Request Status
Current stage of the medical record transfer.
Patient Record Request Details
Details for request ID RR019

Patient Name

Stephanie Evans

MRN

MRN63096

Status

Fulfilled

Requesting From

University Hospital

Requested Date

7/3/2023

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, Stephanie Evans, has a complex medical history including chronic hypertension and Type 2 Diabetes, managed by University Hospital. 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

S

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

Jul 5, 12:54 AM
Y

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

Jul 5, 1:57 AM
S

I have an appointment with the new specialist next month, so I'm hoping to have the records by then.

Jul 6, 4:51 PM