• We’re currently investigating an issue related to the forum theme and styling that is impacting page layout and visual formatting. The problem has been identified, and we are actively working on a resolution. There is no impact to user data or functionality, this is strictly a front-end display issue. We’ll post an update once the fix has been deployed. Thanks for your patience while we get this sorted.

Chiropractor failing to release medical documents to insurance

James Bond

James Bond

Diamond Member
On March 20th of last year I was involved in a pretty large accident. Two cars totaled (including mine), and one other damaged pretty badly.

Several of us went to the hospital with bumps and bruises, but nothing catastrophic. After getting checked up over a few days, it was advised that I see a chiropractor.

My parents referred me to "their lady", who specializes in athletic stuff, but seemed very personable - I started seeing her on a weekly basis.

After about 7 months I was completely back to normal. Full range of motion everywhere.

At this point - she *should* have sent all of my medical documentation to both insurance companies (mine, and the driver who hit me). Mine will be paying for my chiro, and her's will pay for my settlement, etc.

For the last 4 months we have been trying to contact the chiro with absolutely no luck. I leave a voicemail every week, as do with both insurance companies. No response. Not a single response since my last checkup. I have now started going into her clinic and leaving her written messages - every time I've been there I am informed that she is currently busy.

Last time I spoke with my insurance Co. they informed me that they had never seen anything like this. She hasn't been paid yet - and she doesn't get paid until I settle, so I'm not sure why she is holding everyone up. The insurance woman said she isn't sure what the law requires, but she guesses that there is some law that requires her to release these documents. Actually, she even asked me if the chiro was even licensed, as this is beginning to look mighty shady. I recently found out that she is licensed, although, she laid her secretary off in Nov.

I really want to settle and get all of this behind me... It's almost been a year now. Short of breaking down her door, what are my options?

CLIFFS:
Got in car accident.
Started seeing chiropractor.
Finished chiro therapy several months ago.
Chiro won't give insurance company medical documents. Ignores all phone calls and messages.

UPDATE 03-05-09:

I ended up having to go in to her office three times. Two of them were face-to-face.

The first time I spoke with another chiropractor at the clinic and explained the situation. He was really surprised to hear about the whole thing, and I ended up leaving him a message for her.
The second time, she left the patient she was working with and pulled me into a side room - before I could even sit she started apologizing profusely and went on for 5 minutes about family problems. She assured me that she would send the documents out within a couple days. One odd thing - when she was explaining this, she told me that the documents were off-site at her HOUSE. I deal with HIPAA compliance (digital), and I know damn well that she's in violation here.
The third time she left her patient again - this time it was extremely awkward for both of us, and she promised she would send the documents out the following day.

Three days later I finally got the fax, etc.

Now I have a few options - One of my roommates is a personal trainer and is really pushing for me to see a physical therapist. I see nothing wrong with this, as I would be all for getting any medical help I need (while I still can) - is it reasonable for me to explore this avenue, or is it too late at this point?

Also - Is there any point in me bringing up the HIPAA violation? I realize that she took forever to release the documents, but I don't want to bring her down just for the hell of it (she actually is a nice person).
 
Originally posted by: biggestmuff
7 months of "adjustments" for 'bumps and bruises'?
Click to expand...

I downplayed how bad it was. I lost a lot of motion in my neck. I was trying to get the point across that no one was severely injured.
 
Maybe try walking in and requesting, in writing, that they release copies of your records to you...and wait there until they do. You might consider filing complaints with any state licensing boards that apply.

Usually, obviously, the insurance companies just handle it all...it is weird that they're having such problems with it.
 
Originally posted by: Gooberlx2
Maybe try walking in and requesting, in writing, that they release copies of your records to you...and wait there until they do. You might consider filing complaints with any state licensing boards that apply.

Usually, obviously, the insurance companies just handle it all...it is weird that they're having such problems with it.
Click to expand...

That's what I tried doing last time - I saw the secretary walk in back and (I assume) hand her the letter. They sorta shooed me out so I didn't really wait around... I guess I can try that next time.

Both insurance companies are quite miffed by the whole thing. Definitely odd.
 
Originally posted by: James Bond
On March 20th of last year I was involved in a pretty large accident. Two cars totaled (including mine), and one other damaged pretty badly.

Several of us went to the hospital with bumps and bruises, but nothing catastrophic. After getting checked up over a few days, it was advised that I see a chiropractor.

My parents referred me to "their lady", who specializes in athletic stuff, but seemed very personable - I started seeing her on a weekly basis.

After about 7 months I was completely back to normal. Full range of motion everywhere.

