Hey everyone, I haven't posted for a really long time, but I used to read these boards a lot and I thought I would come here and ask for opinions or answers once more.
I had palate expansion surgery back in 2007 and had my wisdom teeth removed before being braced. Paid the oral surgeon ~$7,000. Got braced, my total fee was $5,100. My insurance paid $1,000 of that, and then I paid $160 monthly for 1 year, so I have fulfilled $2,920 of my orthodontic payments so far. Here's the bad news: in June of 2008 I ended up leaving an abusive marriage very suddenly, and had no source of income or savings. I am currently living with my parents, finally got a job in September after having been laid off for 8 months, but am still in debt and not able to make payments on what I still owe the orthodontist, which is $960. He was kind enough to take off a portion of what I owed him originally. However, he will not release my records until I pay the balance off, and without my records no one else will treat me or even remove the braces. I moved 5 hours south of where I was being treated, and I cannot even afford to drive up there to have these braces removed. I've been at a standstill with treatment since June 2008. I cannot even get my teeth cleaned at this point with no records, as far as I know.
My question is this: is it ethical for my orthodontist to refuse to release my records? It's not as if I never paid him or the oral surgeon he referred me to any money at all. I've spent almost $9k out of pocket to get my oral situation straightened out, then my life completely fell apart and I'm totally stuck now. Any advice is welcome and greatly appreciated. I have already spoken to the orthodontist and he is adamant that I must pay him this $960. Even if I paid a small amount at a time, say, $100 a month, that would mean 9.6 more months of going with no treatment whatsoever since I can't get up there for treatment anyway.
Thanks,
Monarch
Serious Question
Moderator: bbsadmin
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Soworththeeffort
- Posts: 29
- Joined: Wed Dec 03, 2008 10:34 am
First, I can't think of a reason you wouldn't be able to get your teeth cleaned in your new town. I think any new dentist would only care about getting your teeth clean, and not about your issues with your orthodontist.
As far as the ethics of the situation, I'm afraid your doctor is acting in accordance with the rules and standards of his profession, so he's acting ethically. He's handling it the way pretty much all orthodontists would, although I'm sure that's a bit of cold comfort for you.
I don't know where you live, but at this time of year, you may be able to pick up a part-time retail gig to help whittle down the cash you still owe (there are actually lots of these kinds of jobs in my area). Perhaps you could work out a deal with your folks? (If your divorce isn't final, you may even be able to have responsibility for this bill assigned to your ex in the decree.)
Even if nothing does work out in the immediate future with this situation, please try to remember that you took a major step forward in your life when you exited your abusive marriage. I'm sure that wasn't an easy thing to do, but you know it was the right thing to do (let's face it, if it was easy to do the right thing, everybody would do it). Doing the right thing, unfortunately, often comes at a price. What advice would you give to someone if they said, "Should I stay in my abusive marriage for another year until my braces are paid off, or should I start changing my life for the better today?"
If you had the courage to make that break, you can see this through, too. I'm proud of the example you're setting for other women in your situation, and I wish you the best.
As far as the ethics of the situation, I'm afraid your doctor is acting in accordance with the rules and standards of his profession, so he's acting ethically. He's handling it the way pretty much all orthodontists would, although I'm sure that's a bit of cold comfort for you.
I don't know where you live, but at this time of year, you may be able to pick up a part-time retail gig to help whittle down the cash you still owe (there are actually lots of these kinds of jobs in my area). Perhaps you could work out a deal with your folks? (If your divorce isn't final, you may even be able to have responsibility for this bill assigned to your ex in the decree.)
Even if nothing does work out in the immediate future with this situation, please try to remember that you took a major step forward in your life when you exited your abusive marriage. I'm sure that wasn't an easy thing to do, but you know it was the right thing to do (let's face it, if it was easy to do the right thing, everybody would do it). Doing the right thing, unfortunately, often comes at a price. What advice would you give to someone if they said, "Should I stay in my abusive marriage for another year until my braces are paid off, or should I start changing my life for the better today?"
If you had the courage to make that break, you can see this through, too. I'm proud of the example you're setting for other women in your situation, and I wish you the best.
Not sure how I feel about the assumption here that abusive relationships are always the product of a man's doing.Soworththeeffort wrote: If you had the courage to make that break, you can see this through, too. I'm proud of the example you're setting for other women in your situation, and I wish you the best.
The OP never stated their sex.
Just saying....
Wow, it sounds like you have been through a lot this year; I applaud you for having the courage to leave your abusive marriage. If there were ever a way your ortho could write off a balance because of someone's personal situation, I'm sure you would fall under that category. Unfortunately, I believe he is acting ethically.
I have no doubt that you would eventually pay off the balance after the records were released, but your ortho probably doesn't know whether you'd repay what you owe, and he probably doesn't care to find out. I won't give you any suggestions on how to repay the money - you've probably already tried many ways. The whole situation is just very unfortunate. I'm sorry this happened to you, and I hope you find a way to rectify the problem.
I have no doubt that you would eventually pay off the balance after the records were released, but your ortho probably doesn't know whether you'd repay what you owe, and he probably doesn't care to find out. I won't give you any suggestions on how to repay the money - you've probably already tried many ways. The whole situation is just very unfortunate. I'm sorry this happened to you, and I hope you find a way to rectify the problem.
