Detailed Answer
Gathering and submitting medical records and bills is vital to proving the extent of your injuries in a Rhode Island personal injury claim. Follow these steps to secure and present the necessary documentation under Rhode Island and federal law.
1. Identify All Healthcare Providers
List every doctor, hospital, urgent care center, specialist, therapist, diagnostic lab, and pharmacy that treated you for the injury. Include dates of treatment and locations to ensure you request complete records.
2. Sign a HIPAA-Compliant Authorization
Under the federal Privacy Rule (45 C.F.R. §164.524), you must sign a valid authorization before providers release your protected health information. Use each provider’s form or a standard HIPAA release that clearly states:
- Your full name, date of birth, and contact details
- Specific dates or types of treatment to release
- The name of the person or entity authorized to receive your records
- Your signature and date
Learn more: HHS Guidance on Patient Access.
3. Submit Record Requests and Pay Authorized Fees
Send the signed form to each provider by mail, fax, or their online portal. Under Rhode Island law, providers may charge reasonable copying fees but cannot withhold records for non-payment if you dispute excessive charges. See R.I. Gen. Laws § 5-37.3-6: https://law.justia.com/codes/rhode-island/2017/title-5/chapter-37.3/section-5-37.3-6/. Providers must respond within 30 days or notify you of a 30-day extension.
4. Collect Itemized Medical Bills and Insurance EOBs
Obtain itemized invoices showing services, dates, CPT or billing codes, and provider charges. Also gather “Explanation of Benefits” (EOB) forms from insurers, which detail payments and patient responsibility. If a provider has placed a lien on your claim, request a lien statement to understand potential offsets.
5. Organize and Review Documentation
Arrange records chronologically. Highlight key entries: admission notes, diagnostic findings, surgical reports, physical therapy progress notes, and billing summaries. Create a table of contents or spreadsheet to track documents, dates, and providers.
6. Submit Records and Bills to the Insurer or Court
If you negotiate directly with an insurance adjuster, send a cover letter summarizing your injury, attach copies of all records and bills, and include your demand amount. If you file a lawsuit, include relevant records and bills as exhibits under Rhode Island Superior Court Rule 26. Remember Rhode Island’s three-year statute of limitations for personal injury under R.I. Gen. Laws § 9-1-14: https://law.justia.com/codes/rhode-island/2017/title-9/chapter-1/section-9-1-14/. Serve all parties and file according to the court’s procedural schedule.
Disclaimer: This article is for educational purposes only and does not constitute legal advice. Consult a qualified attorney to discuss your specific situation.
Helpful Hints
- Request records early to avoid delays in your claim.
- Confirm fee schedules with each provider before paying.
- Use certified mail or tracked emails to document submissions.
- Keep a detailed log of all record requests and responses.
- Review all documents with an attorney before filing with the court.