Progress notes

[PikminOC]

I got a consent for the last three progress notes from a therapist.
Therapist didn't want to send notes, just a summary.
I said that was fine. She said it would cost at least 150 for the summary as that's an hour of time. She asked for me to venmo the money.
I said I would talk to the family about it and she got pissed.
I ended up not paying for the summary it the notes and got nothing.
Is this ethical?

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[WisNeuro]

$150 seems like a lot, and an hour seems like a lot of time to fax over some notes. This would take about 10, 15 minutes tops. People are allowed to charge for the time that it takes to send info. But, in some states, what people can charge is limited by statute.

 

[PikminOC]

$150 seems like a lot, and an hour seems like a lot of time to fax over some notes. This would take about 10, 15 minutes tops. People are allowed to charge for the time that it takes to send info. But, in some states, what people can charge is limited by statute.

They said they would write a summary instead. Didn't want to send notes

 

[WisNeuro]

They said they would write a summary instead. Didn't want to send notes

So they are charging for the time that it takes to write up a summary. But, if they do not want to send notes, tough. If you have a release, they can't ethically or legally withold those. Unless there is some kind of reason they believe those notes would be harmful is disclosed, It'd be very hard to argue that would be the case in disclosing to another provider.

 

[PikminOC]

So they are charging for the time that it takes to write up a summary. But, if they do not want to send notes, tough. If you have a release, they can't ethically or legally withold those. Unless there is some kind of reason they believe those notes would be harmful is disclosed, It'd be very hard to argue that would be the case in disclosing to another provider.

Is it normal to bill a provider so much for a summary?

 

[WisNeuro]

Is it normal to bill a provider so much for a summary?

It would depend on the time needed to provide the summary. Honestly, in this case, I would just fax over the notes verbatim if I were the therapist. I'm curious as to why they are reluctant to do so. Honestly, if you just want the notes, which would take a minimal amount of time to send, I would simply ask for those as stated in the ROI. If they still do not want to do so, I would mention that I would then be compelled to contact the state board of psychology with a complaint for breach of ethics.

 

[PikminOC]

It would depend on the time needed to provide the summary. Honestly, in this case, I would just fax over the notes verbatim if I were the therapist. I'm curious as to why they are reluctant to do so. Honestly, if you just want the notes, which would take a minimal amount of time to send, I would simply ask for those as stated in the ROI. If they still do not want to do so, I would mention that I would then be compelled to contact the state board of psychology with a complaint for breach of ethics.

This is the kind of stuff I run into on a regular basis

 

[WisNeuro]

This is the kind of stuff I run into on a regular basis

I have had to resort to the threat of complaint after faxing several ROIs and weeks of waiting. The threat of ethics complaint usually gets the job done same day.

 

[PikminOC]

I have had to resort to the threat of complaint after faxing several ROIs and weeks of waiting. The threat of ethics complaint usually gets the job done same day.

I don't threaten a complaint. I just report them to the board

 

[WisNeuro]

I don't threaten a complaint. I just report them to the board

Our code of ethics stipulate that you make a reasonable attempt at resolving the ethical conflict informally, unless it represents a clear and imminent harm to a patient.

 

[PikminOC]

Our code of ethics stipulate that you make a reasonable attempt at resolving the ethical conflict informally, unless it represents a clear and imminent harm to a patient.

I don't threaten tho. These therapist know the rules

 

[WisNeuro]

I don't threaten tho. These therapist know the rules

Sometimes. I've been surprised before at how little some professionals know about the statutes that given them. Additionally, if I can get it done without board involvement, easier for me as well. I don't get reimbursed for time spent formally documenting complaints or testifying before the Board.

 

[AcronymAllergy]

I've seen first-hand that some providers don't know they're required to release patient records with the patient's authorization.

I agree that on the surface, it seems odd the provider is wanting to write a summary, and isn't offering to instead release the notes as they stand at a relatively minimal cost. I could see charging $150 if it's going to take an hour of the provider's time to write up the summary, and the summary (rather than the actual notes) was specifically requested by the other provider. But not to offer that as the only option. Also, like WisNeuro said, some/many states will limit what providers can charge for releasing notes.

 

[borne_before]

Your a physician, right?

Why do you want the progress notes? That get to the very center of the ethics...

 

[PikminOC]

Your a physician, right?

Why do you want the progress notes? That get to the very center of the ethics...

I am a Psychiatrist. It helps me understand the patient

 

[PikminOC]

Sometimes. I've been surprised before at how little some professionals know about the statutes that given them. Additionally, if I can get it done without board involvement, easier for me as well. I don't get reimbursed for time spent formally documenting complaints or testifying before the Board.

I don't get reimbursed for that either. But I don't threaten

 

[WisNeuro]

Your a physician, right?

Why do you want the progress notes? That get to the very center of the ethics...

It's perfectly reasonable for another MH provider to want to see chart notes of the patients for whom they deliver continuing care.

 

[WisNeuro]

I don't get reimbursed for that either. But I don't threaten

It's your call in the end. But, it's easier for me, and part of my ethical code to attempt informal resolution first. And, sometimes it is genuinely a misunderstanding that is quickly remedied by a phone call.

 

[borne_before]

It's perfectly reasonable for another MH provider to want to see chart notes of the patients for whom they deliver continuing care.

Is TikiTorches another MH professional or podiatrist?

 

[WisNeuro]

Is TikiTorches another MH professional or podiatrist?

Fairly certain they are a psychiatrist.

 

[cara susanna]

I'm just wondering why the therapist would only want to send a summary in this situation. I get why you would want to send only a summary to the patient, but another provider?

 

[borne_before]

I don't threaten tho. These therapist know the rules

You sound rigid TBH.

 

[PsychPhDone]

I got a consent for the last three progress notes from a therapist.
Therapist didn't want to send notes, just a summary.
I said that was fine. She said it would cost at least 150 for the summary as that's an hour of time. She asked for me to venmo the money.
I said I would talk to the family about it and she got pissed.
I ended up not paying for the summary it the notes and got nothing.
Is this ethical?

What state?

 

[PikminOC]

I complained to the board and got the notes on another case. Its ridiculous thats the only way things get done

 

[thebalmofhurtminds]

Check with your state specifically, but. If you've already been corresponding with this person, it seems like the natural next step would be to let them know that you are requesting the notes as required by the board/law. Seems like that should solve the problem.

 

[borne_before]

I complained to the board and got the notes on another case. Its ridiculous thats the only way things get done

What if I told you that there is more than one way to skin a cat? You know, like hold off on telling the teacher and having an adult conversation to attempt an informal resolution?

 

[PikminOC]

What if I told you that there is more than one way to skin a cat? You know, like hold off on telling the teacher and having an adult conversation to attempt an informal resolution?

The therapists tell me they don't send notes. They barely sent it when the board asked them.

 

[PikminOC]

Every single therapist wants to talk about the patient. That would end up being a full time job to talk to all of them