Charge To Transfer Medical Records

[UVaWahoo]

Probably a valid point.


Ok. I don't want this to go political. Bit I will just say this. UVAWahoo is in the "medical field" I don't know how specific he would like me to be.

But he said during our round on Sunday that
"The devil is in the details" speaking about Obama Care. This might be an indication of what he meant.

I agree that this is not the place to get political, those details will come out in time and there may be some unhappy people. There is a reason every event mandated by law has been postponed by executive order. The bill you received is a trade off. The law mandates certain actions by the physician regarding your record and those mandates take time. Time that reduces the time available to see patients, which means lost revenue.

With an admitted bias, I do not think some people understand the intricacies of and outside influences on health care systems and sometimes are too negative about the American system. But remember, anytime any where an organ is transplanted--thank the American health care system. Anytime, anywhere some high speed radiology machine makes exploratory surgery unnecessary--thank the American health care system. Anytime, anywhere some new drug cures a decease or treats a symptom--thank the American health care system. If not for our free enterprise system, none of this would have happened or at the minimum would be years away. Is it expensive-yes, is it perfect-no, can it be improved-most definitely. But again remember, it has not only extended or saved the lives of Americans but the peoples of the world as well.

 

[arydolphin]

Another way for the health care industry to rape the working man.

Same could be said for the fees and charges associated with many professions. Please don't hate everyone in the health care industry, some of us aren't half bad.

 

[JRod]

Same could be said for the fees and charges associated with many professions. Please don't hate everyone in the health care industry, some of us aren't half bad.

I don't and I know.

My father was a doctor. It just gets old getting hammered by insurance companies.

I know the docs get screwed just as bad.

 

[CAA_Beat]

Same could be said for the fees and charges associated with many professions. Please don't hate everyone in the health care industry, some of us aren't half bad.

I don't and I know.

My father was a doctor. It just gets old getting hammered by insurance companies.

I know the docs get screwed just as bad.

Agree with both of these posts.

My Dr. told me several years ago, the corporate office mandated they each fit in two more patients per hour.

When asked how to do that thy were told and I'm paraphrasing "rush them in out of the room. Don't let them ask to many questions or talk to much."

I'm sure it's very frustrating to Dr.'s that actually care about providing quality service with compassion.

 

[emart2173]

One of the guys I normally play with in Saturday group is a doc and he stopped doing rounds at the hospital because it wasn't profitable under the new rules so he left his business and went to someone else practice. He was losing money seeing patients in the hospital

 

[CAA_Beat]

One of the guys I normally play with in Saturday group is a doc and he stopped doing rounds at the hospital because it wasn't profitable under the new rules so he left his business and went to someone else practice. He was losing money seeing patients in the hospital

That just seems so wrong. And honestly worrisome as I have a 4 day hospital stay coming up in two months.

 

[lightningbolt44]

Man our healthcare is messed up. How they can charge you for your History is just amazing to me

 

[arydolphin]

That just seems so wrong. And honestly worrisome as I have a 4 day hospital stay coming up in two months.

It's the trend nationwide. It's more prevalent in the adult population than the pediatric population, but there are tons of hospitals that employ hospitalists, aka physicians that only practice medicine in the hospital. They oversee the care of patients when those patients' primary care providers do not round in the hospital. Full disclosure: part of my job has me as a pediatric hospitalist in a community hospital in the suburbs of Boston. In the past 2 years, that hospital has had multiple pediatric practices that have stopped rounding on their own patients and turned their care over to hospitalists. Most families don't have an issue with it, for what it's worth.

 

[tequila4kapp]

I played with a chiropractor a month or so back who determined all the intricacies and rules most of us don't know about were too much and would kill his practice so he gave it up and took up a new profession. I won't bore people with those details but people aren't going to like it as they learn about it, that's for sure.

 

[dcbrad]

Man our healthcare is messed up. How they can charge you for your History is just amazing to me

How is it any different than an auto shop charging a "diagnosis fee" or a computer shop charging a fee just to open up your computer?

In an age where a health care physician can be sued for anything, we have to put a lot of time and effort into documentation to adhere to many guidelines. Not to mention, stay up to date on those guidelines on our own dime. The fact that someone has to compile the notes and pay for the paper, ink, man hours, etc and asks for a bit of compensation to that doesn't seem to be unreasonable to me.

