ob won't release records to midwife, what to do? - Mothering Forums

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Old 07-07-2010, 03:38 PM - Thread Starter
 
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So I recently got fired by my ob....it's a long story.... I mentioned in passing to a nurse, that we were considering getting a midwife for a homebirth, two weeks letter I got a letter in the mail firing me a patient..... so anyway... in the letter I recieved it offers to send my records, for a large fee of course, to a new obgyn. When I called the office, they informed me that they would not give me copies directly, or my midwife. How can a doctor deny me access to my own medical records? Is my midwife not an equal partner in healthcare? Not to mention I had pending labs results that I have not been given, seeing how I was fired and all. Because I even considered hiring a midwife, I am without prenatal care, and I am scrambling to find a midwife. We were pretty sure we wanted to hire a midwife anyway, but we weren't expecting all of this. And if a dr feels strongly against homebirth, take the time to explain it to your patient, instead of sending a certified letter.
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Old 07-07-2010, 03:43 PM
 
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I'm pretty sure that's not legal. They are YOUR records!

Yep, according to HIPAA they must release your records to you: http://www.hhs.gov/ocr/privacy/hipaa...ers/index.html
(click on What Rights Does The Privacy Rule Give Me Over My Health Information)

Quote:
Health Insurers and Providers who are covered entities must comply with your right to:

* Ask to see and get a copy of your health records
~snip~
If you believe your rights are being denied or your health information isn’t being protected, you can

* File a complaint with your provider or health insurer
* File a complaint with the U.S. Government
I would, in person, politely remind them that they are legally required to give you a copy of your records. They'll probably charge you for them (printing fees usually) but they must release them to you!

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Old 07-07-2010, 06:35 PM
 
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That ain't right!

When I switched from an OB to a midwife, my OB's office sent my records over at no cost to me. It was a non-event, really.

Good luck... fight for your rights!

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Old 07-07-2010, 06:52 PM
 
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Uh, yeah, I work at a medical center - the paper the information is printed on is theirs, but the INFORMATION on that paper is YOURS. You are legally entitled to that information. Print out that HIPAA info AFWife posted and take it with you to the office and make your request in person.

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Old 07-07-2010, 09:16 PM
 
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Odds are extremely good that if you show up in person citing HIPPA they'll comply in short order. Talk to the clinic manager if necessary. If they don't and they are part of a larger health system locally, call the main hospital/administration and just tell the operator that you believe your rights under HIPPA have been violated by one of their clinics. They should put you through to their HIPPA/privacy coordinator who should make sure you get your records. HIPPA is serious business. You can also call your insurance company and if you have a group policy through your HR department, get them involved too. You can also file a complaint with the government.

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Old 07-07-2010, 09:19 PM
 
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Originally Posted by AFWife View Post
I'm pretty sure that's not legal. They are YOUR records!

Yep, according to HIPAA they must release your records to you: http://www.hhs.gov/ocr/privacy/hipaa...ers/index.html
(click on What Rights Does The Privacy Rule Give Me Over My Health Information)



I would, in person, politely remind them that they are legally required to give you a copy of your records. They'll probably charge you for them (printing fees usually) but they must release them to you!
OMG! I am so sorry you have to go through this! The nerve of some people... Good luck!

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Old 07-08-2010, 12:55 AM
 
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Here is a link to a site which lists what fees they are legally allowed to charge you. I recently filed for mine from my hosp birth in PA and the bill I got back was for $102. That didn't include my daughter's records, even! I am going to see if my primary care doc can get them for me and give me a copy, as we don't have an extra $100 at the moment. They are your records, I hope you make a big stink so they don't do this to someone else! I am so sorry you have to go through this, what a terribly unprofessional doctor!

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Old 07-08-2010, 10:46 AM
 
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That really sucks! And yeah, isn't exactly legal.

For starters, I would go right to the OB's office and request your own copy of all labs. JUST the labs, which is the most important part right now (so you know what's going on in case you need to act, such as correcting anemia or something).

