Requesting Healthcare Records
By Barby Ingle
(excerpt from The Pain Code Book)
One thing I have learned over the years is how important it is to keep a copy of all of your medical records. My insurance companies have tried to force me into “step therapy” and without my medical records it would have been very difficult and long process to get through. I save my providers time as well, when I can fill out the insurance forms for appeals and send them over for the doctor to just review and forward on. In 2012, I was again faced with a step therapy request from my insurance company that came in the form of a written letter. They said, “If you have already tried the other medications with fail, your doctor should have done the Medform 3500, which is completed and sent into a clearing house.”
There is voluntary reporting form 3500, and the 3500A that is for issues that are mandatory to report. I went online and found the form and directions on the FDA government website. [1] Once I filled in all of the information, I copied it, attached the pertinent records, and sent it to my doctor. He finished completing it (using the records I attached) and signed and faxed it in. A few days later I called the insurance company to let them know I had a Medform 3500 on file. Within a few hours of calling my insurance company to let them know my medication was ready to be picked up from the pharmacy and they dropped the step therapy requirement for me.
You can typically obtain your medical records by writing out a request or filling out a premade form from the provider.
Your record request should include the following: [2]
- Date of the request
- Full Name
- Date of birth
- Social security number
- Telephone number
- Name, address, fax, and telephone number where the records are to be sent
- Purpose of the request (typically, there can be a charge for ordering your records). Each state has different laws on how much can be charged, for instance, there is a law in Arizona that if the records are being used for continuing care, the provider cannot charge you
- Specific items or dates of service needed
- Any restrictions on the request
- Date this authorization expires (authorizations must be less than one year old)
- A statement in writing indicating that the patient knows that they have a right to revoke this authorization at any time
- A statement indicating that the patient knows that signing this authorization is not a condition of obtaining treatment
- A statement indicating that the patient understands the potential for the protected health information to be re-disclosed by the recipient and no longer protected
- The signature of the patient or, if the patient is a child, the parent or guardian. If signed by a personal representative, a description of his/her authority to act for the individual and a copy of the document giving that authority. Records are not usually released while a patient is still hospitalized because they are incomplete
If you are in a state that is able to charge for copies of your medical records, you may save some money asking for specific documents or all recent major reports rather than requesting the entire record. Most of my requests have been filled with in 5 to 10 days but it may take up to one month. If you have not heard back in 30 business days, you may want to call or send a written follow up request. A few providers are offering your records online and others may provide it to you in electronic form if you provide them a flash drive.
Check with each provider as to the method they prefer. Some providers will fax medical records and some will only fax them to another healthcare provider in cases of immediate emergency. Your records are the physical property of the provider, however, the patient controls the release of the information contained in their record. In addition, if you are moving away from your provider, you may request your entire file so that you may provide it to the next provider who will be taking over your care. Providers must keep a copy of your records for a particular amount of years. In some states it is seven, others it is ten years, although most providers keep them longer.
[1] www.fda.gov/Safety/MedWatch/HowToReport
[2] Sample in The Pain Code Journal