Bottom Line
Occasionally a request for a release of information is unable to be fulfilled because no date of service and corresponding health information is found on the requested patient within an organization’s database. When this occurs, ScanSTAT defers to state law regarding billing for these requests. Many states do allow records custodians to bill for requests that do not return a corresponding patient or date of service due to the resources expended trying to fulfill the request. ScanSTAT treats third party requestors with respect and understanding of workflow costs, and we expect the same in return. If your organization receives a phone call about an invoice such as this, please refer the requestor to ScanSTAT.
No Date of Service
When a third party seeks a record for which no date of service can be found, it means a mistake was made at some point during the request workflow prior to arriving at ScanSTAT. Possible mistakes include:
- Patient gave the wrong Provider name and / or wrong name of the organization
- Insurance Company provided wrong information and no patient exists
- Patient confused which services they received at different Providers
Some states have recognized that it is not the burden of the records custodian if they are sent a request that returns no results. At ScanSTAT, we execute our HIPAA compliant workflows for every single request received. If we reach the end of our workflow and find no results, we are within our rights to seek compensation for the expended resources and issue an invoice.
State Laws
ScanSTAT references state law when determining if an invoice can be issued for a request which results in no data. Few states have laws that expressly prohibit billing for a request with no date of service found. While some states do specifically have laws and allow billing for these requests, what about the states where no regulatory language exists? Essentially, the practice is open for interpretation on both the end of the records custodian and the requestor. Therefore, ScanSTAT does submit an invoice to requestors for states where no regulatory language is found, as there is also no language prohibiting the practice.
Third party requestors will sometimes dispute invoices when no records are received as a result of their request. We expect that these requestors will ensure accuracy of the information they submit in a request. ScanSTAT is always willing to discuss fees and regulations with third parties to share our understanding and professional best practices. With many years of experience in the release of information arena, ScanSTAT has developed strong relationships with many third party requestors who value the service we provide and are willing to pay for requests which turn up null. If you receive a question from a requestor regarding an invoice where records were unable to be fulfilled, please defer to ScanSTAT and let us work with the requestor.
In summation, someone ultimately pays for attempting to fulfill the request; we do not believe that cost should be unfairly passed on to ScanSTAT, but even more importantly, ScanSTAT will not allow that cost to be passed along to our clients.