If you get just the lab reports, then you will only pay (if anything) a copying fee for those few pages.

Don't let them BS you, delay you, run you around with a pretense of authority--or a pretense of a lack of authority, such as the receptionist saying she needs to discuss it w/the OB first. You have a right to get a copy of your records, or any part of them, without dr permission!

Just say that you are there to get a copy of your lab reports. If they give you any runaround, just say that you have a legal right to your own copy and will be needing that now.

Then you can sort the rest out later--your new mw may or may not need everything the OB has, it depends on a variety of things. A copy of labs may be enough.
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Old 07-08-2010, 11:59 AM
 
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Here in Minnesota, to go in and have a copy of your labs/prenatals will cost you money to get, but if you have them faxed over to your new care provider, it is free. So have them faxed over to your midwife when you hire one and it shouldn't cost you anything. It is just forwarding medical records to a new care provider.

FWIW, I would totally go in and say that your HIPPA rights have been violated and that you demand a copy of everything right then and there and for free!

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Old 07-08-2010, 04:50 PM
 
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Also FYI... if a doc fires you. They have to give you 30 days notice and if your pregnant they have to care for you until you find acceptable/similar care. If your unable to find a care provider because your 39 weeks and no one will take you they legally have to care for you or they are abandoning their patient... which is a criminal offense.

I'd look up the specifics on the laws in your state reguarding doctors firing patients and abandoment and waive that in their face as well

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Old 07-08-2010, 05:07 PM
 
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If I was in your position, I would sign a records release from your OBGYN TO your Midwife. If they refuse, I'd take the copy to a lawyer and file a lawsuit. Seriously. I'm not court or sue happy, but this is a CLEAR violation of the HIPPA law's and they have no room to dictate WHO you can release your records to. If you need your lab's before then, go in and request a copy (here it's 20 cents per page) and then have your records sent to a midwife. Don't tell the staff anything. Ask for your lab report. THEN, have the midwife fax your record release. One step at a time

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Old 07-08-2010, 11:02 PM
 
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When I hear your story the first thing that comes to mind is walking in, with a witness, to the doctor's office and asking to have your records released to your midwife, then when they refuse informing them that they are violating hipaa and then asking again. Then you go home and report them. A willfull violation of hipaa is a $10k fine. If you can prove that they don't typically charge copying fees for transferring records to other practitioners and they try to charge you fees, all the better.

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Old 07-09-2010, 09:36 AM
 
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When I hear your story the first thing that comes to mind is walking in, with a witness, to the doctor's office and asking to have your records released to your midwife, then when they refuse informing them that they are violating hipaa and then asking again. Then you go home and report them. A willfull violation of hipaa is a $10k fine. If you can prove that they don't typically charge copying fees for transferring records to other practitioners and they try to charge you fees, all the better.
Wow, $10k? That's huge. I wouldn't be surprised if this were something that they've pulled on people before...if that's the case, and it's on record, I'm pretty sure they can get their license yanked.

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Old 07-09-2010, 01:54 PM
 
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I had this problem when I wanted to change primary care physicians during my first pregnancy. After several phone calls, I googled the state law and sent a threatening fax (quoting the law) to the doctor's office. I got my records, but never lose an opportunity to complain about that doctor, who still works in my home town.
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Old 07-09-2010, 02:02 PM
 
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I'm in Ontario, so ymmv!

Here they have to release records to you when asked for, but they can drag it out, make you go to different places, fill out forms to get them, pay lots of money for the work of digging them up and photocopying them, etc.

Is it legal? Yes. Is it right? No. I work in the emergency dept. in a large hospital, and doctors won't even release lab results to people. It's sent to their family doc, or if they want a copy they have to go to the records dept.

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Old 07-09-2010, 02:14 PM - Thread Starter
 
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I submitted a records release and named myself as the person to recieve the records. We haven't hire a midwife yet, and I don't want to wait until I find one to request them... the letter says it will take at least 2 weeks to get the copies sent to a new ob. I sent the request in writing with a copy of HIPPA.

