Speaker 1: Hey everybody, it's Joel Williams of Williams LLB. We kicked Chase out of the videos this week to bring in Shannon, who is our medical records aficionado here at the firm. She also does medical illustrations and things like that for us when needed for our cases, but today we really want to talk about medical bills and medical records, what they are, how to get them, what we do with them once we get them, and really how they're utilized in a personal injury case. So let's start with step one, Shannon, and like just what are medical records? Right.

Speaker 2: So medical records, every time you go to your doctor's office, you're always given several forms to fill out. All that paperwork you're filling out in the lobby, and then when you actually go back to talk to your doctor, your doctor's writing notes. They're finishing the notes when you're leaving your appointment, they're writing things down, and all that information gets put into your medical records. A lot of times there's electronic medical records these days, and that information can also be shared with other providers. Your referrals and things of that sort will get sent to to other doctors to work on

Speaker 1: your care. It's really just a way for your medical provider to document your condition, what you're complaining of, what they discover in their differential diagnosis, what their plan of treatment for you is, and they can be utilized by other health care professionals. So if you go to your primary care physician and your primary care physician wants to send you to an orthopedic doctor, they may send those records over to the orthopedic doctor so they have a full picture of what's already been done and kind of what the care plan is. But it documents it, and we're able to utilize that information as well in a personal injury claim or case, and we really have to because we have to prove what the injuries are, right? Right. And we can't just call up an insurance company and say, hey Allstate, Shannon hurt her leg. They're gonna say, all right, prove it. Yeah. Right? So that's how we do it is through the medical records that are generated by the medical professionals. We also have to use medical bills, right? Because part of the damages are proving the amount of money that someone is responsible for as part of the medical treatment that they receive. So it's medical records and medical bills. So I guess the next question is, if somebody needs to get those records and bills, there are certain ways that it can be done. So what are some of the options and ways that people can go about getting their medical records and bills or having someone else do it for them?

Speaker 2: Right. So for any personal injury case, when your attorney tells you they're gathering medical records for you, that is one way. You can sign over a HIPAA release and your attorneys can send that HIPAA to your medical providers and obtain your records for you. Now, that is the most costly way because there are fees associated with that and often it's a per page. So if your medical records are pretty extensive and you've got several hundred pages, the bill is going to be several hundred dollars. And it can really add up and it does save you a headache from having to get your own records, but it's going to cost in the end. So you'll see that itemized when your case actually settles. So if you're

Speaker 1: wanting to maybe... Well, one quick thing with that. So the cost, you know, the increased cost when the attorney orders the records, if you've hired a firm, a personal injury firm that's working on a contingency fee basis, they're not charging you more by the hour. This is just what the hospital or the doctor's office is charging the attorney's office to deliver those records. So it's not an increased cost generated by, you know, or formed or billed to you by your attorney. It's an increased cost from the medical provider because they charge more to give it to your attorney, at least in the state of Georgia. It may be different in other states where there's statutory limits for what the medical providers can charge, but that's that. And then also, real quick on HIPAA, not to assume that everybody knows what HIPAA is, but there are medical privacy laws to protect you from just some random person off the street getting your medical information. So in order for a medical provider to be legally able to release your records and bills to an attorney, you have to sign a form giving them written permission to do so. Correct. But I just didn't want to skip over that because, you know, people that aren't dealing with this every day may not understand that. But you were about to mention a second way that people

