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Pet Forum / Miscellaneous / Animal Health / February 2006



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Any here work for a veternarian ?

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John Dixon - 21 Feb 2006 04:19 GMT
I have a couple of questions regarding customer requesting copies of records
and masking charges on the records.  Is it legal to hide the prices on the
customers copy ?
buglady - 21 Feb 2006 13:01 GMT
> I have a couple of questions regarding customer requesting copies of records
> and masking charges on the records.  Is it legal to hide the prices on the
> customers copy ?

........If you're in the US, the state law may cover that issue. I know that
most states have laws concerning clients getting copies of written records.
I've only seen prices on the receipts that I get after paying.

buglady
take out the dog before replying
sighthounds & siberians - 21 Feb 2006 13:09 GMT
>I have a couple of questions regarding customer requesting copies of records
>and masking charges on the records.  Is it legal to hide the prices on the
>customers copy ?

I don't know whether or not it's legal, but I think it's inappropriate
and possibly somewhat unethical.  A customer has the right to know
what he/she is paying for.

Mustang Sally
John Hasler - 21 Feb 2006 13:56 GMT
Mustang Sally writes:
> A customer has the right to know what he/she is paying for.

You are paying for whatever it is that you authorized the vet to do.  Your
receipt is your record.
Signature

John Hasler
john@dhh.gt.org
Dancing Horse Hill
Elmwood, WI USA

sighthounds & siberians - 21 Feb 2006 15:03 GMT
>Mustang Sally writes:
>> A customer has the right to know what he/she is paying for.
>
>You are paying for whatever it is that you authorized the vet to do.  Your
>receipt is your record.

But a receipt isn't very helpful if the charges are masked, is it?  

Let me rephrase:  

A customer has the right to know what s/he is paying for each and
every service/procedure performed.  Actually, the customer has the
right to know those charges ahead of time, if s/he wants that
information.

Mustang Sally
John Hasler - 21 Feb 2006 16:42 GMT
I wrote:
> You are paying for whatever it is that you authorized the vet to do.
> Your receipt is your record.

Mustang Sally writes:
> But a receipt isn't very helpful if the charges are masked, is it?

The original question was not about a receipt but about copies of records,
presumably of such things as blood test results.  Thus one presumes that
the OP had already been billed for the service described by the records and
had a receipt (the amounts masked out may have been such things as what the
vet paidd to the lab, not what the vet billed the customer).

> A customer has the right to know what s/he is paying for each and every
> service/procedure performed.

It would be rather difficult to pay for it without knowing what it cost.

> Actually, the customer has the right to know those charges ahead of time,
> if s/he wants that information.

Actually, the customer has the right to decline the service if the vet
refuses to quote a price.  If you ask "What is this going to cost?", the
vet says "I don't know" and you say "Go ahead anyway" you have agreed to
pay without knowing the charges.
Signature

John Hasler
john@dhh.gt.org
Dancing Horse Hill
Elmwood, WI USA

John - 22 Feb 2006 00:53 GMT
I know that it is done here alot in southern california when customers bring
in records from other vets the prices are masked ( I know that there is alot
of competition with prices here with vets) the customer has the original
receipt with the prices of what they paid for.  If they wanted to know what
they paid for for a certain date they either have the original receipt or
the doctor can make a copy of the original receipt.  I guess you can call it
protecting ones own price interes from other vets ( it's called price wars
and there is alot of that here)
>I wrote:
>> You are paying for whatever it is that you authorized the vet to do.
[quoted text clipped - 23 lines]
> vet says "I don't know" and you say "Go ahead anyway" you have agreed to
> pay without knowing the charges.
buglady - 22 Feb 2006 12:52 GMT
> I know that it is done here alot in southern california when customers bring
> in records from other vets the prices are masked ( I know that there is alot
> of competition with prices here with vets) the customer has the original
> receipt with the prices of what they paid for.

.......I've never gotten records that included prices, because what I'm
after are lab tests and the written clinic records.  Accounting stuff is
separate.  They fill out a sheet with those stupid medical codes on them
with prices attached.

