Is it possible/easy to revoke written permission for an opposing ins. co. to access a person's medical records?

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I am asking this question for someone else.  I know little about legal issues, so I couldn't advise my friend, who asked me to keep the main details private while the issue is still outstanding.  She is not looking for overall advice about getting her own lawyer, although most people would say to do that, of course.  As time is of the essence in her view, Linda has just a basic question at the moment -- she was repeatedly asked by the insurance company that is representing a person who caused Linda an injury (accidental) to sign over permission to obtain copies of her medical records.  Recently, she signed their form saying that they could have her records from the past two years from the specific doctors who have treated her for this accidental injury.  Then that insurance co. representative turned around, was pretty rude, then he stopped communicating with her.  Linda regrets signing the form for them and wants to pull back this permission, to the extent that it is possible, until she figures out how to approach the wider situation.

Her immediate question that she wants to act on today is: 
Would it be a pretty straightforward process for her to repeal her permission for the other person's insurance co. to obtain her medical records (at least the records that they don't have a copy of yet)?
The form Linda signed says that if she wants to revoke her permission, she can, but she needs to contact each named doctor individually and ask them what their policy on doing this is. 
Generally speaking, is this something that is pretty easy to do?  What do doctors usually require for this - can she send their office a letter by fax?  Is there an example of a standard wording to use, or is a simple statement okay?  (If possible, she hopes to keep explanations/discussions about the wider situation to a minimum, when interacting with the medical office staff.)  With which staffperson at the medical offices should she speak about their policies on this -- would it be the billing person?  Is revoking permission like this, after only recently giving it, going to look suspicious/weird after it is noted in her medical files, or is it a reasonably understandable thing that people occasionally do?

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IANAL, but I'd say the Drs don't get to have a policy limiting the terms of her revocation.
Just prepare a simple one paragraph statement immediately revoking permission, sign it, visit every office, and hand it to a responsible adult in the Drs employ.
If you can't drive there, Express Mail it and keep the receipt.
But act quickly or there's no point to it, the insurance company might already have it or the medical offices might be preparing to send it out.

I recall the prof in a business law class I took in the 1980s, had a weekly class newsletter that included a personal advice column. The only topic that really stuck with me was the one he wrote about why your insurance company is not your friend, and when you file a claim everything they do is preparation for a lawsuit, and everything you do SHOULD be treated as preparation for a lawsuit. I'd say that goes double when the insurance company isn't your insurance company. When they wanted her medical records, they were collecting evidence to defend a potential lawsuit.
 

taxmantoo said:   Just prepare a simple one paragraph statement immediately revoking permission, sign it, visit every office, and hand it to a responsible adult in the Drs employ.
If you can't drive there, Express Mail it and keep the receipt.
But act quickly or there's no point to it, the insurance company might already have it or the medical offices might be preparing to send it out.
 

Thank you for your help and suggestions.

Linda can't drive around to all the offices today, half of which are in different part of our state, but she can call and fax them.  I'll tell her to ask them if they require receiving a hardcopy by documented USPS mail.

She knows that insurance companies aren't there to be our friends, although knowing the details of the situation (which she doesn't want me to share publicly) makes it easier to see why she did what she did, and harder to understand why the ins. guy became rude and uncommunicative, since she was being cooperative and not meaning to sue, so becoming a jerk was a pointless step on his part... but anyway.

I wonder if telling the doctors' offices that permission is now revoked immediately stops the release of information, even if they have received a request from the ins. company in the last few days and are in the process of preparing the documents to send to the ins. guy. 

oppidum said:   
taxmantoo said:   Just prepare a simple one paragraph statement immediately revoking permission, sign it, visit every office, and hand it to a responsible adult in the Drs employ.
If you can't drive there, Express Mail it and keep the receipt.
But act quickly or there's no point to it, the insurance company might already have it or the medical offices might be preparing to send it out.

Thank you for your help and suggestions.

Linda can't drive around to all the offices today, half of which are in different part of our state, but she can call and fax them.  I'll tell her to ask them if they require receiving a hardcopy by documented USPS mail.

She knows that insurance companies aren't there to be our friends, although knowing the details of the situation (which she doesn't want me to share publicly) makes it easier to see why she did what she did, and harder to understand why the ins. guy became rude and uncommunicative, since she was being cooperative and not meaning to sue, so becoming a jerk was a pointless step on his part... but anyway.