Speaker 2: can go and get their records. So another way is a patient request. So I just discussed the legal requests, and we've got patient requests. And typically there's no charge associated with that when you yourself, the patient, gets your own records. You can either access them through a portal that your doctor's office or hospital utilizes to share medical records, or you can directly go to the front desk of your doctor's office. You can ask them, hey, I need my medical records. What do I need to do? They'll probably have you sign a form. They may print them out to you. They may email them to you. But oftentimes if you're working with an attorney's office, you'll typically be able to contact here at our firm. I work with our clients. If they're wanting to get their own records, we work with our clients, and we help them walk them through the process. Because we're very familiar with how to do this and the ins and outs and the tricks of the trade to try to get your own medical records, just to help you help yourself, help your case. It speeds things along. It's a lot less expensive. And also with the patient requests, anytime you're going to get any x-ray films, I always encourage our clients to ask for a copy of their disc. So if you go and get an x-ray, go and get an MRI, you can ask them to save that to a disc and get that yourself. Now if an attorney's office requests those films for you, it's going to be a minimum of $50 to $100. Just a flat fee as a legal request, and then they take their time to get it to you. So it benefits you. It's just a way to help you help your case. And everybody's different, right?

Speaker 1: Some people do not want to be bothered with the headache of it, and that's okay. That's what we're here for. We're more than happy, and most attorney's offices are more than happy to just order it and gather it. It's just a little bit more expensive on the cost, and sometimes it takes a little bit longer. But then other people would like to try to save those expenses in their case, and most attorney's offices, including us, will be more than willing to help the client and patient walk through that process to make it as painless as possible. There's always a little bit of pain associated with it, because it's just a pain in your you-know-what, but it's just a necessary element of the case. So let's talk about what happens once we gather all, either the client or we, get all the records and

Speaker 2: bills in. Right. So once we have all the medical records and bills, we organize them in a way that we can essentially read through them to read the story of a treatment timeline. And we review them to make sure nothing's missing, because a lot of times there are things missing. Either the dates of service don't have a matching bill, or vice versa. And you always want those things to line up. So you go to your doctor's office, there should be a matching bill for that. And if you're sent for an MRI or an x-ray, there should be a referring physician or somebody who sent you for that. So you really have to read and review the records to make sure that it completes the full picture. So we review

Speaker 1: those. And that's super important, because not only is it important to be completely accurate and thorough with that, but a lot of times when you go to a hospital, for example, like in one of the biggest hospitals here in Cobb County, Georgia, is Wellstar Kenestone. They're a big trauma center, so a lot of injury victims go to Wellstar Kenestone. But when you go to Wellstar Kenestone, you're gonna have the hospital fee, there may be an ambulance bill, you're gonna have an ER physician's bill, you're gonna probably, if you have films done, you're gonna have a quantum radiology bill. At least now, they could change it in the future. But you have radiology. There's all these other bills associated with it. When you may just think, well I just went to the hospital, I'm gonna get one bill from the hospital. I wish it were that simple. But there's all these different groups that work together, and some are contracted, some are employees, and all that. So we have to make sure we identify it all, because if we missed a quantum radiology bill, or if we didn't have that record, then that's what, like maybe a thousand dollars sometimes. Yeah, especially the ER

Speaker 2: physician's bills. That's something you know most of our clients don't even

Speaker 1: have no idea. It's called the Bortolazzo Group, right now at Kenestone Hospital. And that bill will sometimes show up. It's almost always over a thousand dollars for just a single visit. Yep, and so if that bill is missed prior to trying to settle your case, well you just cost yourself a thousand dollars on the bill, and probably more when you factor into how we value cases and all of that stuff. Right. One thing that I'm particularly interested in, once Shannon gives me the records and bills and says, hey Joel, we've got everything, here it is. So the next thing that happens is I'm going to go through and read it and see. And sometimes Shannon, well most of the time Shannon will read it too, and she may say, hey you might want to pay special attention to this, or there's something troubling on page whatever of these records. But I want to go through and look and see if there's anything documented in the records that's going to cause problems in the case. The most common example would be something like a radiology film that says, oh well this client's full of arthritis and there's no indication of trauma. Or there's some kind of pre-existing injury that's been aggravated. It's okay if there was, but we need to know about it because every time the insurance company or the defense lawyer is going to raise a big stink about, oh well this is already there, this was not caused by this trauma, it was not caused by the wreck, the fall, whatever. So we're not going to pay you for that, but we have to know that it's there and then be prepared how to be prepared to deal with it. And so that's important for us to kind of go through it with a fine tooth comb and identify any issues that could cause us problems. Right, so another

