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The Law And A Client With A Balance Due New York

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  • The Law And A Client With A Balance Due New York

    This, of course, is what happens when I am not in the office *sigh*.

    New York State Office of the Professions law regarding Veterinary Treatment Records:

    "6714. Treatment records.
    Upon written request from the owner of an animal which has received treatment from or under the supervision of a veterinarian, such veterinarian shall provide to such owner within a reasonable time period a copy of all records relating to the treatment of such animal. For the purposes of this section, the term "records" shall mean all information concerning or related to the examination or treatment of the animal kept by the veterinarian in the course of his or her practice. A veterinarian may impose a reasonable charge for providing copies of such records. A veterinarian may make available to the owner either the original or a copy of such record or document including x-rays, electrocardiograms and other diagnostic tests and may impose a reasonable fee for the reproduction of such copies."

    Approximately one year ago, our office provided services to Client A for the medical treatment of their cat. Client A claimed financial hardship at the time, and out of the goodness of our hearts, we had Client A sign a Payment Agreement form to pay off the blance due upon the account in specified monthly payments over a period of time.

    Part of the treatment protocals for Client A's cat was a prescription diet.

    For the past year, we have not recieved payments as agreed upon by the signed Payment Agreement. I have sent monthly statements, and documented all communications regarding paying the balance due that I have had with Client A. The only time we get payment on the account from Client A is when they need to purchase the prescription diet for their cat. Then, Client A pays for the diet in full, and places a minimal amount towards the balance of the bill. This has not decreased the balance due significantly, and Client A still owes the practice approximately $180.00.

    Now that appoximately a year has gone by since Client A's cat last had a medical evaluation, the veterinarian no longer wants to supply Client A with the prescription diet until such time that Client A makes an appointment to have the cat medically evaluated to insure that the diet is still meeting the cat's theraputic and nutritional needs.

    Of course, Client A is having a catnipion fit ;0. Client A is still claiming financial hardship as the reason why they can't afford to pay for a medical evaluation of their cat up front at the time services are rendered. We will not write any more Payment Agreements for this Client since they are still in default of their previous arrangement. The veterinarian is being equally stubborn, which I know is their right as a medical professional, to refuse to provide prescription renewals without an examination of the pet.

    Client A is now demanding copies of their cat's medical records. They say we are legally obligated to provide such copies, which, under the above quoted law, I am well aware that we are. Also, in the midst of their disgruntlement, Client A stated that the practice would "not see a penny" of what is still owed upon their balance due.

    Client A was informed that we will provide such copies if 1) we recieve a written request from them, and 2) that there will be a fee involved. Nobody at the time told Client A how much that fee would be, or that the fee would be connected to the amount owed on their account. Client A was simply told to call the office back on Monday to speak to myself, the Office Manager, to try and resolve the situation. I love my job.

    Is requring Client A to pay the remaining balance on their account, approximately $180.00, in full, considered to be a "reasonable" fee for the release of their cat's medical records? Of course, the business finds it to be reasonable, but I doubt Client A would think that it is.

    Would a better course of action be to release Client A's records, and then just take Client A to small claims for the remaining balance? I have never been through the small claims process before, and would really like to avoid the hassle if possible, considering that I am due to go into labor at any point in time this month. Also, since Client A has such financial hardship, even if we had to go through the whole small claims process for a measly $180.00 and got the judge to agree that Client A would be responsible for our legal fees as well, I doubt we'll be able to collect anyway without the added hassle of getting writs of garnishment, etc.

    I feel caught between a rock and a hard place. I would like to inform Client A on Monday that I cannot release their cat's medical records without payment in full on the account, but feel as if the veterinarian has put me in the difficult position of having to release the medical records regardless due to the fact that Client A was told we'd do so for an undisclosed fee that according to law must be "reasonable."

    I don't think Client A has the resources to take the practice to small claims court for the records, but I do not need them to complain to the State Veterinary Boards, which would be an even BIGGER hassle as it would place the veteterinarian's, and possibly my own, licenses under review, which is more devestating then a court claim. The State Boards usually try to stay out of financial disputes between practices/clients, but this might fall under some sort of professional misconduct seeing as how the law for release of medical records might be interpreted. All it takes is a phone call to the Boards to start an investitation, without any financial investment on the client's part.

    Does anyone have any different interpretation of the law that might help me collect on this account without having to release the medical records before I have an opportunity to do so?

  • VeterinaryGroup
    replied
    *sigh* That's the interpretation that I figured as well. Although, why a client could pay a "reasonable" fee to have their pet's medical records released, and not be able to make payments towards their A/R are beyond me. Even if the client pays the fee, and I release the records, our practice is still out the $180.00, unless we pursue it through small claims.

    It is common practice in veterinary medicine to hold records "hostage" as you have described in demand for payment due. In fact, in my practice management class, this was the technique we were told to use before things resulted in collections or small claims. I suspect this probably plays upon a client's ignorance of the law.

    It could also be interpreted that the practice is refusing to provide a service (ie copy of records) until such time as the account is paid. We are legally allowed to withhold services, medical or otherwise, from clients who have outstanding balances. I have refused the release of certificates, written prescriptions, and even medical care that could not be paid up front, to clients who have outstanding A/R's and are in default of their payment agreements. How could withholding copies, or refusing to make copies, of medical records be considered different? Pet medical records are legally considered property of the practice, not property of the owner.

    Does anyone know what the process for small claims would be if I did decide to pursue this client via this method for the account balance due?

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  • CarynG
    replied
    I would interpret a "reasonable fee" to be somewhere in the neighborhood of the cost of paper, toner, and an employee's time to retrieve, copy, and refile the records. My bank charges a $3 fee to reprint my monthly statement, and I would interpret something like that as reasonable. I could understand a slightly higher fee to reproduce things like Xrays that might require special materials.

    I don't think $180 is reasonable - IMO that would amount to holding the medical records hostage pending payment in full of the bill. However, I don't think whatever fee you charge her needs to go toward her outstanding balance at all - again, it is to cover your cost of reproducing the records, which is a separate issue from her balance. I also think you have every right to take her visit to the office to pick up the records as an opportunity to press her further for payment.

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