If a doctor is in-network with an insurance company and the patient wants a refund for what they paid out of pocket, what are the mechanics of the transaction? Here, you likely have more than two parties. You have the patient and the physician, of course. You also have an insurance carrier. I’ll explain. First … Read more
If a patient asks for their records, according to HIPAA, what records must you provide? According to HIPAA you need to send the patient their medical (dental) records. And within 30 days in the format they want. Some states, such as California, have an accelerated timeline of 15 days. OK, so, what are “patient records?” … Read more
Most doctors are aware of what is meant by a “consent to settle” policy. With such language, the carrier will not settle a claim without your explicit written consent. Once you provide such consent, the carrier will make a decision. Settle for an amount it can live with. Or defend the case. If you provide … Read more
A patient slips in your office. Do you turn it over to your general liability insurance carrier or your professional liability carrier? Or both? Of course, the devil is in the details. Such cases will have different trajectories. If a professional liability claim, the plaintiff will generally need to secure an expert to prove you … Read more
Can a patient sign away their rights to sue you in the future for a case that will be performed in the future? Let’s go down memory lane. Back to 1963. Tunkl v. Regents of the University of California. The University of California at Los Angeles Medical Center admitted Tunkl as a patient on June … Read more
Physicians sometimes have to say no to patient requests. Often, the “No” with an explanation suffices. The patient gets it. They understand. They’re not angry. In fact, they may be appreciative. But not always. Sometimes “No” is followed by denial, anger, bargaining, depression, etc. Sound familiar? How one says “No” matters as much as what … Read more
Lenin is alleged to have said “There are decades where nothing happens; and there are weeks where decades happen.” Snopes.com says it’s not true. That Lenin never uttered the quote. A similar version of the quote was published in 1908, during Lenin’s lifetime, although there is still no evidence to link it to Lenin himself. … Read more
The doctor-patient relationship is an intimate relationship. It is based on trust. One of the tenets of trust is that it will not be exploited for personal gain. Doctors become aware of patients’ most private secrets. And their vulnerabilities. Still, medicine is “hands-on.” Examination of the patient often requires touch. And, if a patient initiates … Read more
Most telemedicine visits are little more than visual addendums to standard phone call encounters. Still, they add a face to a voice. One can pick up on body language. And they do enable limited examinations. For example, does the patient have a tremor? If so, what type? How would you characterize the patient’s gait? Is … Read more
This question hit my desk. I’ve received some version of this same question over and over. A plastic surgeon performed aesthetic surgery on a patient. Objectively the results look good. Subjectively, the patient disagrees. Sound familiar? There’s a conflict. The patient takes the conflict online. She posts photos which are a few days post-op. They … Read more
