Medical Records Release for Paralegals

The Paralegal Resource
January 8, 2013 — 3,220 views  
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The HIPAA (Health Insurance Portability and Accountability Act) was passed by the US congress in 1996. The federal regulations were established, which force hospitals, doctors, and providers of health care to meet baseline standards while handling the protected electronic health information like patient's medical accounts and health records.

Before this act was enacted, the health care provider assumed that the personal information of patients, which was collected in different private databases, belonged to them as they owned the database. The concept that was underlined by HIPAA was that the database owners need not necessarily own the data that contained therein and are just intermediaries. The organizations that are HIPAA compliant must adhere to the rules and ensure that the owners of records are guaranteed the following:

  • Right for a request of correction of errors and access to their records
  • Information on how their data will be used
  • Taking the individual's consent before using the electronic health information for marketing
  • Right to expect the health care organization to keep healthcare related communication confidential
  • Civil rights to file privacy related issues to the Human and Health services department

Obtaining Medical Information and Records

For both defense firms and plaintiffs, paralegals play an important role in managing the compensation cases of the workers by organizing, obtaining, and summarizing the medical records. The responsibility is not only to gather all the records that are related to illness or work injury, but also to gather unrelated and prior records for litigation purposes. Also, paralegals have to organize and locate the records as required while representing a firm.

Paralegals should know when to disclose the information, how to get the records, how to understand and read the records, and to organize them for an easy access by firms.

Ethical Considerations

Paralegals must be aware of the applicable case law and state statutes regarding who is allowed to obtain the records and based on what circumstances he can do so. They also should be familiar with the requirements of HIPAA before they contact medical providers.

Medical reports can be obtained by injured people or it can be obtained by the plaintiff’s paralegal firm by signing a HIPAA-compliant medical authorization form.

If the injured has not signed on HIPAA to allow the employers to get his/her medical records, it can still be obtained, if it is permitted by state laws.

Contacting the Medical Providers

There are different ways of requesting for medical records. The request method may differ and depends on the preferred contact method of the medical provider. Paralegals can help in creating a form if a company does not have one for a medical request. Medical providers, sometimes, only accept signed releases within a time frame like 6 months or 90 days of the request.

Verifying the Complete set of Medical Records

Obtaining records through paralegals is not just applicable to workers’ compensation cases but also to any case where the expenses and medical records have to be gathered by paralegals, such as medical malpractice or personal injury cases.

The records must be matched with the dates on the itemized billing statement by the medical provider. Date of services on the statement must also be matched with that on the medical record.

The Paralegal Resource