What really makes me angry is all of this headache because I mentioned in passing that I might want to hire a midwife. If say maybe someday I'll dye my hair red, my hair stylist would try to talk me out of it, not fire me as a client.
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Old 07-09-2010, 05:48 PM
 
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I also had a similiar experience when switching to a midwife I also recieved a rather rude certified letter. Stating that my ob was further withdrawing from my care and the dismissal applied to all the doctors in their group. I had no problem getting my records transferred. But it definently made me realize even more that I had made the right choice. I went from 3-5 minute cold and impersonal office visits to a wonderful midwife who takes the time to talk with me and address any questions or problems I have been having.
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Old 07-09-2010, 05:55 PM
 
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Having worked in records release for 6 years, I can tell you that you will be charged and probably won't get them any quicker asking for yourself. Also, it is illegal to charge the patient for a records transfer to another healthcare provider. Also, in most states, it is courtesy when the pt is "fired" to release a copy of the records for free, to the patient. I would call the office manager and talk to her. But a week to 2 weeks to get the records does sound accurate for a dr's office.
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Old 07-10-2010, 10:24 AM
 
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I submitted a records release and named myself as the person to recieve the records. We haven't hire a midwife yet, and I don't want to wait until I find one to request them... the letter says it will take at least 2 weeks to get the copies sent to a new ob. I sent the request in writing with a copy of HIPPA.

What really makes me angry is all of this headache because I mentioned in passing that I might want to hire a midwife. If say maybe someday I'll dye my hair red, my hair stylist would try to talk me out of it, not fire me as a client.
What was the reason they gave in the letter for discontinuing care?

If their fees are within legal limits for releasing the records to you then you have a choice of paying or not getting the records. If you don't want to pay you will have to wait until you find a midwife. It isn't likely that it will take 2 weeks for them to fax the info, especially if you or the midwife's office is calling them daily to check on the status of the request.

Getting labs for now, as a pp suggested might give you what you need in the mean time if you can't pay but don't want to wait for all the info. Unless you've had complications this pregnancy the labs are the most necessary information your midwife will need.

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Old 07-10-2010, 08:06 PM
 
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You can also have the paperwork faxed to your primary care provider. On my insurance plan, I have a primary care provider, but also a "Women's Health Care Professional". When I'm not pregnant or having female issues, then I go to my primary care physician. When I am pregnant, I go to the WHCP. If you have something like that, I would go to the primary physician and ask them to fill out the records transfer paperwork and get a copy from them...

Still report them for HIPPA violations and abandoning you during pregnancy (pulling care without you having any back-up in place). Most states have law against this. But, before you go in, read up on those laws, print them out, and walk into the doctor's office...with a witness and see how it goes.

Good luck!
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Old 07-11-2010, 11:06 PM
 
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This doesn't exactly answer your question (you've gotten good advice from others), but I'm an attorney by training and I strongly suspect this is a liability thing. You mentioning you were thinking of hiring a midwife made them think you might use them for shadow care, then try to birth at home and potentially show up at the hospital as what they refer to as a "train wreck", have a bad outcome, and then sue them because your midwife doesn't carry liability insurance. This is why the letter states that it applies to all doctors in their practice (i.e. whomever is on call, so you would have to get care from the hospital's on-staff OB and any liability would be the hospital's alone). Is their response overly paranoid and frankly absurd? Absolutely. But this is the world we are living in these days.

Regarding the records, they may believe that if they send records directly to a midwife they are somehow countenancing your choice to pursue midwifery care and could be subject to liability for in some way cooperating with your midwife (who you haven't even hired yet ...). Most likely, this is a draconian response to something that has either happened to this particular practice or to someone that one of the doctors knows. Sometimes I hate lawyers and the entire legal profession, and the fact that their antics have caused such grief and suffering for mothers and babies is at the top of my list of complaints.

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Old 07-12-2010, 04:59 AM
 
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Definitely request the records be sent to a MW of your choosing. Get those labs first so you know what you need to know now. They can't charge you to send to the MW, but they WILL charge to have them released to you.

