Many lawyers assume that going to the ER is one bill. Also, make sure you appreciate who all of the health care providers are.
Most hospitals have different departments for records and bills. Make sure you submit a separate request for the medical bills.
We would greatly appreciate getting these records as soon as possible. Please also send the itemized billing statement for services rendered, including any HICFA forms or UB92 forms.Īs you know, Maryland’s Annotated Code, Health General Title, §4-309 requires that you produce these records within twenty-one (21) working days of this request. Pursuant to the enclosed HIPAA compliant medical authorization, please provide the undersigned with copies of all records, reports, x-rays and other diagnostic imagery, nurses’ notes, and your prognosis, diagnosis, and treatment plan. He was admitted for two days, suffering from broken ribs, a broken femur, and a closed head injury. It is our understanding that our client was seen at your facility for these injuries. My law firm represents Brian Sequoia in connection with injuries he suffered in a motor vehicle crash on April 23, 2021. You can learn how to obtain your client’s medical records quickly and cheaply here. Make haste and download it right away! You can also see more on Medical School Letters.Below is a sample letter requesting medical records for a hospital in a personal injury accident claim.īelow we also talk a little bit about the challenges in collecting medical records from doctors. The file is quite compatible with all portable devices where you can make your changes before you print it our or decide to send it digitally. Our Formal Medical Request Letter in DOC format has been designed for your convenience, so you can easily get this basic template on your editing software programs and add the details you would require to finish the letter. You can also add your identification number of the previous hospital if for accuracy.Ĩ+ Medical Request Letter Templates 1. The last step left is to provide your creative signature, along with the typed full name at the bottom of the letter to the left corner. Make sure you thank the doctor who treated you before and helped you with the progress along with the other staff. Leave a space and add your file number as well for specifications.Īfter providing the hospital details, you need to construct a body of the printable letter mentioning your medical history in the previous organization and the current situation relevant to past emergencies.
Mention the hospital name, address of the hospital and the contact details. Once you inform them that you need your medical records to send them the details of the hospital or center you want them to be transferred. Next, you have to mention the reason you left the area or locality, it may be due to a job transfer or change of residence and so on.
Mention how you know the medical center and what kind of medical history you have with them. If you have cordial relations with the person, you can just write “Sir/Madam” instead of the name.Īfter the salutation, now you need to add your details. Leave a line after the organization details and then write “Dear Mr/Mrs. Salutations are added to address the person whom you are writing this letter. If you wish, you may also add the address as well. (full name)” and in the corresponding lines, write the person’s title and name of the organization. Since it’s a formal letter, write “Mr/Mrs. The first section in a request sample letter to start with is the details of the receiver to whom you are sending the letter. 6 Steps to Write a Medical Request Letter Step 1: Receiver Details