One of the most important steps in making an insurance claim or preparing a dog bite lawsuit is gathering the medical records. “Medical records” include:
- Ambulance “run” records
- Paramedic (fire department) “run” records
- Emergency room records (frequently maintained in a separate location at many hospitals)
- Hospital records, including examinations, consultations, nurses’ notes, test results, operative reports, admission and discharge summaries, and more
- Private physician records of exams, treatment and consultations
- In-home nursing records
- Physical therapy records
The medical records are kept separate from the medical billings. The billings must include the standard codes for descriptions of services, the dates of treatment, and the itemized charges on each date. The billings also must show the gross amounts charged, as opposed to the net charges after receipt of payments or application of discounts.
Why all signs and symptoms of the victim have to be written into the medical records
Signs and symptoms have to be reported to a medical doctor and written into the victim’s medical records or the insurance company will not consider them. The reason is that a case has to be resolved on the basis of credible, admissible evidence. Neither the victim nor people related to or friendly with the victim are considered to be credible when giving testimony about the victim’s aches and pains. Only the victim’s doctor and other medical personnel are considered credible. Additionally, their observations have to be written in the medical records, which are admissible into evidence.
How the medical records and bills are gathered and reviewed internally
Medical records must be gathered by an experienced copy service that knows where to look for them. The copy service will provide a certified copy of the records that can be introduced into evidence in a court case, and that insurance companies will accept as being correct and complete.
Copy services are difficult to deal with, however, because they often are slow. Additionally, they can be expensive. Therefore a lot of supervision is required.
Mr. Phillips and his case manager analyze all of the records and bills, and prepare a comprehensive summary of them which is used for gathering additional records if any, effectively conveying the nature and extent of the injuries to the dog owner’s insurance company, and presenting the case in court if the need arises.
The costs of gathering medical records and bills
The costs of the copy service must be paid on a current basis, and are never contingent upon the success of the case. These costs are one of the factors that make dog bite cases risky for any attorney who agrees to represent a victim.
Some attorneys will not accept a case unless the victim undertakes these costs as well as all the other costs associated with the case (i.e., all expenditures except the attorney’s fees). Mr. Phillips’ policy is to advance all costs and defer reimbursement until money comes in on the case, except in unusual circumstances (such as when he accepts a case that appears to involve an uninsured dog owner). Additionally, Mr. Phillips’ policy is to waive reimbursement if the case does not produce any money.
When talking to a lawyer about legal representation, dog bite victims must always ask “will you advance all of the costs, and will you waive reimbursement if the case does not produce any money?” The answer should be put into writing, along with the rate the attorney plans to charge as his legal fee. It is perfectly legitimate for attorneys to insist that the client pay the costs of the case, and in some states it is even required. By the same token, however, it is equally legitimate for a dog bite victim to ask these questions and require that the terms of the retainer agreement be put into writing and signed.