RISK Management General Guidelines
Medical Record requests (from patients or attorneys)
Comply with statutory requirements if you charge for copying.
Send a complete copy (with authorization received).
Do NOT alter any records either before or after sending the records.
Keep a copy of the medical records request in the file.
We do NOT accept these requests as claims or probable claim events, but if you need risk management advice, we will assist.
Patient Complaint/Difficult patients/Negative Clinical Outcomes
Be respectful, do not overpromise. Listen attentively to the concerns.
Do not make any admissions of negligence or wrongdoing.
Be consistent with response to the family or patient and educate your practice manager or staff on how to handle.
Document thoroughly and carefully in the medical record as to patient complaint or demands and your response.
If patient becomes abusive or threatens violence to you or your staff, notify police immediately.
If you need to discuss further with one of our claims’ attorneys, please call the claims department at (866) 520-6896.
Calls from an Attorney
If you receive any calls from an attorney representing a patient or state/federal agency requesting an interview, please notify us PRIOR to any discussion or interviews.
State Board Complaints
We may cover certain board investigations if your policy allows and if the board complaint is regarding quality of care. You must report to us with a copy of the board letter, medical records in your possession, and any other documentation that you have received.
FOR REPORTING CLAIMS OR PROBABLE CLAIM EVENTS, please see Report a Claim.