.
Alternatively, and as authorized by 45 C.F.R. 164.512(e)(v), a “covered entity,” which includes medical providers that receive medical records requests, can release protected health information when the lawyer making the request has obtained a “qualified protective order” that assures the covered entity that the records won’t be used for any other purpose than the present litigation and will be returned to the covered entity or destroyed when the litigation has concluded.
Whichever route your team takes, HIPAA secure retrieval is a critical component of any request for medical records.
Work with a Document Retrieval Company
Experienced litigators know that even a relatively straightforward personal injury or workers’ compensation case can include thousands of pages of medical reports, treatment records and related documents. For the busy practitioner, managing document requests can eat up valuable time and resources. Moreover, what might seem like a minor oversight or mistake in a records request can lead to delays in retrieval. A document management system like eSummary by ABI allows users to review, analyze and summarize records beginning with the first uploaded record.
This is where a document retrieval company can be a strategic partner for law firms and claims adjusters. With its advanced record retrieval and document management platform, ABI gives litigators the tools they need to stop the record retrieval runaround, so they can focus on protecting their clients’ interests and achieving exceptional results in the courtroom and around the settlement table.