Problem with APS and Records

[WinoBlues]

I could learn a lot from your treachery lol

Ha, when you are a bitter old agent.

Hardest part is getting the name and email addresses. kinda like chain of command. If you go straight to the top they kick it down to a underling. If you start working your way up ccing everyone on your way somebody is going to say ''somebody take care of this *** ****''

 

[Cash]

Technically if they go over 30 days it is a hippa violation. The carrier is requesting the records on behalf of the client. Any patient records request must be fulfilled within 30 days by hippa regs.

Of course many doctors/offices do not realize this or just do not care. And of course you dont want to strain the clients relationship with their doctor... but ive had some clients get extremely upset at their doctor over records request. Most of the time the doctor has no clue that his staff is dropping the ball.

I had one go up to 60 days. So I sent a letter certified mail to the doctor himself informing him of the situation and the fact that is was a hippa violation. I didnt use threatening language, just informed him of the situation. He called both me and the client personally to apologize. He also told us that "heads rolled" and he now has a new office manager. He was well aware that it was a hippa violation, and apparently my clients was not the only records request that was over 30 days.

Man I wished I would have known that about six months ago. It took me over 5 months and many many phone calls to get records out of a hospital system.

After being transferred untold amount of times a got a hold of a woman who said
"oh yes I see the request here."
Me: "well can you send it"
Her: "oh well the request is too old now, you will need to resend it."
me:

 

[TriciaS]

I wouldn't be concerned about the number of pages. That includes everything. All lab results, letters from other Drs, providers. He was in an accident, there are probably at least 50-100 pages from the ER and follow up visits at least. I am a healthy 40 year old. Sinus problems and the typical cold, injury things. My records are 530 pages from 5 stitches and a 3 page follow up report for each of my 20 PT visits!

 

[dabulls]

Thanks for the reply.
Here is the latest update:

5/10/2015 Doctor's fee is excessive. Need approval. Advised requestor Doctor requests $172.30 in total...

Could they not approve it because the cost of records is too high????

 

[WinoBlues]

Thanks for the reply.
Here is the latest update:

5/10/2015 Doctor's fee is excessive. Need approval. Advised requestor Doctor requests $172.30 in total...

Could they not approve it because the cost of records is too high????

No. They can cancel the application as incomplete.

This is a $450 AP

 

[dabulls]

No. They can cancel the application as incomplete.

This is a $450 AP

Yes, a very small case. But I wrote a lot with them and about a million in their annuities. It would make me think twice about using them if alternatives are just as good.

It's the little things with me.

 

[WinoBlues]

Yes, a very small case. But I wrote a lot with them and about a million in their annuities. It would make me think twice about using them if alternatives are just as good.

It's the little things with me.

I hear you. But it is what it is. I have only placed a couple cases with them and they went smooth enough.

If she is healthy give her the option shopping a bigger, deeper pockets, company or Non med if the case qualifies.

You are at that tough place on a smaller case. Can you afford or want to chase it? But you also have time invested already so want to get paid not to mentioned you want the client. I have paid for APSs myself before. But doubt I would on this one.

Ask them if they will make an offer based on what they have. In the meantime shop it.

 

[dabulls]

I hear you. But it is what it is. I have only placed a couple cases with them and they went smooth enough.

If she is healthy give her the option shopping a bigger, deeper pockets, company or Non med if the case qualifies.

You are at that tough place on a smaller case. Can you afford or want to chase it? But you also have time invested already so want to get paid not to mentioned you want the client. I have paid for APSs myself before. But doubt I would on this one.

Ask them if they will make an offer based on what they have. In the meantime shop it.

Good advice. I have paid for APS before as well, but they usually ran $30 lol.

I will call midland tomorrow. Hopefully I can at least get a final answer.

 

[WinoBlues]

Good advice. I have paid for APS before as well, but they usually ran $30 lol.

I will call midland tomorrow. Hopefully I can at least get a final answer.

Yeah, $50 -$75 on a small deal and maybe get reimbursed. No problem. $175 on $4,500 case? Yeah OK. On $450 case? That _may_ get issued? Nope.

 

[dabulls]

They approved the fee.
Good on you, Midland