I wonder if telling the doctors' offices that permission is now revoked immediately stops the release of information, even if they have received a request from the ins. company in the last few days and are in the process of preparing the documents to send to the ins. guy. 

  It's psychology. They are playing mind games. 

It should but IANAL

I'm an MD.
1)As mentioned, act quickly
2)I'd call the doctor offices you need to and see what they want.
3)As a general rule, doctors are VERY paranoid about releasing information when they are not allowed to. Releasing information when you are not allowed to is a quick way to get sued. I would imagine it should be pretty easy to get the permission revoked.

wp746911 said:   I'm an MD.
1)As mentioned, act quickly
2)I'd call the doctor offices you need to and see what they want.
3)As a general rule, doctors are VERY paranoid about releasing information when they are not allowed to. Releasing information when you are not allowed to is a quick way to get sued. I would imagine it should be pretty easy to get the permission revoked.


Thanks so much for your expert perspective.  I will pass your advice along.
 

Seems like she can revoke authorization. Here is what the US Dept of Health and Human Services says: "Yes. The Privacy Rule gives individuals the right to revoke, at any time, an Authorization they have given. The revocation must be in writing, and is not effective until the covered entity receives it. In addition, a written revocation is not effective with respect to actions a covered entity took in reliance on a valid Authorization, or where the Authorization was obtained as a condition of obtaining insurance coverage and other law provides the insurer with the right to contest a claim under the policy or the policy itself."

caterpillar123 said:   Seems like she can revoke authorization. Here is what the US Dept of Health and Human Services says: "Yes. The Privacy Rule gives individuals the right to revoke, at any time, an Authorization they have given. The revocation must be in writing, and is not effective until the covered entity receives it. In addition, a written revocation is not effective with respect to actions a covered entity took in reliance on a valid Authorization,
or where the Authorization was obtained as a condition of obtaining insurance coverage and other law provides the insurer with the right to contest a claim under the policy or the policy itself."

I really appreciate that pertinent excerpt.

I am not sure what the last line (the part after "or where") is actually saying -- I'm thinking that it probably describes the situation of being a willing customer of an insurance company, rather than being a non-customer injured party, and probably doesn't apply to Linda's situation.  But I'm not sure.

It is interesting that it "must be in writing" (more on this below, in my update post), which makes sense of course, and we had assumed that would be the proper way to go about it.

Send the revocation letter to the insurance company. Send a notice to the doctors informing them that nobody other than you has the right to access your information.

If the insurance company attempts to obtain records after they have received the notice, that's when they get sued.

Here is an update on how it went, and a final question.

----
Final question:

Does Linda have to inform that insurance company that she has now revoked the authorization which she had originally given them to obtain some of her medical records?

She'd rather not, and they recently have been quite uncommunicative with her -- but is it required, or advised, that she do so?

----
Update:

Today she telephoned each doctor's office, asked to speak to the medical records person, and asked them what their office's procedure was for a patient to revoke authorization for an ins. co. to obtain medical records.

She wasn't sure what reaction she'd get, but everyone was uniformly understanding and helpful.

All but one person kept it on a professional, detached level and didn't ask any personal questions about the situation (besides, of course, her name, date of birth, home address on file at the dr's office, to make sure that she was a registered patient there).
The one person, however, was chatty and inquisitive about the personal details of the accident, what was Linda's reasoning for revoking the permission so quickly, did she have a lawyer, etc.
That ratio wasn't too bad, given that in our state revealing personal stuff to total strangers is pretty typical/expected.

About half the medical records people didn't even know if their office had a policy on how a patient should revoke this kind of authorization. They said that whatever Linda wanted to do would be okay.

One of the offices claimed that asking by telephone was enough, that they didn't need it in writing, and they'd put it on a post-it in her file that she had called. Linda suggested that maybe sending them a written fax would be a more formal way to go about it, in case they later got a request from the ins. co. and they needed to prove to the ins. co. that her permission had been officially revoked. The records person said that would be fine, too.
[And now it turns out that that records person's advice was legally/technically incorrect, according to Caterpillar123's information above.]

All of the records people agreed to accept the notice by fax. They said that as soon as they received it, they would honor the request and not send out any medical information to that company.

Only 2 of the offices suggested that they had better check while she was on the phone to see if the ins. co. had already sent them a request for information, and if they had already released anything to the company. Neither one had yet heard from the ins. co., which was a good sign.

One of the offices she called ended up being closed until Monday, and it's here in town, so she'll drop a hardcopy off on Monday morning.