.........And quite frankly I think it's silly to mask the prices from other
vets.  Does this mean if I called and asked the price for a certain
procedure no one at the clinic would tell me without an appointment unless I
was a current client?   Your clientele comes to you for a reason.  For some,
it's the price, others the expertise.  The lowest price in town doesn't
always mean best care as they're either running it like a human medical
factory (you talk to 2 or 3 people first, then the Dr. doesn't even look at
you or spend any time with you other than looking at your chart) or they
don't have high end equipment to pay for.  Being without fancy equipment
BTW, doesn't necessarily mean there's no expertise.  Sometimes the priciest
clinic in town is a worse bet than the vet who's been in business for years
and doesn't own an ultrasound.  I really think that all those volume clients
they try to get with low prices for basic procedures, who don't even know
what shots the vet just gave will be the first to desert when something goes
wrong because they haven't the faintest idea of what is going on with their
pet in the first place.  And they'll be the loudest at spreading ill will
among the community.  Loyalty is a funny thing, and isn't necessarily tied
to the lowest price.

.........Vets have a chance to get it right instead of following the totally
broken human medical model.  They should be acting like a community, sharing
expertise and even equipment if it is needed.  That way everyone gets a
piece of the pie and the clientele are treated the same.

I've heard some horror stores about prices in Cal though, particularly WRT
euthanasia and cremation.  Dr. Deb (who posts here frequently) mentioned
once that euthanasia at the clinic where she works is ridiculously cheap.
The clinic's thinking on this is that this is a time in particular that you
don't want to be making it harder for those who don't have much cash to
release their pet from misery.  THAT is the kind of thing that buys client
loyalty - caring about the critters.

buglady
take out the dog  before replying
Nicole - 22 Feb 2006 00:51 GMT
That's horrible customer service.  I would not take my business to some
place that hides its prices.  What's the reasoning behind this?
When I pay, I get a receipt for however I paid but I also see the break down
of what everything costs.
Nicole
>I have a couple of questions regarding customer requesting copies of
>records and masking charges on the records.  Is it legal to hide the prices
>on the customers copy ?
John - 22 Feb 2006 02:30 GMT
Nicole, I am not talking about a receipt. Of course I would expect to get a
receipt for services done. I am talking about the records the hard copy for
the patient if you read the actual post- "regarding customer requesting
copies of records".

> That's horrible customer service.  I would not take my business to some
> place that hides its prices.  What's the reasoning behind this?
[quoted text clipped - 4 lines]
>>records and masking charges on the records.  Is it legal to hide the
>>prices on the customers copy ?
Nicole - 23 Feb 2006 07:21 GMT
Like I said, I always see a breakdown of all services rendered.   My vet
breaks down everything and my receipt will show that breakdown.
The breakdown of prices are even in my animals' charts.
There's no sneaky beahvior of trying to hide the price.
> Nicole, I am not talking about a receipt. Of course I would expect to get
> a receipt for services done. I am talking about the records the hard copy
[quoted text clipped - 9 lines]
>>>records and masking charges on the records.  Is it legal to hide the
>>>prices on the customers copy ?
John - 23 Feb 2006 14:47 GMT
It's not "Sneaky Beahavior""  idealistic.realism put it perfectly, if you
don't understand then im sorry.  My questions were answered and satisfied
with the conclusion.  The thread is now closed. Thanks to all.
> Like I said, I always see a breakdown of all services rendered.   My vet
> breaks down everything and my receipt will show that breakdown.
[quoted text clipped - 13 lines]
>>>>records and masking charges on the records.  Is it legal to hide the
>>>>prices on the customers copy ?
Toni - 23 Feb 2006 15:04 GMT
> My questions were answered and satisfied with the conclusion.  The thread
> is now closed.

Like that ever stopped anyone from posting <g>!

Signature

Toni

Nicole - 23 Feb 2006 22:15 GMT
It is sneaky behavior.  We're all entitled to our opinions although you seem
to disagree.
You would never go to a mechanic without an estimate (break down of parts
and labor) yet you expect clients to pay whatever bill you put in front of
them.  Ludicrous.