Do I agree with the cost in the OP? No. Are there certain situations where that cost seems excessive? Like JB's thumb drive scenario? Yes absolutely. So I'm not condoning nickel and diming people, but paying a small cost for a service being provided to you doesn't seem that bad.

In regards to getting them free after each visit, I can only speak for my office, but I usually don't finish the entire SOAP note while the patient is in my office. Usually are done at the end if the day first thing next morning, so I don't know how I would be able to provide that person's note before they left, it would be very counter productive and i would not be able to help as many people daily if that was the case.

 

[lightningbolt44]

How is it any different than an auto shop charging a "diagnosis fee" or a computer shop charging a fee just to open up your computer?

In an age where a health care physician can be sued for anything, we have to put a lot of time and effort into documentation to adhere to many guidelines. Not to mention, stay up to date on those guidelines on our own dime. The fact that someone has to compile the notes and pay for the paper, ink, man hours, etc and asks for a bit of compensation to that doesn't seem to be unreasonable to me.

Do I agree with the cost in the OP? No. Are there certain situations where that cost seems excessive? Like JB's thumb drive scenario? Yes absolutely. So I'm not condoning nickel and diming people, but paying a small cost for a service being provided to you doesn't seem that bad.

In regards to getting them free after each visit, I can only speak for my office, but I usually don't finish the entire SOAP note while the patient is in my office. Usually are done at the end if the day first thing next morning, so I don't know how I would be able to provide that person's note before they left, it would be very counter productive and i would not be able to help as many people daily if that was the case.

I dont know something about paying for my own history just bothers me. My wife is in healthcare so I completely understand that side of it as well as I know the offices see less money than people actually think they do. I guess I feel as I am paying for the diagnosis and the print out by coming in for a visit but again its just a viewpoint which I understand others will feel differently

 

[tequila4kapp]

I understand your point, I really do. But something feels off when a federal law has to get passed to make me pay for what was previously free.

 

[CAA_Beat]

How is it any different than an auto shop charging a "diagnosis fee" or a computer shop charging a fee just to open up your computer?

In an age where a health care physician can be sued for anything, we have to put a lot of time and effort into documentation to adhere to many guidelines. Not to mention, stay up to date on those guidelines on our own dime. The fact that someone has to compile the notes and pay for the paper, ink, man hours, etc and asks for a bit of compensation to that doesn't seem to be unreasonable to me.

Do I agree with the cost in the OP? No. Are there certain situations where that cost seems excessive? Like JB's thumb drive scenario? Yes absolutely. So I'm not condoning nickel and diming people, but paying a small cost for a service being provided to you doesn't seem that bad.

In regards to getting them free after each visit, I can only speak for my office, but I usually don't finish the entire SOAP note while the patient is in my office. Usually are done at the end if the day first thing next morning, so I don't know how I would be able to provide that person's note before they left, it would be very counter productive and i would not be able to help as many people daily if that was the case.

Thanks for the post. Many of us may not realize how much time goes into it and how many of these request a day or a week the office gets.

At this office in the past, I had to always ask for a receipt for my co-pay (FSA) and you would have thought I was asking for the world. I think it was mostly laziness on the staffs part, not financial but I couldn't help but think what it would take to get the actual record of the visit


My Dr. who I truly like, seems to compile all her notes and orders on a tablet during the appointment. So I would think it would be accessible.

 

[JRod]

How is it any different than an auto shop charging a "diagnosis fee" or a computer shop charging a fee just to open up your computer?

In an age where a health care physician can be sued for anything, we have to put a lot of time and effort into documentation to adhere to many guidelines. Not to mention, stay up to date on those guidelines on our own dime. The fact that someone has to compile the notes and pay for the paper, ink, man hours, etc and asks for a bit of compensation to that doesn't seem to be unreasonable to me.

Do I agree with the cost in the OP? No. Are there certain situations where that cost seems excessive? Like JB's thumb drive scenario? Yes absolutely. So I'm not condoning nickel and diming people, but paying a small cost for a service being provided to you doesn't seem that bad.

In regards to getting them free after each visit, I can only speak for my office, but I usually don't finish the entire SOAP note while the patient is in my office. Usually are done at the end if the day first thing next morning, so I don't know how I would be able to provide that person's note before they left, it would be very counter productive and i would not be able to help as many people daily if that was the case.

I'll bite.