Speaker 2: another reason that it's so important to review those records is to make sure there's no information we're missing. If there's any other providers that are mentioned in there, we're going to want to go ahead and order those records. Sometimes the clients may forget all the providers they've been to and it's helpful when we review those records to see the other providers that are mentioned in there. And if you've met with a client and they have maybe forgotten that they had treated elsewhere three, four, five years ago, that information is often in the medical records. We'll order those prior records

Speaker 1: as well. Yeah, or it could be a situation where they don't even know about it, right? Right. Like the radiology bill from the ER or whatever, the physician bill from the ER. So another thing that we like to look through is at least in Georgia, and I know some other states are very similar, we look for what we call collateral source information. So there, once the case resolves, there are a lot of different people that may need to be paid back, including the medical providers or health insurance companies or Medicare or Medicaid. Or in some states like Georgia, the hospital itself can file a lien on the case. So we try to analyze not just the records but the bills as well to identify anybody and everybody that made payments on that bill to make sure that once we resolve the case that our client walks away not owing anybody any money. That's just super important because it can be a huge pain to deal with if you miss something like that and then all of a sudden you find out about this provider six months later. Right. But speaking of resolving cases, the next step, once we know we have all the records, we have all the bills, the next thing we do is put together a settlement demand to send to the defendant or their insurance company demanding whatever amount of money that case, we believe that case, is worth. Sometimes we're limited by the amount of insurance that's available, so we're not sending for a whole lot of reasons that will be discussed in a different video. We may send demands for policy limits on insurance and not for, say, a million bucks if there's only a hundred thousand of coverage. But we use those records and attach them as exhibits to a demand to prove to the insurance company what we were talking about earlier, that this particular event did cause these damages. And so we send it off, we wait, and then we negotiate. The insurance company will then look at it and they'll try to pick it apart and find anything in there that's weakness in the case that we've hopefully already identified. And then we'll have some negotiations and discussions about what's the appropriate amount. Sometimes they'll settle, sometimes they won't. If it doesn't settle and we file the lawsuit and we can't get it settled during the lawsuit, then we will use those medical records at trial. And once we get to trial, we do have to have what we call certified records so that just to comply with Georgia statute to make those records admissible. So we don't have to bring a secretary or an office manager from the doctor's office there to get them into evidence, right? So we use those certified records. And then one interesting thing that we try to do with bills, especially when there's a lot of them, and Shannon's actually very involved with this, but there's two things that have to be done to the bills before we go to trial. Number one is we need to remove what we call collateral source information. Because in Georgia, the at-fault party does not get the benefit that you have health insurance. So the fact that you have health insurance is not admissible at trial, nor is the fact that the defendant has liability insurance admissible at trial. You just can't talk about it except for in very rare circumstances. So we take out all mentions of insurance so that the bills are clean. And sometimes in the records it'll mention it too, so we have to take that out. Now if there's anything in there like social security numbers and all that, we'll obviously redact that because anything that goes in the evidence of trial is public record. And then Shannon will also help us with an exhibit, a summary exhibit of the bills, where we'll have A, B, C, D, E, and F bills itemized out with the attached bills behind them in a summary sheet, and then the total amount of the medical bills there. And then we present that to the jury as one exhibit at the trial of the case.

