Sunday, March 22, 2015

Why don't health insurance companies return the patient's medical records to them ?

My father recently had hip replacement surgery. The surgery went well, and we submitted the insurance claim to his insurer, New India Assurance, through their TPA, Medicare TPA. We had to submit all the original medical records, along with the bills and the claim forms. We did so, and after 4 long painful weeks of silence, the TPA reimbursed 70% of the total bill, without even bothering to give an explanation for why they failed to provide a 100% reimbursement.

Even worse, even after processing they claim, they have held on to the original medical records, and have not returned them to us.  This is completely unacceptable . The medical records are the property of the patient, and they contain valuable medical information, which is worth its weight in gold.  It makes no sense for the insurer/TPA to hold on to these records. They should return them promptly, once the claim has been settled. If they want to keep a copy for their records, they can xerox these, or digitise them.

Patients need to fight back, and insist that insurers and TPAs return their original medical records to them !

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