What to do when a CA has access to all my medical records???

[CreditDiva]

I Dv'd a CA, and in return they sent me all of my medical records that they obtained from the OC, it shows all the procedures and codes that I was treated for, and then, for each itemized procedure, there are line items which are crossed out and edited in pen or pencil by hand , I don't if it was modified by the OC or CA..the OC will not deal with me, the total balance, after the edited and modified line, a total amount written in pen, for $40.87 says owed and then a collection fee has been added by hand....it all looks very fishy, but more so I am peeved that they have all access to my medical records and were dumb enough to send it to me. What are my options here?

[Equaliser]

This is a very gray area and I'm going to try to explain this as best as I can. To begin with there are different kinds of medical records.

Physican notes are those records in which a physician notes his observations, what investigative measures he took to accomplish a diagnosis, any procedures he performed, tests performed, results of tests and procedures, diagnosis, recommended treatment, prescription notes, and prognosis.

Nursing notes obviously deal with the nursing issues surrounding your case, and yes, they cover a whole different dimension of the situation than do physician's notes.

Bedside notes indicate measures taken for patient maintenance while a patient is staying at a hospital.

Pixis Record indicates drugs administered during a hospital stay.

Pre-operative, Operative, and Post-Operative Notes deal with all events surrounding a surgery.

Sentinel Event Report deals with any situation involving a life threatening incident or death.

Billing Notes list the procedures carried out. Each procedure has its own billing code which is listed in a book, Current Procedural Terminology . Some billing records, particularly on HIPPA forms also list the diagnosis code, which comes from the ICD-9 Manual.

Medical records are privileged communications. Physician-Patient Privilege is, like any other privileged communications, are granted that status by the courts, not the constitution. This is a commonly misunderstood concept. The US Supreme Court, recognizing that priveleged communications are necessary for a society to function, granted special status such that these communications are not allowed in court as evidence unless certain conditions exist.

While it has been said by Justice Blackmun that the 1st Amendment infers the right to privacy, I must also agree with Chief Justice Burger that even privacy has its limitations.

By law, it has been determined that collection agencies do carry out legal procedures. That is one of the determinations that gives the FDCPA and the FCRA their powers. When you dispute medical charges, obviously certain information must become known to be able to question the bill. This very aspect can limit privilege and privacy - and these two issues are indeed separate.

CA's are traditionally allowed access only to the billing records. However, if certain procedures are contested, the courts have ruled that opening up other records may be allowed in certain circumstances.

Having said all of that, what records has the CA been exposed to?

[CreditDiva]

This is a very gray area and I'm going to try to explain this as best as I can. To begin with there are different kinds of medical records.

Physican notes are those records in which a physician notes his observations, what investigative measures he took to accomplish a diagnosis, any procedures he performed, tests performed, results of tests and procedures, diagnosis, recommended treatment, prescription notes, and prognosis.

Billing Notes list the procedures carried out. Each procedure has its own billing code which is listed in a book, Current Procedural Terminology . Some billing records, particularly on HIPPA forms also list the diagnosis code, which comes from the ICD-9 Manual.

Medical records are privileged communications. Physician-Patient Privilege is, like any other privileged communications, are granted that status by the courts, not the constitution. This is a commonly misunderstood concept. The US Supreme Court, recognizing that priveleged communications are necessary for a society to function, granted special status such that these communications are not allowed in court as evidence unless certain conditions exist.

Having said all of that, what records has the CA been exposed to?

Both physican notes and billing notes

[Equaliser]

There would have to be an extreme situation in existance to warrant the release of those (such as malpractice). My concerns are these:

1) The billing records should have been the only records to be released first. That alone would have given you ample opportunity to look over what was charged, and then agree or disagree to the charges. Only as a last resort should the Phys. Notes be released. As you had no chance to contest the charges in detail, too much was released too soon.

2) The medical provider, in my view, is the one who breached your confidentiality/privilege/privacy. You've definately got a lawsuit there, as that constitutes a form of malpractice.

3) Recommendation: See a malpractice attorney for a suit in breach of privacy. Continue to act against the CA, but only in terms of the credit issues. Whether release of medical records is warranted or not is not the jurisdiction of the CA, but of the Doctors instead.

You have a claim here, just for a different type of law. I would think $10,000.00 would be in the neighborhood.