> It's not "Sneaky Beahavior""  idealistic.realism put it perfectly, if you
> don't understand then im sorry.  My questions were answered and satisfied
[quoted text clipped - 16 lines]
>>>>>records and masking charges on the records.  Is it legal to hide the
>>>>>prices on the customers copy ?
idealistic.realism - 23 Feb 2006 22:22 GMT
Woah, I think we're taking what I said a little out of context.  I
would never expect a client to pay for anything without an estimate
that has a complete breakdown of all the services.  Nor would I expect
them to sign it without having a full understanding of exactly what
they are signing.  Which is why it constantly baffles me that we do
have more than a few clients that will sign such estimates without
reading them first.  I would never tell a client they couldn't have any
part of their animal's record, and that's not the original question
asked.
Sharon - 23 Feb 2006 17:24 GMT
> Like I said, I always see a breakdown of all services rendered.   My vet
> breaks down everything and my receipt will show that breakdown.
> The breakdown of prices are even in my animals' charts.
> There's no sneaky beahvior of trying to hide the price.

Most animal hospitals have computer systems with multiple programs. The two
we have had (newest installed in Sept.) have separate programs for records
and invoices. A client is more than welcome to save all of the invoices they
get and share them at *their* will. These are their receipts and we even
give them a nice pocket folder when they come on their first visit so they
can keep track of them. The prices for the services and products are right
there -no "masking". But when they need copies of patient *records* the
receptionist goes to another program that keeps these detailed records and
prints them out. These are technical lists of dates of visits,
communications, lab results, pathologies, surgeries and procedures with
differentials and diagnosis' etc... These programs do not merge for many
reasons. One being that which I described before - we legally cannot share
clients' personal financial information with anyone outside the practice.
Invoices have method of payment as well as outstanding balances. Should
clients wish to have particular copies of invoices we can do that also, but
it's not what the other vet is primarily interested in and we have never
been asked to provide them for such reason.
idealistic.realism - 23 Feb 2006 22:12 GMT
To Bug Lady,
The low prices on "basic procedures" like annual vaccines and
spay/neutering surgeries are not to "lure" clients into a clinic.  We
try to keep our prices down AND work with several shelters in the area
as well as the state's low cost program so that everyone can afford
these essential things.  There's no "luring" involved.

And, if you read my post, I said the record is not what is covered.
ALL of that information is transferred. Most clients wouldn't want
their personal financial information and account history to be shared
with the next clinic.
buglady - 23 Feb 2006 23:52 GMT
> To Bug Lady,
> The low prices on "basic procedures" like annual vaccines and
> spay/neutering surgeries are not to "lure" clients into a clinic.  We
> try to keep our prices down AND work with several shelters in the area
> as well as the state's low cost program so that everyone can afford
> these essential things.  There's no "luring" involved.

.........kudos to you for that.  There's a lot of corporate clinics
sprouting up though that are operated more like a factory than a medical
office.  I just don't understand masking prices.  It makes no sense to me.

> And, if you read my post, I said the record is not what is covered.
> ALL of that information is transferred.

.....no what you said was this:
Because the records belong to the clinic, it's not illegal
> to block any part of it.  You're not telling the client they can't have
> the information, it's not the same thing at all.

......if you meant to say that it is not illegal to block parts that are NOT
part of the medical  record such as accounting/financial, then OK.  It's not
really clear from what you said above, which makes it sound like they can
block out anything they want.

..........BTW, there's a way to reply to a message on Google groups that
will include the reply, which you can then snip down.  Since I don't post
from there I don't remember what it is, but I think you hit options, then
reply to.

buglady
take out the dog before replying
idealistic.realism - 24 Feb 2006 00:27 GMT
> ......if you meant to say that it is not illegal to block parts that are NOT
> part of the medical  record such as accounting/financial, then OK.  It's not
[quoted text clipped - 8 lines]
> buglady
> take out the dog before replying

