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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 118253
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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How can we have BCBS of OK pay records they have

Customer Question

how can we have BCBS of OK pay for medical records they have requested on patients? They demanded records, which we sent, because they said they owned the records. We wanted to bill for the copies/invoice. They said they do not have to pay and if we do not sent the records, we will not get paid.
Submitted: 2 years ago.
Category: Legal
Expert:  Ely replied 2 years ago.
Hello and welcome to JustAnswer. Please note: (A) This is general information and is not legal advice. No specific course of action is proposed herein, and no attorney-client relationship or privilege is formed by speaking to an expert on this site. By continuing, you confirm that you understand and agree to these terms; and (B) the site allows experts not participate in phone calls and I may or may not be able to participate in this feature.Can you please clarify who exactly you are? A patient? A doctor's office? Etc? And what are you attempting to achieve here?This is not an answer, but an information request. I need this information to answer your question. Please reply, so I can answer your question. Thank you in advance.
Customer: replied 2 years ago.
I represent the doctor's office. This has taken up so much of the office time to prepare and send off all the required documents they are requesting, office notes, lab orders, results, and a few other requests. The time involves means that the doctor has to pay for office help to prepare which he does not get compensated for.
Expert:  Ely replied 2 years ago.
Thank you. In the contract between the physician and the insurance company, does it say who is to pay for the copies?
Customer: replied 2 years ago.
Thank you. I will just look up the Statues in Ok. Good-by. I know they can be charged a base rate of $10 and 30 cents/page on electronic records and 50 cents/page if mailed. (I can't believe you would think the doctor would pay for the copies, really?)
Expert:  Ely replied 2 years ago.
Hello,You are not going to find any statutory code in Oklahoma in regards ***** ***** has to pay for medical notes between physician's office and insurance company. The primary source for this is the contract between the two entities. If this is silent, it falls on administrative code. This is why I was first asking what the contract stated (if anything), so as to determine if it controlled, and if not, then to go on to administrative code.Regardless, I will opt out and open this up for others. Good luck.
Expert:  Law Educator, Esq. replied 2 years ago.
Thank you for your question. I am a different contributor and look forward to working with you for educational purposes only. I am afraid that the law in OK is not exactly the best for you.76 Okla. Stat. Sec. 19 statesAny person who is or has been a patient of a doctor, hospital, or other medical institution shall be entitled, upon request, to obtain access to the information contained in the patient’s medical records, including any x-ray or other photograph or image.The cost of each copy, not including any x-ray or other photograph or image, shall not exceed One Dollar ($1.00) for the first page and fifty cents ($.50) for each subsequent page.May produce the records in digital form at a cost not to exceed twelve cents ($0.12) per digital page.The cost of each x-ray or other photograph or image shall not exceed Five Dollars ($5.00) or the actual cost of reproduction, whichever is less.The physician, hospital, or other medical professionals and institutions may charge a patient for the actual cost of mailing the patient’s requested medical records, but may not charge a fee for searching, retrieving, reviewing, and preparing medical records of the person.The law is for patients requesting records, but there is no law allowing a doctor to charge the insurer for sending the insurer records to justify the insurance claims they filed. A doctor, pursuant with their contract to collect from insurers has to provide proof of the claims and if that means the insurer wants medical proof of the claim filed, then before the doctor can get paid they have to submit those records and there is no provision in the OK law for charging them for that purpose.