Request Status
Current stage of the medical record transfer.
Patient Record Request Details
Details for request ID RR030

Patient Name

Lisa Smith

MRN

MRN68678

Status

Denied

Requesting From

Mercy General

Requested Date

1/2/2023

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, Lisa Smith, has a complex medical history including chronic hypertension and Type 2 Diabetes, managed by Mercy General. 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.

L

Thanks for your help, I really appreciate it.

Jan 4, 11:01 PM
Y

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

Jan 5, 4:29 AM
L

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

Jan 8, 12:02 AM
Y

We've received your consent form. The records should be transferred shortly.

Jan 10, 11:39 AM
L

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

Jan 13, 12:19 AM
Y

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

Jan 14, 10:47 AM