Medical records/information release is a process which is initiated by the concerned healthcare provider on receiving a duly filled medical records release form. As this release provides access to private medical records, this form must be submitted only by parties who have the necessary authorization under US federal law. Let’s take a closer look at who those authorized parties are, and how the various laws apply in medical records release and retrieval, such as Medicare insurance St George Utah companies offer
Which Parties Can Gain Access to Medical Records?
In order for any organization or individual to access specific or a cluster of patient data, they must either be the patient party, or belong to an organization or profession such as:
- Health care providers such as general physicians, surgeons and other specialists
- Insurance companies, Medicaid, Medicare, Social Security, Department of Veterans Affairs and other similar entities paying for the treatment (full or partial)
- The federal and the state government
- Prescription databases
- Medical Information Bureau (MIB)
- In case of a clash between the medical providers and the insurance company, the patient medical records play a significant role. As stated by the no-fault billing & collections | sigalovfirm, medical providers will get a fair amount for the treatment they have provided.
Why Do Insurance Companies Invest in Medical Record Retrieval?
Medical information retrieval is essential for insurance companies because:
- It allows them to exchange and/or share patient data with the appropriate, authorized parties
- Medical record retrieval is essential to prevent insurance fraud
- It also makes processing genuine reimbursements a much faster and customer-friendly process
There are in total, three main methods of recovering the necessary medical information for insurance companies, and you can find more about the pros and cons of each on American Retrieval at: https://www.americanretrieval.com/invest-record-retrieval.
What Kind of Information Can Insurance Companies Get Access To?
The list would be far too long if we were to state everything that’s included in the retrieved data, but we can still highlight some of the key facets:
- Patient’s personal and family medical history
- Genetic history and test results
- Diagnostic lab results, medications prescribed, and other forms of treatment received
- The results recorded post-treatment
- All information provided by the patient on their life and medical insurance forms
- Past history of smoking, drinking, drug abuse, etc.
Is It Illegal to Share and Sell Medical Records Data?
It is not illegal to share or sell medical records data in the US, but that is only as long as the data has been made anonymous. Any and all ID from the information must be removed, so that it cannot be used to trace back to any of the patients. The anonymous data is then grouped and categorized as readable data sets, before being shared/sold for both research and marketing purposes, depending on the buyer.
Illegal Disclosure of Medical Data is a Criminal Offence
Hacking and illegal, targeted medical information access are considered to be criminal offences. While hacking is almost always large scale, targeted medical information access usually involves the perpetrator using illegal means to acquire medical information on a specific individual. This crime is quite abundant in high profile divorce cases.
Aside from large scale hacking and targeted medical data stealing, there is also a third possibility to consider. Accidental leaks are instances where the data was made public or given access to by mistake. It is often a result of negligence towards safety protocols, and should, in most cases, be treated as a criminal offence as well.
