Request Status
Current stage of the medical record transfer.
Patient Record Request Details
Details for request ID RR017

Patient Name

Jessica Lopez

MRN

MRN65205

Status

Denied

Requesting From

Suburban Health

Requested Date

4/9/2023

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, Jessica Lopez, has a complex medical history including chronic hypertension and Type 2 Diabetes, managed by Suburban Health. 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).

Denial Reason

The request was denied due to an invalid or expired patient consent form. Please obtain a new consent form from the patient and resubmit the request.

Eligibility Results
Patient's coverage details based on last check.
StatusInactive
Plan NameUnitedHealthcare Choice Plus
Coverage Dates01/01/2023 - 12/31/2023
Primary Care Co-payN/A
Specialist Co-payN/A

Deductibles

IndividualN/A / N/A
FamilyN/A / N/A

Out-of-Pocket Max

IndividualN/A / N/A
FamilyN/A / N/A

Notes

Coverage terminated on 12/31/2023. Please check for new insurance.

J

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

Apr 12, 6:07 PM
Y

The transfer is complete. The records are now available for your specialist.

Apr 14, 2:22 PM
J

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

Apr 15, 2:03 AM
Y

The request is still in progress. We expect to have an update within 3-5 business days.

Apr 15, 3:58 AM
J

Just confirming my new address is on file for the transfer.

Apr 17, 4:41 AM
Y

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

Apr 19, 1:49 PM
J

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

Apr 21, 11:17 PM
Y

The request is still in progress. We expect to have an update within 3-5 business days.

Apr 23, 7:08 PM
J

Can you confirm you received the documents I sent over last week?

Apr 24, 11:17 PM
Y

The transfer is complete. The records are now available for your specialist.

Apr 25, 1:27 AM