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  1. #1
    sabrynne is offline Junior Member
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    Doctor is withholding medical records

    What is the name of your state? This question refers to CA.

    Through a filing mistake by my old insurance company, I wasn't covered for a month and ended up owing a doctor about $500.00, of which I have not yet paid (I was laid off an have not found employment yet).

    I recently tried to apply for health insurance again, and when the insurance carrier called this doctor to obtain my medical records, the doctor said she would not release my records because I had not paid the bill and would not release them until I paid it. Obviously the insurance company has denied coverage.

    My question is, does a doctor have the right to withhold my medical records because I owe her money? It would seem to me that there are legal avenues, if she so chooses, such as sending me to collections, etc. and that withholding medical records from an insurance company for any reason would be illegal.

    Thanks.

    Sabrynne
  2. #2
    ellencee is offline Senior Member
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    sabrynne
    The physician may be justified in withholding the records in this instance. Consult with an attorney in your area; the attorney may be able to get the records and may be able to get this filing error fixed to your benefit. If you did not cause the error, the insurance company may be liable for payment of benefits that should have been available to you.

    You have to pay the bill whether or not you are employed; make arrangements and pay it.

    Send the new insurance company copies of all of your itemized billing for the records in question. The itemized billing should provide the insurance company with enough information; include any prescriptions during that time. You can get a printout of all of your prescriptions from your pharmacy.

    EC
  3. #3
    Hisbabygirl77 is offline Senior Member
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    Im sorry I disagree the dr owns the chart yes but according to HIPPA regulations all the information within the chart is owned by the patient. In other words the dr HAS to release the records to the patient ( she could get them instead of the insurance company and mail) unless the dr feels that releasing the medical information is going to harm the mental/pysical health of the patient. The dr can charge for the copies but legally all that information in the charts is the customers. The dr CAN NOT refuse to release the information due to to the fact that the poster hasnt paid a bill.
  4. #4
    ellencee is offline Senior Member
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    Hisbabygirl77
    The poster is not asking for the physician to provide her with a copy of her records. An insurance company from which she is seeking a policy is asking for the information. As of yet, the MD has no duty to cooperate with the insurance company. There may be a rule or regulation that states the physician does have duty to provide "potential" insurance companies with copies of medical records, but if so, I am not aware of it.
    The poster is essentially asking the physician to do her a favor and he is declining to do so until she favors him with payment in full for services he has provided. I believe he is justified. Afterall, if she can't pay her physician's bill now, why should he assist her in becoming further indebted and further delinquent in paying his billing in full?
    EC
  5. #5
    Hisbabygirl77 is offline Senior Member
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    True the doctor does not have to release to the insurance. But the simple solution is for her to go get her own records which the dr has to release and then in turn send them to her insurance pretty simple
  6. #6
    ellencee is offline Senior Member
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    Yeah, but...the insurance company may not accept information that has passed through the hands of the person seeking to be insured. Not everyone is honest, you know. And...the MD can certainly stall providing the patient with her records. The physician would be duty-bound to provide the records to another physician or healthcare provider who requested full records, but the patient's request for her records could be delayed without the physician's being in any trouble. The physician has the right to be paid either at the time of service or within 30 days and if the patient filed a complaint against him, the physician could possibly win the battle.

    EC
  7. #7
    Hisbabygirl77 is offline Senior Member
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    Could be delayes yes but for no more than 30 days. And the Dr can charge for records but no more than 50$. I used to work in medical records for a large facility and trust me the drilled HIPPA regulations into our head lol. Plus we always gave records to people to give to SSI and insurances and never once did the insurance say the wouldn't accept them from the patient.
  8. #8
    scmarshall is offline Junior Member
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    I'm just left wondering why the doctor wouldn't send the information to the insurance. I worked in a small clinic, and if there was any way possible to get an insurance to pay on an outstanding account, we jumped all over it
  9. #9
    ellencee is offline Senior Member
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    scmarshall
    This is for a new insurance policy, not an existing policy.
    EC
  10. #10
    scmarshall is offline Junior Member
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    I know. My previous post came from past experiences with trying to collect on deliquient accounts. I had come across some insurance plans that allowed for retro-active billling and we usually tried all means possible of getting payment before sending an account to collection. Collections usually meant not getting any money at all and just writing off that bill.

    Now, if the new insurance at the time had explained to the doctor's office that the records request were for retro-active billing (and that is usually explained to the doctor's office), then I'm at a loss really as to why the doctor didn't go for it. Unless, the new insurance was state medicaid/medicare which would have actually lessened the chances of the doctor getting any payment (very hard to get the state to take care of previous bills) and if payment were to occure, a huge write-off would be taken and that remainder could not be billed to the patient(at least by Washington state law it can't).

    The only other reason I can think for the doctor's denial of access is that the patient had a history of non-payment, and basically the doctor was fed up.
  11. #11
    MellowCat is offline Member
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    Doctors in Texas must furnish records within 15 days of a request. The doctor is not supposed to withhold records to any entity the patient wants their records sent to due to an outstanding bill - though it sure would be nice to be able to use that to "lord" over those deadbeats.

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