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khagihara
khagihara, Doctor
Category: Health
Satisfied Customers: 6589
Experience:  Trained in the multiple medical fields for many years.
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Is there a way to get medical records if the institution refuses

Customer Question

Is there a way to get medical records if the institution refuses to release medical records even with proper forms signed!
Submitted: 1 year ago.
Category: Health
Expert:  khagihara replied 1 year ago.
What is the reason it refused? Can you tell me the situation?
Customer: replied 1 year ago.
After a stay in hospital for leg weakness and infection of lower extremities requiring IV antibiotics. Pt was pre-cleared for. 193 days by provider line from insure to provider to go to skilled nursing facility for special medical treatment and Reh via physical therapy , occupational therapy and even speech therapy.
The SNF failed to properly file the claims with correct reasons , codes and timely filling! The claims filed correctly were paid after Medicare discounted billing was applied . Well as. The SNF did not submit all claims with proper codes and on time, many claims were denied. Even on some forms 89 and. 48 Reh days were written approved on billing forms. The carrier states they can only discuss billing and provider line approvals with provider and provider in turn can give that to the client. But the carrier will not put in writing this information to any group but the provider. The provider refuse to request this key information that can clear the problem and the SNF refuse to release the clients medical records .
Than to add to insult to the client the SNF summoned the 84 yr Pt to court for nonpayment and stated the client was always a long term resident left for non payment and was always a self pay/ non insured resident ! All not true! Even with the short term approval for pt ot and speech therapy on a short term basis not a long term nursing home stay! Even as the SNF got some payment on proper filed claims they not filing correctly not providing the therapy as directed and contracted and non respecting the discounted agreement with contractual Medicare supplemental plans , SNF inflated the bill back to cost before Medicare discounts and are hiding records and approvals so not to prove the clients claims.
Customer: replied 1 year ago.
Patient ask by proper signed forms for their medical records. Three yrs and many signed forms requesting records are misplaced lost never received ! The attorney of client bedded with promises of the SNF attorneys to bury this and "CONTROL THE CLIENT" which means get your client to sign off on this and you will be compensated!
By law all patients have the right to their medical records !
This provider filed to properly file claims and to properly file within the time restraints of a year. So it was easier for the facility to alter facts, not provide disputing records that only the could release or obtain and with time much if this could get lost! The facility obtained a power house legal group that convinced the clients attorney not to dig for this proof not to get the provider line approvals not to pursue the filing codes dates or the wrong reasons of service or all the hospital admissions the client had during the stay with this center! Not to investigate the neglect if the facility that did not allow client rehab as contacted, the lack of care and safety that had pt end up in the ER 4 times with three hospitalizations form infections , increase wounds and declining ambulation during a 79 day stay for rehab and skilled nursing care esp IV antibiotics!
Customer: replied 1 year ago.
There was no reason for refusal.
They just ignored the request forms signed and mailed as well as handed in person! Even if we mailed return receipt things were misplaced or lost.
This institution had not filed the claims in time nor with proper codes/reasons of service. They also neglected to previous what that had agreed to providing for the client. This client ended up going to the ER 4xs and was admitted to three hospitals while client was to be cared for at this skilled nursing facility. It is all advantage for facility to prevent and bury or loss misplace request and documents long enough that times get confused beyond archive filing allowance to neglect providing records SNF can prevent one to prove the abuses and misfilings!
This center was contracted with Medicare! They are to agree to discounted billing of Medicare. They have gotten paid some money from insurance when the SNF did file proper codes and dates. But they did not provide the pt ot (therapy for ext strengthening and ambulation nor did they properly attendant or care the infection or wounds as proven by multiple hospital stays under their care) hospital stays for increased infection worsening wounds and infection and declining ambulation .
With all these deficiencies , it was best for the SNF( already rated in the low 2 's by NC state rating) to prevent any release of information that would expose their deficiencies and abuse.
By buying off the defendants attorney, the client is unable to get her med records the approval statements that exist but unless the SNF releases this
Along with the improper codes and late filing that insurance carrier agree the SNF failed to do , the client is unable to receive justice or the proof all under the control of the plaintiff! the SNF!
Customer: replied 1 year ago.
The only reason is the SNF have done everything over the Three years to say they never get the forms even when they have been signed and handed to them! So would one say they just will never fill the request law or no law?
Expert:  khagihara replied 1 year ago.
Have you contacted Medical Board of your state?
Customer: replied 1 year ago.
Not on this. It is difficult to get one to take an intake on major problems . And they never give follow up. So my experience with Nc is many calls and weeks to speak to the correct person. The statement of the problem vanishes into a circular file. There is no follow . And to call for status generates leaving message without return calls. It is as one never called.Not unlike what the medical records dept is doing. I practiced In NYC. It was rare to need to contact the Ny med board. But when one did they got back a letter.
Expert:  khagihara replied 1 year ago.
You should contact it. They could take an action or provide information to solve the problem.
Customer: replied 1 year ago.
As the Nc med board and quality And pt safety have failed in past issues, I suspect they will ignore this request as well. Would JCC be an option? As this is denying pt rights. Or fed gov as Hippac? I will attempt NC MED BOARD FOR quality and safety or umibus.
Expert:  khagihara replied 1 year ago.
What is JCC and Hippac?
Customer: replied 1 year ago.
Joint commission committee
Hippa pt priv acts hospital information pt privacy act
Joint commission reviews hospitals and med centers under spot reviews and assessments and monitor complaints on a federal basis.
Expert:  khagihara replied 1 year ago.
You should ask the state medical board what you should do. You should call them so that they can't ignore you. They would help you.
Customer: replied 1 year ago.
Well I will thank you.
Expert:  khagihara replied 1 year ago.
You are welcome. Hope you get the solution.
Customer: replied 1 year ago.
Five star help
Expert:  khagihara replied 1 year ago.
Thank you very much.