A major hospital where my first son was born took MONTHS to get my records to my MW. They sent me (and her) a large bill for it, first, and when I called to complain, they seemed to have NO idea what a midwife or CPM was. She did get the records, eventually... and called to tell me I'd be just fine for my VBAC, as I was nursing my 3 month old.

Anyway, get what you need now, and make sure they do their job and give your new provider your records *for free*.

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Old 07-12-2010, 12:02 PM
 
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Are home midwives licensed or legal in your state? The only reason I can see them legally refusing to send the records to a midwife is if it is not seen legally as a licensed healthcare provider.
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Old 07-12-2010, 08:13 PM
 
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CPMs and CNMs can both legally attend homebirths here. The OBs in this city successfully stopped midwives from being able to deliver in the hospitals here and now there is only this practice and one midwife at the "public" hospital (and I believe she works for the hospital). People seem to think the top doc at this practice is the "mother teresa" of OBs but she still wants to keep her territory under lock and key.
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Old 07-13-2010, 02:43 PM - Thread Starter
 
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PoppyMama...don't know if you live in ATX, but it sure sounds like we are talking about the same "mother Teresa" that fired my pregnant butt....
Msmiranda.... abandoning your patient with pending labs and an ultrasound that needs to be review to me is a huge liability. If she was worried about my intentions, she should've asked me, instead of taking a nurses word for it. I feel like she got her panties in a bunch because I was considering using a CPM at home instead of her CNM's in the hospital. Her practice uses midwives, but not necessarily the midwife model of care.
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Old 07-13-2010, 02:53 PM
 
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Ask to speak to their HIPAA Compliance Officer. Every office is required to have a person designated as the compliance officer, and they are required to tell you who that person is in their privacy policy. It's important that you use that official wording - HIPAA Compliance Officer - to let them know you know what you're doing, you know what they are doing is wrong, and you know you have recourse.
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Old 07-13-2010, 10:13 PM
 
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PoppyMama...don't know if you live in ATX, but it sure sounds like we are talking about the same "mother Teresa" that fired my pregnant butt....
Msmiranda.... abandoning your patient with pending labs and an ultrasound that needs to be review to me is a huge liability. If she was worried about my intentions, she should've asked me, instead of taking a nurses word for it. I feel like she got her panties in a bunch because I was considering using a CPM at home instead of her CNM's in the hospital. Her practice uses midwives, but not necessarily the midwife model of care.
Absolutely -- didn't mean to sound like I was defending her at all! You are completely in the right. I am shocked and appalled at their behavior, and was just trying to come up with a (in their minds, not in reality) logical explanation for why they decided to handle things this way.

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Old 07-14-2010, 01:30 AM
 
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This is ridiculous! I think that they are legally bound to release copies of your records to you. I had a problem once with a doctor's office that wouldn't send test results to my midwife. I ended up paying a nominal fee ($1 per page) to have my test results given to me, and I then faxed them to my midwife. It wasn't that my doctor didn't agree with seeing a midwife; his office simply had a policy not to send records to anyone but another MD. Whatever the reason is, you doctor can't just summarily refuse you copies of your own medical records/test results. I'm sorry to hear that your doctor is treating you like this.

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Old 07-15-2010, 01:57 PM
 
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What really makes me angry is all of this headache because I mentioned in passing that I might want to hire a midwife. If say maybe someday I'll dye my hair red, my hair stylist would try to talk me out of it, not fire me as a client.

we had to stop seeing our OB too when i mentioned the word 'homebirth.' he said even mentioning the possibility, they have to stop seeing you immediately. because of the ever-increasing tax of malpractice insurance. something to do with the OB being responsible if something should go wrong in your homebirth, if he has knowledge of it. so he/she has to essentially fire you, to make sure they are relinquished from any responsibility, for malpractice reasons.

that was #3 for me. with #4 & now with #5, i still saw the same OB through about 30 weeks. we have a don't ask, don't tell policy. he doesn't ask what i plan to do, i don't tell. and it works out fine.
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