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Medical Records: One For The Insurance Company And One For Doctors & Patients?

Apparently, there are some legitimate reasons why a patient may lie to their physicians.

A recent article in the Los Angeles Times discusses the phenomenon, which as Dr. Gregory House would aptly summarize as, “Everyone lies.”

In fact, a recent survey suggests that “38% of respondents said they lied about following doctors’ orders and 32% about diet or exercise.”

One interesting reason is that patients are wary disclosing potentially damaging information to health insurance companies. Indeed, when patients apply for individual health insurance, their medical record is pulled up. And since trivial details can cause insurance companies to deny health coverage, patients certainly may have second thoughts about giving an accurate history.

Furthermore, “when processing a claim, the insurance company finds something in a patient’s records that contradicts something the patient said when purchasing the policy, the company can retroactively cancel the policy.”

That’s pretty harsh.

But making medical decisions on inaccurate information has consequences as well, including providing poor patient care.

One suggested option would be to maintain two sets of medical records, one that is shared with the insurance companies, and a private one that is not released to third parties. Some patient advocacy groups even go as far as saying, “If your physician won’t do that, it’s reason enough to leave the physician.”

I currently don’t offer such an option. I wonder how many other practices do.

*This blog post was originally published at KevinMD.com*


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2 Responses to “Medical Records: One For The Insurance Company And One For Doctors & Patients?”

  1. Alan Dappen says:

    Your post excellently summarizes one of the huge unexamined assumptions about health care, namely that all citizens are best served when all their medical problems stream through the insurance system.

    It’s amazingly difficult to get most people to understand that HIPPA permits maximizing the protection of information transferred between doctors’ offices and the insurance companies.
    What they learn can hurt you.

    At our medical practice, (http://www.doctokr.com), patients, not insurers pay the bill. This means that patients remain in control of their confidential health information. This leaves the decision in the hands of each patient to decide if seeking reimbursement from insurance companies is worth surrendering their confidentiality.

    Our website gives instructions on submitting a claim, links to claim forms, and a tutorial to help people decide if they really want to have their information permanently in a national storage data base. (http://www.doctokr.com/patients/insurance.php)

    Alan Dappen, MD

  2. Alan Dappen says:

    Your post excellently summarizes one of the huge unexamined assumptions about health care, namely that all citizens are best served when all their medical problems stream through the insurance system.

    It’s amazingly difficult to get most people to understand that HIPPA permits maximizing the protection of information transferred between doctors’ offices and the insurance companies.
    What they learn can hurt you.

    At our medical practice, (http://www.doctokr.com), patients, not insurers pay the bill. This means that patients remain in control of their confidential health information. This leaves the decision in the hands of each patient to decide if seeking reimbursement from insurance companies is worth surrendering their confidentiality.

    Our website gives instructions on submitting a claim, links to claim forms, and a tutorial to help people decide if they really want to have their information permanently in a national storage data base. (http://www.doctokr.com/patients/insurance.php)

    Alan Dappen, MD

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