Posted on 03/23/2006 3:47:56 PM PST by neverdem
Complain to the state department of public health. You don't want to be the hospital after you do that.
Nope, the physician owns the chart, but you have a right to see whatever's in there. Of course, it costs money to make copies.
And leaving a message on your home answering machine isn't a HIPPA violation. This has already been litigated, and is considered a reasonable thing to do. Of course, this depends on what was said on the machine as well.
Thank you. I figured it wasn't worth bothering in with. I do think $40 is a bit much per record for my each person in my family. I was finally able to get them to fax the basic shots etc for my 6 yr old.
Those numbers are gross receipts. Assuming the charges are rarely paid in full by all the insurance companies.
The doctor is required by Federal Law to have one fee schedule and to charge all his or her patients the same fee. They are allowed to make contracts with insurance patients under those laws, but not allowed to discount more than 10% for "cash and carry" patients.
Some docs have been fined hundreds of thousands and even jailed for discounting fees below the fees set by Medicare. Most of us are used to being threatened for antitrust action and with RICO if we discuss our actual fees with another doc or if we want to work outside of Medicare regulatons.
See Association of American Physicians and Surgeons for years of examples.
Here's an overview
http://www.thenewamerican.com/tna/1999/06-21-99/vo15no13_overdose.htm
http://www.aapsonline.org
specifically
RICO - http://www.aapsonline.org/newsletters/jan94.htm
Coding felony - http://www.aapsonline.org/newsletters/july94.htm contains this excerpt from Medicare instructions to their undercover investigators:
"" ``One tape-recorded, undercover visit can make an entire case....Closely supervise each undercover visit...to maximize inculpatory conversations...You want to prove a pattern so that you can use RICO forfeiture to financially dismantle the fraud'' (Medicare Compliance Alert, 3/28/94).""
Antitrust - http://www.aapsonline.org/newsletters/sept95.htm
I love your description of your friend's technique for taking a history. It goes against everything we're taught about taking a history in med school. But I know it's bound to work except for some of the very compulsive patients.
Those are the ones who have to tell their story from beginning to the end and any distraction or question means we start over. I eventually figure them out, let them finish and try a version of your friend's 20 questions.
And I imagine them frustrating the dickens out of every other doc they ever saw.
In my business, one of my great joys were those occasions when one of my frustrating clients would announce that he was leaving me for another practitioner who I knew to be precisely the individual he deserved to be with. A guilty pleasure, I know, but damn near irresistable.
A kindred soul!
(sometimes I worry that it's really that their personality disorder is irritating mine. Then, the more irritated I get, I remember that I don't *have* a disorder...)
About a year ago my 5yo son came down with a really nasty repiratory illness and had a terrible asthma attack. We took him to the closest place- a very 'nice, high-tech urgent care' so we could at least get a breathing treatment started. My husband had to carry him in because he couldn't get enough breath to walk on his own power. He was listless and white as a sheet when he checked him in. My husband then had to sit in the wating room with his son gasping for air in his arms while all kinds of trash went sauntering back for colds and sniffles. My husband finally went back up to the desk and said 'maybe you didn't understand me- my son cannot breathe' The lady looked very annoyed and said 'well, I guess we'll have to put you ahead of some of these other people, then' Yeah, I guess you will.
After getting the breathing treatment and the md determining that his blood oxygen was low enough for him to be transported by amublance to the hospital, he got there only to be put in a room (oxygen now removed) to wait 1&1/2 hours for anyone to even come ask why we were there. This is at one of the top children's hospitals in the country. He was subsequently admitted for a 4 day stay and trying to get discharged was like trying to make a prison break from Alcatraz. We had to go on a recon mission to find a doctor to discharge us 7 hours after they said we could go home.
Flame away folks.
Just for what it's worth, there is considerable controversy about the wisdom of giving asthma patients oxygen. You may have been dealing with a medical professional who believes it's unwise. Nevertheless, that should have been made clear to you, and the whole experience was certainly traumatic.