The person making the copies and doing the work is probably not making 70k a year as a certified trained professional. I always get a kick when people think diagnosing a car is as simple add plugging in my 12 thousand scanner and it tells me exactly what's wrong.

You do realize properly diagnosing a vehicle can take hours whereas copying paper and faxing it or sending it electronically game 10 minutes?

This is not a slap to secretaries but let's be realistic here. The doctor isn't the one doing the work here. The Secretary making beans is.

 

[Ballsohard]

Same could be said for the fees and charges associated with many professions. Please don't hate everyone in the health care industry, some of us aren't half bad.

I don't think 85 percent of the general community know the effort that goes in to getting an accepted claim and that's why you see some inflammatory comments.

 

[JB]

How is it any different than an auto shop charging a "diagnosis fee" or a computer shop charging a fee just to open up your computer?

In an age where a health care physician can be sued for anything, we have to put a lot of time and effort into documentation to adhere to many guidelines. Not to mention, stay up to date on those guidelines on our own dime. The fact that someone has to compile the notes and pay for the paper, ink, man hours, etc and asks for a bit of compensation to that doesn't seem to be unreasonable to me.

Do I agree with the cost in the OP? No. Are there certain situations where that cost seems excessive? Like JB's thumb drive scenario? Yes absolutely. So I'm not condoning nickel and diming people, but paying a small cost for a service being provided to you doesn't seem that bad.

In regards to getting them free after each visit, I can only speak for my office, but I usually don't finish the entire SOAP note while the patient is in my office. Usually are done at the end if the day first thing next morning, so I don't know how I would be able to provide that person's note before they left, it would be very counter productive and i would not be able to help as many people daily if that was the case.

There is one major difference. Both of your examples are pre-treatment. That would be the same as charging me for coming in and having the nurse or assistant take weight and blood pressure (which I get charged for as part of my visit).

If I get my car worked on and then need the itemized history of what was done, they do not charge me again. With this new law in place, and the way it is being done (meaning at the end of the day or the next day), the only way to get this history without charge, is to write a letter saying one cannot afford it. That part I do struggle with.

Im not against paying for procedures or even for time. Everybody's time is precious and valuable and one that does "helping" should be no different. What I am against is nickel and diming and price gouging. The costs associated with some of this is outrageous compared to the time and materials it actually takes.

I completely understand what the newest laws are going to do to the profession. It is awful and only going to get worse throughout.

 

[Trout Bum]

I just went trough this myself recently and was shocked at an $80 dollar charge for it. I know it takes work to do things like this but Sheesh shouldn't it be included in the over priced health care we pay for?

I don't know if any of you are aware of this or not.

Earlier this week I called the medical office of my current Dr. to have them transfer my records to another office. They said they would send a release form, ok great all is good.

Well the form comes along with a cover letter explaining that the following charges will apply.

$22.95 Processing Fee

additional .76 a page

$5 to fax or mail to the new office.

I was shocked and before I called up to berate them, we did some research. It appears congress passed a law in December that allowed them medical practices/doctors to charge this fee to it's patients. Went into affect in 2014.

I don't know how many pages my records are, but I know it's more than one or two. I think it's outrageous. I plan on contacting the new Dr's office, to see what they suggest, or if they will cover part of the cost, which might be a long shot.

Interested to see if anyone has heard of this.

 

[dcbrad]

There is one major difference. Both of your examples are pre-treatment. That would be the same as charging me for coming in and having the nurse or assistant take weight and blood pressure (which I get charged for as part of my visit).

If I get my car worked on and then need the itemized history of what was done, they do not charge me again. With this new law in place, and the way it is being done (meaning at the end of the day or the next day), the only way to get this history without charge, is to write a letter saying one cannot afford it. That part I do struggle with.

Im not against paying for procedures or even for time. Everybody's time is precious and valuable and one that does "helping" should be no different. What I am against is nickel and diming and price gouging. The costs associated with some of this is outrageous compared to the time and materials it actually takes.

I completely understand what the newest laws are going to do to the profession. It is awful and only going to get worse throughout.

I 100% agree, and I believe we are on the same line of thinking about it. Hopefully not coming across that I am condoning $80.00 transfer fees, because that is ridiculous. My costs cover my paper, ink, and time to do it. The largest I have ever seen a patient pay in my office is right around $2.50

 

[dcbrad]

Here is another scenario I want to throw out there. Do you feel it is right for an office to charge you to fill out a supplemental insurance form (like Aflac) for short term disability or a form to help file for those supplemental benefits?

