Disclaimer: This article is for educational purposes only and does not constitute legal advice. Consult a licensed attorney in Oregon for guidance on your specific situation.
Detailed Answer
When you pursue an injury claim in Oregon, medical records and bills form the backbone of your proof of damages. Follow these steps to gather and submit them effectively.
1. Obtain a HIPAA Authorization
Under the federal Health Insurance Portability and Accountability Act (HIPAA), health care providers need your written permission to release records. Request a standard HIPAA form from each provider or use a generic authorization that meets federal requirements.
2. Identify All Relevant Providers
List every medical facility and professional who treated you after the injury: hospitals, urgent care centers, primary care physicians, specialists, diagnostic labs, imaging centers, physical therapists, and chiropractic clinics.
3. Send Written Requests for Records and Bills
- Include a signed HIPAA authorization.
- Specify the dates of service and types of records (e.g., progress notes, imaging reports, billing statements).
- Mail requests via certified mail or use each provider’s secure patient portal if available.
4. Pay Any Processing Fees
Oregon law allows providers to charge reasonable copying and mailing fees. Confirm the fee schedule in advance and include payment or a promise to pay when submitting your request.
5. Review and Organize the Records
Once you receive records, check them for completeness and accuracy. Organize them chronologically and label each document clearly. Also collect Explanation of Benefits (EOB) statements from your insurer.
6. Submit Records and Bills to Your Insurer
Most insurers require an initial claim form along with medical documentation. Follow the insurer’s submission guidelines—often via an online portal or a specified mailing address—and meet any filing deadlines. Include:
- Itemized medical bills
- EOBs showing amounts paid by insurance
- Medical records demonstrating treatment, diagnoses, and prognoses
7. Include Records in Court Filings (If You File a Lawsuit)
If settlement fails and you file a lawsuit, use Oregon Rules of Civil Procedure (ORCP) to obtain and attach records:
Attach copies of your medical records and itemized bills as exhibits to your complaint or in response to a request for production. Label exhibits (e.g., “Exhibit A – Hospital Records”).
Be mindful of Oregon’s two-year statute of limitations for personal injury claims. Under ORS 12.110 (ORS 12.110), you generally must file suit within two years of the injury date.
Helpful Hints
- Maintain both digital and printed copies of all correspondence and records.
- Track deadlines—note when you mailed requests and received responses.
- Request itemized bills even if insurance covers part of the cost.
- Use a spreadsheet to log provider names, dates of service, and fees charged.
- Follow up in writing if a provider delays or withholds records.
- Consider a medical records retrieval service if you have extensive treatment history.
- Keep a copy of each EOB to show payments by insurers or Medicare.