3 Important Things to Know About Locating Hospital and Pharmacy Records

In the case of many casualty insurance claims, locating hospital and pharmacy records is a vital part of the claims investigation process. The good news is, when done correctly (meaning legally and ethically) this is an excellent tool to either verify that all the medical records have already been provided or to locate additional records that have not been provided during the normal claims process. What is important is to understand three things about locating hospital and pharmacy records that will help you to expedite the process and to set reasonable expectations. Here is the list:

  1. Many times, a signed records release must be provided to the hospital or pharmacy or they simply will not cooperate. In some instances, a hospital may even require that the release be their release and no other. We recommend that you try and obtain a signed release as soon as possible and be prepared for additional foot dragging from some hospitals. It is just how they roll.
  2. If a release is mandated, it can often take time to get a hospital or pharmacy to respond and sometimes they simply don’t reply at all, requiring the request to be submitted multiple times. A bit of patience needed more often that it should be.
  3. Sometimes the canvass must be performed in multiple geographic areas. If a claimant has lived in more than one geographic area in the past few years, it is highly likely that records exist at facilities in their old neighborhood. In some cases, claimants have moved three and four times in a short amount of time, leaving you with the decision to have the search conducted in more than one location, which increases the cost.

Now for the bad news: if you are working with an investigator or search firm that is providing you with actual medical information (i.e. diagnosis, prescription information, etc.) from a provider or a pharmacy and they do not have a signed release from the claimant, they are NOT acting within HIPPA compliance and they are certainly exposing you to serious liability in the process.

For more information about our hospital and pharmacy records canvassing, please contact one of our team at 888-989-2800.