I am very new to Medical Billing and Coding and recently started a new job. A request came in from an insurance company asking for medical records on a patient for a very wide date range. It stated they were looking for pre-existing conditions. My question is can they do this, request medical records for 5 years back when the medical records for the claim in question has already been provided?
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Wiki Medical Records requests
- Thread starter pgreen19
- Start date
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- Tags
- insurance medical records
mitchellde
True Blue
Yes they can request this. It may be at a patient request that they are doing this, something has prompted them to make the request and they can go as far back as they deem necessary. It may be that the patient is challenging a pre existing condition determination or it could be that they have found an inconsistency.