Your front office experience reminds me of an occasion when I visited an urgent care facility for a minor injury, and noticed while checking in that the guy in line behind me was pale and clutching his chest. The receptionist spoke to him in an irritated fashion, and told him to sit down and she'd call him when she was ready to take his information. As we sat, I inquired of the guy's wife what the problem was, and she said he'd developed a crushing feeling in his chest that wouldn't go away. About that time, I spotted a nurse behind the desk, flagged her down (over the objections of the minimum-wage receptionist), pointed to the guy and said "chest pains". The nurse took him back immediately, and he went out of there a few minutes later in an ambulance. I most certainly didn't mind having him jump ahead of me in line. The minimal skill level of some employees who interface with the public in a medical setting is pretty scary!
Dang! That is a lot. Maybe I need to re-think what I charge! ;) Now, if you’re talking a copy of the entire medical record of an elderly patient, 200 pages thick, that may be reasonable.
But for about 20 pages of a fairly young person, that seems very high.
And for something like a shot record, I do that kind of stuff for free. But others don't.
I don't, it's a good analogy!
Of course, I also restore old Britsh cars and Corvettes, so I ALSO double as a REAL mechanic. ;)
What was so ridiculous was that the urgent care md insisted that he be transported by ambulance to the hopsital over our offer to drive him because she felt he could not be without oxygen for the drive. Then when we get to the hospital, they remove the oxygen and let him sit there for and hour and a half (the ride was only 25 minutes) which probably led to another decrease in his blood oxygen and the ensuing 4-day imprisonment at the hospital. And it wasn't a matter of 'deciding' not to give him oxygen for a medical reason. It just took that long for someone to get around to seeing us and deciding what to do!
I remember hiding under a dresser in my bedroom when Dr. Montgomery made a house call. He's the same man who delivered me. I was like part of the family. He talked to me about real things until he passed away about ten years ago. I miss that man, and I know that there are thousands of others who do too.
Flame away folks.
No flames here. I actually agree. The free market will bring down prices (and probably improve patient satisfaction) once people start shopping based on both price and satisfaction.
"Why did you have to wait for 12 hours? Were there that many people in the ER?"
I was in the ER in a Phoenix hospital 2 years ago. It was in February (cold/flu season) and the place was filled with Hispanic* mothers holding screaming snot nosed kids and elderly Hispanics* coughing and sneezing.
This was at 2AM and the kids were tired because of the hour, not the colds. I suspect the parents waited until the bars closed befor coming in.
I had to wait over 4 hours (6AM +) until they were mostly cleaned out and a bunch of yelling by me and my wife finally got some attention.
As it turned out, my blood sodium level had dropped to the "you should be dead or at least having convulsions" level. (Quote from the attending Doctor)
Eight to nine bags of saline got me going again and some mis-diagnosis and refusal to listen to the patient caused some harsh words.
* Note the PC terminology, even after 20-30K of those toilet ticks had the balls to march on one of the busiest streets in Phoenix y'day. Where was ICE?
Yes it is alot when you figure on moving 5 files. They were nice enough to send the shot record for my 6 yr old but as for the rest of us we pay. Unless I just go to the new Dr and say I have no records. I doubt theres much in the records he needs to see anyway at this point, I would rather have him do all new tests anyway. My old dr wasnt much on getting blood work done. I swear he just wanted to get me on zoloft and paxil, my husband too. Funny thing was we never complained about depression.
Good Grief! Around here, we have a requirement that the paramedic with the ambulance continues to treat the patient until the hospital will accept turn-over. That provides some continuity of care, but the flip of it is that if the ER is busy, the patient, the paramedics, and the gurney get stuck in a hallway somewhere. Meanwhile, there's no paramedic coverage for that part of the city. Our ongoing dispute with the hospital is that we're fed up with providing free medical care that the hospital should be providing but aren't just because they won't staff their ER properly.
Our chances of abandonment are somewhat lower here if you come in by ambulance, but walk-in patients still face the chance of reaching retirement age before they get to see a doctor. It's a hell of a way to run a business.
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