Disclaimer
This article is for informational purposes only and does not constitute legal advice.
Detailed Answer
When you file an injury claim in Utah, medical records and itemized bills form the backbone of your proof of damages. These documents establish your diagnosis, treatment plan, prognosis and financial losses. Under Utah Rules of Civil Procedure Rule 34, parties may request production of documents. In settlement talks, insurers typically require you to submit complete medical records and bills to evaluate your claim.
Step 1: Identify All Treating Providers
- List every facility and professional involved in your care (hospitals, clinics, therapists, pharmacies).
- Include provider names, addresses, phone numbers and dates of service.
Step 2: Execute a HIPAA-Compliant Authorization
Send each provider a signed medical records release form. Under 45 C.F.R. §164.524, most health care entities must respond within 30 days. Specify the date range and types of records you need (e.g., office notes, imaging reports, bills).
Step 3: Request Itemized Bills and EOBs
Ask providers and your health insurer for itemized bills showing CPT or HCPCS codes, dates of service and outstanding balances. Also obtain Explanation of Benefits (EOBs) from your insurer to demonstrate payments made and patient responsibility.
Step 4: Organize Your Records
Sort records chronologically in a binder or digital folder. Use tabs or PDF bookmarks for each provider and type of document. A clear index speeds up review by adjusters or counsel.
Step 5: Authenticate Records for Court
If litigation begins, you must lay a foundation for business records under the Utah Evidence Code. Utah Evidence Code §78B-9-803 provides a hearsay exception for records kept in the regular course of business. Include a custodian affidavit or certification confirming the records’ accuracy and regular maintenance. Utah Evidence Code §78B-9-803
Step 6: Submit to Insurer or File with Court
When submitting to the insurance adjuster, attach a cover letter listing your claim number, date of loss and a summary of key injuries. If you file a lawsuit, produce records in response to a Rule 34 request or attach them to a motion with proper authentication.
Step 7: Track Requests and Responses
Keep copies of all authorizations, cover letters and proof of delivery (certified mail receipts or portal confirmations). Note the dates you requested records and when you received them to meet deadlines and avoid delays.
Helpful Hints
- Begin the process immediately after your medical treatment to allow enough time for provider response.
- Use certified mail or a secure online portal to track each request.
- Follow up in writing if you don’t receive records within the HIPAA time frame.
- Verify that your name, date of birth and service dates on the records match your claim details.
- Redact any unrelated sensitive health information before submission.
- Keep a master spreadsheet of all documents, including Bates numbers if you apply them.