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Soworththeeffort
- Posts: 29
- Joined: Wed Dec 03, 2008 10:34 am
Hey tK -
Aw, snap! I did make an assumption that the poster is a woman, based on the whole context of the post (not just the abusive marriage part). You're absolutely right - spousal abuse is not relegated to husbands. I didn't mean to offend you or anyone else - sorry about that (for the record, I find myself adoring nice men all the time). Thanks for the perspective check.
Aw, snap! I did make an assumption that the poster is a woman, based on the whole context of the post (not just the abusive marriage part). You're absolutely right - spousal abuse is not relegated to husbands. I didn't mean to offend you or anyone else - sorry about that (for the record, I find myself adoring nice men all the time). Thanks for the perspective check.
Yeah but without going all politically correct, how much you wanna bet the OP is a women? I think its a safe assumption...theKurp wrote:Not sure how I feel about the assumption here that abusive relationships are always the product of a man's doing.Soworththeeffort wrote: If you had the courage to make that break, you can see this through, too. I'm proud of the example you're setting for other women in your situation, and I wish you the best.
The OP never stated their sex.
Just saying....
No offense taken, it's all good.Soworththeeffort wrote:Hey tK -
Aw, snap! I did make an assumption that the poster is a woman, based on the whole context of the post (not just the abusive marriage part). You're absolutely right - spousal abuse is not relegated to husbands. I didn't mean to offend you or anyone else - sorry about that (for the record, I find myself adoring nice men all the time). Thanks for the perspective check.
In general, it is estimated that only 1/3 of the total spousal abuse cases get reported. On top of that, the US Dept. of Justice reports that far more men than women fail to report or identify their abuser. In other words, the perception is that women are far more often the victim of spousal abuse than men. The reality is very likely different than the perception. I personally have witnessed in friends both sides of the fence - far too often for my comfort level.
Back to the OP, your courage is admirable. You've shown the ability to take charge of your own life and I'm sure that will serve you just as well in solving the issue with your ortho. Good luck!
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Soworththeeffort
- Posts: 29
- Joined: Wed Dec 03, 2008 10:34 am
Meryaten, as usual, you are the bomb (I never even thought of HIPAA as a potential remedy).
Monarch64, if you live in the US, the following link that offers well written instructions about how to request medical records:
http://patients.about.com/od/yourmedica ... ecords.htm
This article also states that if you can't afford the fee and you inform your health care provider of that, they can't deny you your records.
Embedded in the article is the following link, to a Georgetown University site that summarizes medical records regulations for each state. (This information includes statutes related to reasonable fees for copying records, and state level remedies related to failure to comply.) Meryaten is right, however, in that some states only say a "reasonable" fee is required.
http://patients.about.com/gi/dynamic/of ... cords.html
A word of caution: there are no federal statutes that provide remedies to patients for a healthcare provider's failure to comply with HIPAA. There is, however, an established complaint procedure...just no right to sue in federal court.
Additionally, although states may provide the right to sue, they may also significantly narrow the definition of who must comply with HIPAA regulations. For example, one state's statute: "The HIPAA Privacy Rule only covers health care providers that use computers to send health information for certain administrative or financial purposes (such as filing claims for insurance)." That definition would include my orthodontist, but I don't know if it would include every orthodontist in my state.
Really, the Georgetown site is great - it answers all HIPAA procedural and penalty questions for each state, and even summarizes state law that applies when HIPAA doesn't. Given all this info, it seems like your orthodontist may not be in compliance with HIPAA, however, in lots and lots of industries, statutory compliance is typically an afterthought. (Meaning it may just be ignorance on the part of your orthodontist, and not lack of willingness to comply.)
Again, Meryaten, you absolutely bring it every time (and I appreciate that). And tK, glad we're cool.
Monarch64, if you live in the US, the following link that offers well written instructions about how to request medical records:
http://patients.about.com/od/yourmedica ... ecords.htm
This article also states that if you can't afford the fee and you inform your health care provider of that, they can't deny you your records.
Embedded in the article is the following link, to a Georgetown University site that summarizes medical records regulations for each state. (This information includes statutes related to reasonable fees for copying records, and state level remedies related to failure to comply.) Meryaten is right, however, in that some states only say a "reasonable" fee is required.
http://patients.about.com/gi/dynamic/of ... cords.html
A word of caution: there are no federal statutes that provide remedies to patients for a healthcare provider's failure to comply with HIPAA. There is, however, an established complaint procedure...just no right to sue in federal court.
Additionally, although states may provide the right to sue, they may also significantly narrow the definition of who must comply with HIPAA regulations. For example, one state's statute: "The HIPAA Privacy Rule only covers health care providers that use computers to send health information for certain administrative or financial purposes (such as filing claims for insurance)." That definition would include my orthodontist, but I don't know if it would include every orthodontist in my state.
Really, the Georgetown site is great - it answers all HIPAA procedural and penalty questions for each state, and even summarizes state law that applies when HIPAA doesn't. Given all this info, it seems like your orthodontist may not be in compliance with HIPAA, however, in lots and lots of industries, statutory compliance is typically an afterthought. (Meaning it may just be ignorance on the part of your orthodontist, and not lack of willingness to comply.)
Again, Meryaten, you absolutely bring it every time (and I appreciate that). And tK, glad we're cool.