Speaker 2: Another thing I wanted to say, we do attach the records and bills as exhibits for our demands, but something that I have learned that our law firm does that not all law firms do, we create a narrative within the demand itself summarizing the content in the medical records. And I've talked to other paralegals at other firms, and it's kind of been discussed that that helps to send a really strong demand that hopefully it'll help settle your case before it moves into trial. But really helping to kind of serve it on a platter to that adjuster, break down the information. So yes, you're supplying the medical records, but there could be pages and pages of medical records, and you're just summarizing it. So, you know, we're reading and reviewing and summarizing

Speaker 1: that in there. Yeah, that's just kind of a mindset. We're asking this insurance company to pay our client a lot of money, and if we're going to do that, then we kind of accept the responsibility to make it as easy as possible for them to pay our client the money. So we'll do that summary within the demand and break it all down, and then we'll attach the records as well to it. So if the adjuster wants to take a deep dive in the records, he or she is free to do that. It's there for them, but we do provide that summary. So, oh, I skipped one step. So I went straight to trial, but lots of times for between the time you file the lawsuit and when you get to trial, we are in what we call the discovery phase of the lawsuit. And during the discovery phase, we take depositions, which is out-of-court sworn testimony where a court reporter takes down all the words somebody is saying, but an attorney is asking a witness a lot of questions. So the opposing attorney will probably, if you're the plaintiff or the person bringing the claim, the opposing attorney will review your records before the deposition and ask you about anything in the records that he or she needs to know more about, or if they find any weaknesses in there, they may prod and push on that. And then from our perspective, we also use those records when we take depositions of the doctors and your medical providers because, you know, if we're deposing an orthopedic surgeon, that surgeon has probably done 500 surgeries by the time it comes a time to do his or her deposition. So he or she will be relying on those medical records to help refresh the memory about what they actually did and what the surgery was. So speaking of using medical records in a surgeon's deposition, one thing that Shannon does for us is also, if there is a surgery, what we call a medical illustration. So do you want to

Speaker 2: talk about what that is and how you use the medical records? So in the records, if a client has had a surgery, there's an operative report. It details the information contained within that surgery. So I'll create a board based on that information. I'll break it down into simple steps. I'll show a pre-operative view, maybe three, four steps of the surgery, and I often show post-operative view. And Joel likes the actual films used. Every attorney has different preferences, but we like to show the actual films with the hardware in place from the client. And I'll customize it based on the client's ethnicity and the tools and the hardware the surgeon used and all that information so that it can be laid out for use in trial or in doctor's depositions. The doctor can reference the board and, yes, this is what I did, step one, step two, step three, and it just really breaks it down for a jury to understand and not include maybe some of the grotesque actual photos from within a surgery. But yes, medical records are hugely important for that. Yeah, and it just helps us give

Speaker 1: the jury a visual of what actually happened. And if you think about it, it's a lot, it's very different if I'm standing in front of a jury and I say, Shannon had a neck surgery, as opposed to being able to show them a film or illustrations depicting the surgery where the doctor goes in and cuts through somebody's neck to reach the damaged disc area. And then we use the x-ray, the post-op x-rays, to actually show the metal hardware that's put in there. Because when you see that with screws or if you see a broken leg, if I tell you, yeah, Shannon broke her leg, but then I show you an x-ray with a rod and pins and screws going into it, it's much more, it just brings it home as to the full extent of what somebody went through. Right. A lot more persuasive, especially when we're asking for damages instead of just saying, well, she broke her leg. We can say she broke her leg and the doctor did this surgery. Here's the doctor talking about it. Here's what the inside of her leg looks like now. Yeah. Yeah. So I think that's about it. We've covered A to Z with medical records. Medical records, obviously, and bills in a personal injury case are super important. They're the way, one of the most important ways that we prove the type of damages you have as well as the amount of your damages. But there are several steps going from identifying the medical providers to gathering the records. There are several different ways to do that that we went over. And then hopefully we've covered the different reasons and ways that we use that medical information once it's gathered and obtained and organized. So, yeah. If you have any more questions about the medical record retrieval process or how we use medical records and bills in personal injury cases, just insert a question into the comment section below. We'll do our best to respond to that and answer it. But otherwise, if this video has been helpful to you, give us a thumbs up. If anybody likes seeing Shannon better than Chase, go ahead and put that in there. I'll love that part. But then go ahead and give us a subscribe if our videos have been helpful to you. We'd really appreciate it. Otherwise, we'll see you next week for our next video. you