for managers and office staff of members of
the Lake County Medical Society
Photo: Office Managers' Program, May 6, 2010
Medical Records
No, no, no. Doctors cannot withhold medical records because a patient owes money on his or her account. We still receive calls from patients and medical offices about this issue. It simply should NOT be done. Although physicians have the right to charge for the copying and mailing of medical records, they cannot refuse to forward them to another physician until an account is paid in full. In fact, you cannot withhold them until the copying fee is paid. You can bill them, and in the extreme, even send them to collections, but you cannot refuse to release the medical records to the patient or his or her other physician. Medical practices have up to 30 days in which to release records following a request. The request should be in writing, but it can be verbal. Be sure to carefully document any verbal requests.
Medical records management is a tedious and time-consuming responsibility, especially since HIPAA Privacy Rules went into effect, requiring that some records be filtered or screened before copying to avoid the release of highly protected health information. You cannot release information about alcoholism treatment, substance abuse treatment, mental illness treatment, HIV/AIDS records, rape, genetic testing or treatment for injury resulting from domestic violence without the patient's specific written authorization for release of that information. It can be verbal, but we suggest that you get it in writing. We recognize that it can be extremely difficult to abstract some information that may be integrated into physician notes, but it is better to take the time to screen the record than to suffer the consequences of releasing information that a patient might object to after the fact. You can provide a record release form for patients to complete with a checklist referring to specific records that will be included in a record release. There are some Model Forms you can use available on the Illinois State Medical Society's website, or consult your own legal counsel. Members can go to www.isms.org and sign on. A password is needed for the Medical Legal Library section where these forms can be found. Any ISMS member can obtain a password if he or she does not already have one. Call ISMS at 312-782-1654 for information.
There is understandable confusion about the maximum allowable charges for medical record copying. The method used to calculate the charges will be different, depending on who requests the records and for what purpose. If a patient or his or her personal representative requests records for medical care, you cannot charge a handling fee according to the federal HIPAA regulations. You can use a formula that calculates fees based on your labor and supplies costs. Members can call our office to request a faxed copy of the current allowable record copying charges. For additional information, or a sample calculation sheet, as prepared by the Illinois State Medical Society, call our office at 847-482-0222.
Waiving Copays
While the routine waiving of Medicare copays could be a violation of the False Claim Anti-kickback statutes, physicians can forgive the copayment of a particular patient's copay due to financial hardship. Practices should have an indigent care policy in place and available to all patients, not only Medicare patients. Policies may include the following features:
• Consistent and reasonable standards for waiving the copay
• A printed application form for waivers
• The title of who may grant the waiver
• Documentation of waivers granted in an organized manner
Reporting Physicians' Address Changes
Physicians must report office address changes to the Illinois Department of Financial and Professional Regulation, Licensure Maintenance Unit, 320 W. Washington Street, 3rd floor, Springfield, IL 62786. Include the physician's license number and his or her date of birth. Address changes must be submitted in writing. They will not be accepted over the phone. License renewal notifications will only be sent to the address on file, and they are not forwarded. The notice of address change should be signed by the registrant. Questions? Call IDFPR at 217-782-0458.
HealthReach Clinic
Many of you are familiar with the HealthReach clinic in Waukegan. It is Lake County's only free medical clinic. HealthReach is always seeking new physicians and physician assistants to volunteer their expertise to the uninsured patients who seek assistance at the clinic, located at 1800 Grand Avenue.
The mission of HealthReach is to provide access to healthcare for the medically underserved individuals in Lake County, Illinois. The success of the clinic, initiated 1992, is the result of intensive community collaboration. Currently about 22 physicians from the area volunteer their time in the clinic representing such specialties as internal medicine, ophthalmology, neurology, pediatrics and gynecology. Patient care requirements increase each year. Volunteer physicians helped the clinic serve over 8000 patient visits in 2005.
For more information, or to learn about donating time, supplies, equipment or financial support, call Jim Zimmerman, HealthReach CEO at 847-360-8800, or email jzimmerman@healthreachcares.org.
HealthReach is always seeking new physicians and physician assistants to volunteer their expertise to the uninsured patients who seek assistance at the clinic, located at 1800 Grand Avenue.