At this point - she *should* have sent all of my medical documentation to both insurance companies (mine, and the driver who hit me). Mine will be paying for my chiro, and her's will pay for my settlement, etc.

For the last 4 months we have been trying to contact the chiro with absolutely no luck. I leave a voicemail every week, as do with both insurance companies. No response. Not a single response since my last checkup. I have now started going into her clinic and leaving her written messages - every time I've been there I am informed that she is currently busy.

Last time I spoke with my insurance Co. they informed me that they had never seen anything like this. She hasn't been paid yet - and she doesn't get paid until I settle, so I'm not sure why she is holding everyone up. The insurance woman said she isn't sure what the law requires, but she guesses that there is some law that requires her to release these documents. Actually, she even asked me if the chiro was even licensed, as this is beginning to look mighty shady. I recently found out that she is licensed, although, she laid her secretary off in Nov.

I really want to settle and get all of this behind me... It's almost been a year now. Short of breaking down her door, what are my options?

CLIFFS:
Got in car accident.
Started seeing chiropractor.
Finished chiro therapy several months ago.
Chiro won't give insurance company medical documents. Ignores all phone calls and messages.
Click to expand...

This doctor is violating the law. Since 50% of my job is to get medical records for people, I occasionally come across doctors that refuse to release them for various reasons. I send them the HIPAA complaint and a complaint for the Maryland Board of Physicians and a letter stating that these complaints will be filed within 30 days if the records are not delivered to our office. To date I have never had a medical provider not comply once I sent that letter. If you choose to follow the same path, here is where you will find the complaint form for the State of Washington.

Edit - you can read this part of the law here: 45 CFR 164.524 - Access of individuals to protected health information
 
Originally posted by: 1sikbITCH
Originally posted by: James Bond
On March 20th of last year I was involved in a pretty large accident. Two cars totaled (including mine), and one other damaged pretty badly.

Several of us went to the hospital with bumps and bruises, but nothing catastrophic. After getting checked up over a few days, it was advised that I see a chiropractor.

My parents referred me to "their lady", who specializes in athletic stuff, but seemed very personable - I started seeing her on a weekly basis.

After about 7 months I was completely back to normal. Full range of motion everywhere.

At this point - she *should* have sent all of my medical documentation to both insurance companies (mine, and the driver who hit me). Mine will be paying for my chiro, and her's will pay for my settlement, etc.

For the last 4 months we have been trying to contact the chiro with absolutely no luck. I leave a voicemail every week, as do with both insurance companies. No response. Not a single response since my last checkup. I have now started going into her clinic and leaving her written messages - every time I've been there I am informed that she is currently busy.

Last time I spoke with my insurance Co. they informed me that they had never seen anything like this. She hasn't been paid yet - and she doesn't get paid until I settle, so I'm not sure why she is holding everyone up. The insurance woman said she isn't sure what the law requires, but she guesses that there is some law that requires her to release these documents. Actually, she even asked me if the chiro was even licensed, as this is beginning to look mighty shady. I recently found out that she is licensed, although, she laid her secretary off in Nov.

I really want to settle and get all of this behind me... It's almost been a year now. Short of breaking down her door, what are my options?

CLIFFS:
Got in car accident.
Started seeing chiropractor.
Finished chiro therapy several months ago.
Chiro won't give insurance company medical documents. Ignores all phone calls and messages.
Click to expand...

This doctor is violating the law. Since 50% of my job is to get medical records for people, I occasionally come across doctors that refuse to release them for various reasons. I send them the HIPAA complaint and a complaint for the Maryland Board of Physicians and a letter stating that these complaints will be filed within 30 days if the records are not delivered to our office. To date I have never had a medical provider not comply once I sent that letter. Of course my letter is signed by an attorney, but the fact that you are ready to file those complaints SHOULD be enough. If not, file the complaints.

Here is where you will find the complaint form for the State of Washington.
Click to expand...


Yup.

Records of treatment must be released to third party payers if they're footing the bill.
 
I edited my reply a bit. After re-reading it I realized it sounds like advice, which would be crossing the line, me not being a lawyer 🙂
 
Originally posted by: iFX
Makes me think she doesn't have any records to release.
Click to expand...


Also illegal, but not impossible.

Plus she'd be screwed if this thing went to court if that were the case.
 
Originally posted by: ja1484
Originally posted by: iFX
Makes me think she doesn't have any records to release.
Click to expand...


Also illegal, but not impossible.

Plus she'd be screwed if this thing went to court if that were the case.
Click to expand...

Meh, at a chiropractor it wouldn't surprise me.
 
