There are two ways of obtaining medical records when cases are being shopped informally.
First, the agent can obtain medical records themselves from the client or from the client’s doctor. A completed First Protective HIPAA Authorization and Informal Inquiry will need to accompany the medical records. All documents must be sent to First Protective as many carriers will not accept medical records directly from an agent, even if accompanied by a HIPAA.
The second and most common way is for the agent to send the First Protective Authorization and a completed Informal Inquiry to First Protective and request that the medical records be ordered. First Protective’s medical team will then work with the APS vendors and, as needed, directly with the doctor’s office, to obtain the medical records.
To avoid confusion, please be sure to indicate which method you will be using so that records and fees aren’t duplicated. Please be aware that First Protective cannot reimburse you for the cost of medical records if a duplicate set was ordered at our expense!
Important Things to Remember When working with older age clients, there are usually many doctors involved. An APS is needed for all doctors. If there is a question of insurability, First Protective will order one APS from the personal physician to determine if the case can be shopped. Additional APSs may be needed and ordered after receipt of the first one.
When an APS is ordered, we are at the mercy of the doctor’s office when it comes to time served. Many facilities use their own special authorizations and copy services which take more time. You may be contacted to see if the client can call the doctor’s office and speed up the process.
Only request a “rush” on an APS if you are truly under a strict time constraint. The best option may be for the producer or client to obtain the records when it is known that a case is under a strict time constraint from the beginning.