I did mean the financial/accounting aspects.  And thanks for the
replying tip.
idealistic.realism - 22 Feb 2006 05:57 GMT
I do work for a vet.  All prices are listed on the customer's receipt
and are broken down.  If an owner requests a price for any
service/procedure, it is always given.  As for blocking the "prices" on
the patient's record, we do that.  It has nothing to do with the
client, who should have a record of all the prices paid for services on
their receipts (and if they do not, these can usually be reprinted at
the client's request).  Actually, most of the time, the "prices" on the
physical charts aren't really prices, it's accounting.  It's a quick
way for a receptionist, office manager, vet, etc. to see if the client
has a previous balance.  For example, if I'm checking out a Mr. Smith
for his dog Spot for annual vaccines, and the balance due is higher
than normal, especially if I'm busy, the reason isn't always readily
apparent from the computer program.  It's easy to look back on Spot's
chart, see the date of the blance forward, and why it was put on
account.  All of that is blocked out when records are copied for two
reasons: 1. Clinics are getting competetive for pricing and don't want
their prices advertised to the competition.  2. Most clinics don't feel
that the client's accounting history is relative to the patient's
medical history and will block it in respect of the client's privacy.
The records (medical and accounting) are NEVER made unavailable to a
client.  Much like your own medical records, if you want a copy, you
can have it.  Also, most vets that I know of won't put down the "at
cost" price onto patient records (meaning the price we pay for things)
as there's no real purpose and most of the national lab companies don't
include things like that on the results or forms, but in separate books
and invoices.

Hope that helps.
John - 22 Feb 2006 06:08 GMT
Thanks for clearing it up, I have a question for you though is it against
the law to do that ?  I had an incident at our hospital that required me to
call the police because of some crazy client who grabbed out of my hands her
medical records while I was copying them and ran off with it.  After the
report to the police I recieved the medical records back and he gave me a
lecture about it's against the law to cover the prices ....my jaw literally
dropped I couldn't believe this yahoo and besides who is he to give legal
advice, I felt like I was the victim.

>I do work for a vet.  All prices are listed on the customer's receipt
> and are broken down.  If an owner requests a price for any
[quoted text clipped - 24 lines]
>
> Hope that helps.
idealistic.realism - 22 Feb 2006 06:19 GMT
No, it's not illegal.  The medical records actually "belong" to the
clinic, and, by law, HAVE to be kept for I believe five or seven years,
even if the patient is deceased.  Original records are never given to
the client.  Because the records belong to the clinic, it's not illegal
to block any part of it.  You're not telling the client they can't have
the information, it's not the same thing at all.

And you were definitely the victim!  The original records that the
client took are considered stolen property (at least in NJ).  I don't
blame you for being wary of that sort of "legal advice".

We've had to, unfortunately, get the police involved with clients
before (though only once) and it's never a pleasant thing.  People
never believe that my job can be that....I'm not sure if exciting is
the right word, how about hectic?  LOL.
buglady - 22 Feb 2006 12:22 GMT
Because the records belong to the clinic, it's not illegal
> to block any part of it.  You're not telling the client they can't have
> the information, it's not the same thing at all.

........no it's not OK to block ANY part of it.  I think you misspoke.

buglady
take out the dog before replying
John Hasler - 22 Feb 2006 14:05 GMT
> no it's not OK to block ANY part of it.

Of course it's ok to block out the prices on clinical records.  That
information is confidential.  If you want to tell your new vet what you
paid you can do so.
Signature

John Hasler
john@dhh.gt.org
Dancing Horse Hill
Elmwood, WI USA

Sharon - 23 Feb 2006 05:08 GMT
>I have a couple of questions regarding customer requesting copies of
>records
> and masking charges on the records.  Is it legal to hide the prices on the
> customers copy ?

There are records, then there are invoices. Most computer generated records
(reasons for visits, vaccination history, labs, transcribed doctor's notes,
client concerns, pathologies, exam findings etc) do not include individual
invoices (date of visit, service/product cost, method of payment or history
of financial issues) for customer transactions. Think about it as though you
get copies of your own medical records to share with another doctor. Those
do not include the cost of services either. Not hiding anything, just
preserving time and paper and protecting the confidentiality of our clients
(It's also illegal for us to share checking account, credit card info or
even collections history with anyone, and since most of the time client
records are faxed or mailed to another vet, we'd be in big trouble if we
included the invoices). Our computer system can print medical records for
clients wishing to transfer to another doctor for whatever reason, but we've
never had a request for anything *but* records when clients move, get a
second opinion, or are referred are change vets.
 
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