In my experience, chiros are the easiest to deal with. Usually I don't even need to send a HIPPA compliant release and I get weekly updates and bills. It's really weird because DCs usually don't get paid until there is a settlement and even then we usually agree on a less-than-100% fee. I have had a chiro initially be hesitant to send a bill through insurance because they insisted they wouldn't get paid but it was more likely because they would only get about 30% based on insurance contracts.
 
Originally posted by: RKS
In my experience, chiros are the easiest to deal with. Usually I don't even need to send a HIPPA compliant release and I get weekly updates and bills. It's really weird because DCs usually don't get paid until there is a settlement and even then we usually agree on a less-than-100% fee. I have had a chiro initially be hesitant to send a bill through insurance because they insisted they wouldn't get paid but it was more likely because they would only get about 30% based on insurance contracts.
Click to expand...

Plus they send lunch over every few months and baskets full of goodies at Christmas! And the wheels keep turning 🙂
 
that's illegal.

go to her clinic and talk to her face to face about it. if you have to, interrupt her session with another patient to talk to her. the last thing she wants is a pissed off patient amidst various other patients. drop a comment about legal action and let her know that if you don't receive confirmation in a week that she's done what she needs to do, then you'll sue.

if you sue, you'll more than likely win a settlement out of court.
 
Heh that is weird, I know I would be sending that stuff as soon as possible to get paid. "Doctors" seem to spend half their time typing up notes/records..
 
Originally posted by: GodlessAstronomer
You're surprised that a scam artist scammed you?

Edit - actually I read the OP more closely, and I'm 😕 Disregard my kneejerk post.
Click to expand...

ugh, just go away... christ. chiropractors aren't scam artists.
 
Originally posted by: wiredspider
Heh that is weird, I know I would be sending that stuff as soon as possible to get paid. "Doctors" seem to spend half their time typing up notes/records..
Click to expand...

it's lame. insurance screws over healthcare.
 
I am going through exactly the same situation as you. Here

This is about the blood work results. Its been almost 2 weeks now since i requested the blood work result from the lab that actually did the work, who is also the billing company in my case. Still havent received any from them yet.
 
Originally posted by: 1sikbITCH
Originally posted by: James Bond
On March 20th of last year I was involved in a pretty large accident. Two cars totaled (including mine), and one other damaged pretty badly.

Several of us went to the hospital with bumps and bruises, but nothing catastrophic. After getting checked up over a few days, it was advised that I see a chiropractor.

My parents referred me to "their lady", who specializes in athletic stuff, but seemed very personable - I started seeing her on a weekly basis.

After about 7 months I was completely back to normal. Full range of motion everywhere.

At this point - she *should* have sent all of my medical documentation to both insurance companies (mine, and the driver who hit me). Mine will be paying for my chiro, and her's will pay for my settlement, etc.

For the last 4 months we have been trying to contact the chiro with absolutely no luck. I leave a voicemail every week, as do with both insurance companies. No response. Not a single response since my last checkup. I have now started going into her clinic and leaving her written messages - every time I've been there I am informed that she is currently busy.

Last time I spoke with my insurance Co. they informed me that they had never seen anything like this. She hasn't been paid yet - and she doesn't get paid until I settle, so I'm not sure why she is holding everyone up. The insurance woman said she isn't sure what the law requires, but she guesses that there is some law that requires her to release these documents. Actually, she even asked me if the chiro was even licensed, as this is beginning to look mighty shady. I recently found out that she is licensed, although, she laid her secretary off in Nov.

I really want to settle and get all of this behind me... It's almost been a year now. Short of breaking down her door, what are my options?

CLIFFS:
Got in car accident.
Started seeing chiropractor.
Finished chiro therapy several months ago.
Chiro won't give insurance company medical documents. Ignores all phone calls and messages.
Click to expand...

This doctor is violating the law. Since 50% of my job is to get medical records for people, I occasionally come across doctors that refuse to release them for various reasons. I send them the HIPAA complaint and a complaint for the Maryland Board of Physicians and a letter stating that these complaints will be filed within 30 days if the records are not delivered to our office. To date I have never had a medical provider not comply once I sent that letter. If you choose to follow the same path, here is where you will find the complaint form for the State of Washington.

Edit - you can read this part of the law here: 45 CFR 164.524 - Access of individuals to protected health information
Click to expand...

Strange considering she would get paid if she complied but AFAIK 1sikbITCH is absolutely right. She cannot hold your PHI records like this. It's against federal law.
 
You must log in or register to reply here.

TRENDING THREADS

Back
Top