One of the medical records people asked her to include in her fax a copy of the full, original, signed authorization that she had given to the ins. co., along with her revocation notice. Linda called to ask what I thought, and I said I would omit that from the fax, because of the potential confusion that could arise with both the original signed authorization and the new revocation arriving at the same time -- maybe it could be collated incorrectly by a clerk in the mailroom/fax area, and I could imagine how only the "wrong" half of the fax (the original authorization) might end up being put in her records. (I suppose that she could have sent the original auth. form but with a huge "x" across it and a bunch of "don't do this, don't do this" or something.)
She put in her revocation letter that the doctors' offices should contact her if they needed additional information to enact her request.

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I was suprised today - and it was fortunate for her - that it is so easy/quick to revoke something official like this.

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Thank you to all who commented here!

supersnoop00 said:   Send the revocation letter to the insurance company.
Yes, that is her last question to the Fatwallet community -- 
is she required to let the ins. company know that she has revoked the authorization?
Perhaps it's voluntary (but strongly advised) that she does that? 

And supersnoop00's comment above prompts me to add a follow-on question --
if she ought to let them know (and I expect that she ought to),
does she have to send an exact copy to the ins. co. of the letter that she sent to each doctor's office,
or can she simply inform the ins. co. that she has revoked the authorization with each medical provider, according to the procedure that each doctor's office gave her (which is what the original form says that the patient has to do in order to revoke the authorization.)

Can she send that by fax, or does it have to be registered mail?

seems like this could be a game changer, so i would overnight it with receipt confirmation.

oppidum said:   
supersnoop00 said:   Send the revocation letter to the insurance company.
Yes, that is her last question to the Fatwallet community -- 
is she required to let the ins. company know that she has revoked the authorization?
Perhaps it's voluntary (but strongly advised) that she does that? 

And supersnoop00's comment above prompts me to add a follow-on question --
if she ought to let them know (and I expect that she ought to),
does she have to send an exact copy to the ins. co. of the letter that she sent to each doctor's office,
or can she simply inform the ins. co. that she has revoked the authorization with each medical provider, according to the procedure that each doctor's office gave her (which is what the original form says that the patient has to do in order to revoke the authorization.)

Can she send that by fax, or does it have to be registered mail?

  Think of it this way:

You told someone they could stay in your condo for weekend.  You gave them the keys.  Then you decided you don't want them to stay there, so you changed the locks.  What do you expect them to do when they show up? 

Yes, you need to tell them that they are no longer authorized to access the records.  Otherwise they're going to call the office and tell the doctor that they do have authorization, and they'll produce your signed document.  And then what will the doctor do?  

supersnoop00 said:   Think of it this way:

You told someone they could stay in your condo for weekend.  You gave them the keys.  Then you decided you don't want them to stay there, so you changed the locks.  What do you expect them to do when they show up? 

Yes, you need to tell them that they are no longer authorized to access the records.  Otherwise they're going to call the office and tell the doctor that they do have authorization, and they'll produce your signed document.  And then what will the doctor do?  
 


a) I would think that, in a legal sense, the document with the later date would take priority over the document with the earlier date.
b) The medical records staff people had said that as soon as Linda's fax was received by their offices, those were the "current" instructions that they would obey, so I don't think that they would have trouble in deflecting any later request that were put through to the doctor's office by the ins. co.  (The doctor who commented earlier in this thread said that doctors are scared of being sued for any breach in the release of medical records, so they release them with extreme caution.) 
c) The revocation steps were followed just as the original permission-giving form described they must be followed.  Curiously enough, that form did not say that the person needed to inform the company to whom permission was originally granted that the permission had been later revoked, only that the person had to follow the steps that each doctor's office had set out for revocation.
d) I don't think that the analogy of agreeing to let someone stay in your house and then changing the locks on them but not telling them until they are at the front door is similar to this.  (Anyway, if the person who was due to borrow your house a week hence suddenly stopped answering your calls and emails, had their receptionist take messages and say she didn't know when they'd be free to you call back or what their situation was or what the reason for their lack of communication was, etc., you might worry that they were not stand-up people whom you wanted to let loose in your private space the following weekend.)

I think Linda is going to try to contact them one more time tomorrow to see if they will answer the question that she asked them in the early part of last week (after she had signed their form and they were rude to her), and they did not contact her again although she reached out a couple of times via several means of communication.

Then she'll send them a brief letter in the post to inform them that she has revoked her permission for their access to her medical records.

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Thank you all for your advice!



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