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Hi, my name is XXXXX XXXXX I thank you for your inquiry. I have been practicing law for 19+ years and look forward to assisting you.Can you clarify:Did your patient execute a release giving your permission to hand them over? (Usually the requesting party will include such a permission form with its request.)
No, he has not. The request--which came from Aetna says, "we are permitted to obtain these records without obtaining an additional authorization from the member/insured because we are both "covered entities" as defined by HIPPA.
But is that true?
Alexia, I would like to get a more specific answer and appreciate your honesty. It has felt odd to me that they said no release was required. When do you think you can get back to me?
The carrier, Aetna, covers my client's insurance with the corporation he works for.
They write me:
We are conducting a retrospective review of services rendered to the patient listed below. they ask for records for most of his treatment (which was extensive...he had several inpatient stays (rehabs mostly, not hospitals) while he was in phone contact (short sessions) with me.
They write, "We are permitted to obtain these records without obtaining an additional authorization from the member/insured because we are both "covered entities" as defined by HIPPA. Specifically 45 CFR 164.502 (a) (1) allows such disclosures for "treatment, payment of health care operations."
they want a copy of all records and progress notes.
hope this helps.
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