Request Status
Current stage of the medical record transfer.
Patient Record Request Details
Details for request ID RR010

Patient Name

Chris Gonzalez

MRN

MRN83827

Status

Fulfilled

Requesting From

Mount Sinai

Requested Date

1/11/2025

Case Details
Additional information and context for this request.

This record request was initiated for continuity of care following the patient's recent relocation. The patient, Chris Gonzalez, has a complex medical history including chronic hypertension and Type 2 Diabetes, managed by Mount Sinai. We require the last 24 months of clinical notes, lab results, and imaging reports to ensure a safe and effective transition to our practice.

Please expedite this request as the patient has an upcoming appointment for medication management. The signed patient consent form is attached to the electronic request sent via the health information exchange (HIE).

Eligibility Results
Patient's coverage details based on last check.
StatusActive
Plan NameBlueCross PPO Gold
Coverage Dates01/01/2024 - 12/31/2024
Primary Care Co-pay$25
Specialist Co-pay$50

Deductibles

Individual$850.75 / $1,500
Family$1,250.00 / $3,000

Out-of-Pocket Max

Individual$2,100.50 / $5,000
Family$3,500.00 / $10,000

C

Thank you for the update! When do you think it will be completed?

Jan 12, 9:22 PM
Y

We're still waiting for some documents from your previous clinic. We'll notify you once we receive them.

Jan 13, 10:12 AM
C

I've uploaded the consent form you requested. Please let me know if you need anything else.

Jan 16, 3:35 AM