Example: You are off work, and have Aflac that will pay you cash for your disability, but they need a form with diagnosis codes and a brief description of the problem/diagnosis plus your PCP's signature to process the claim. It is your responsibility to get this information and send it to Aflac. Do you feel this something you shouldn't be charged for to have the office fill out the form? Or is it acceptable to pay a REASONABLE fee to have it filled out?

 

[UVaWahoo]

That just seems so wrong. And honestly worrisome as I have a 4 day hospital stay coming up in two months.

As it relates to your hospital stay, since you are in Maryland, it is not like the rest of the nation. Maryland has the Health Services Cost Review Commission (HSCRC). The HSCRC functions much like the public service commission, it reviews and regulates the rates (charges) that Maryland hospitals can assess. More importantly, the HSCRC has a Medicare/ Medicaid waiver. That means these programs pay the rates authorized by the HSCRC, less a volume payer discount. That means in Maryland, the commercial payers are not subsidizing the payment shortfalls of these programs as in other states. It also means that the charges assessed reasonably relate to the cost incurred to provide the service and to provide the needed working capital for future services.

 

[UVaWahoo]

It's the trend nationwide. It's more prevalent in the adult population than the pediatric population, but there are tons of hospitals that employ hospitalists, aka physicians that only practice medicine in the hospital. They oversee the care of patients when those patients' primary care providers do not round in the hospital. Full disclosure: part of my job has me as a pediatric hospitalist in a community hospital in the suburbs of Boston. In the past 2 years, that hospital has had multiple pediatric practices that have stopped rounding on their own patients and turned their care over to hospitalists. Most families don't have an issue with it, for what it's worth.

There is definitely an increase in the use of Hospitalists. The payment for services is a major factor, but additionally primary care physicians do not like getting awakened at 2:00am by a call from the ER. However, in order for a hospital to employ a Hospitalist there must be a sufficient volume to make them financially feasible. Accordingly, this limits their use in rural areas. Likewise, I see an increased use of physician extenders (NPs and PAs) in private practices in order to take care of the shots, sniffles, lumps and bumps. When trying to recruit a physician, it seems they are more interested in being employed as opposed to establishing a private practice, From my perspective that creates a professional liability concern. In most locales, hospitals are only responsible for the actions of physicians employed by them. I would guess the professional liability factor is in the minds of physicians as well.

 

[CAA_Beat]

Here is another scenario I want to throw out there. Do you feel it is right for an office to charge you to fill out a supplemental insurance form (like Aflac) for short term disability or a form to help file for those supplemental benefits?

Example: You are off work, and have Aflac that will pay you cash for your disability, but they need a form with diagnosis codes and a brief description of the problem/diagnosis plus your PCP's signature to process the claim. It is your responsibility to get this information and send it to Aflac. Do you feel this something you shouldn't be charged for to have the office fill out the form? Or is it acceptable to pay a REASONABLE fee to have it filled out?

I would have no problem paying a reasonable fee for that service. I would consider anywhere from $10 to $20 reasonable. (I hate filling out forms!!)

 

[CAA_Beat]

As it relates to your hospital stay, since you are in Maryland, it is not like the rest of the nation. Maryland has the Health Services Cost Review Commission (HSCRC). The HSCRC functions much like the public service commission, it reviews and regulates the rates (charges) that Maryland hospitals can assess. More importantly, the HSCRC has a Medicare/ Medicaid waiver. That means these programs pay the rates authorized by the HSCRC, less a volume payer discount. That means in Maryland, the commercial payers are not subsidizing the payment shortfalls of these programs as in other states. It also means that the charges assessed reasonably relate to the cost incurred to provide the service and to provide the needed working capital for future services.

So in english, does that mean I'll see my Dr. during my hospitalization? Ha

 

[UVaWahoo]

So in english, does that mean I'll see my Dr. during my hospitalization? Ha

I can only discuss hospitals, I cannot and will not even attempt to address the physician charges and services that you may or may not receive.

 

[Ole Gray]

I picked up a scan/test the VA recently completed of my thyroid gland for my family doctor to put in her files. The VA charged nothing so I'm happy with that. I did have to sign a release form at the local VA office. First I have heard of this.