RISK Management General Guidelines

1. Medical Record requests (from patients or attorneys)

   • Comply with statutory requirements if you charge for copying.

   • Send a complete copy (with authorization received). 

   • Do NOT alter any records either before or after sending the records.

   • Keep a copy of the medical records request in the file.

   • We do NOT accept these requests as claims or probable claim events, but if you need risk management advice, we will assist.

2. Patient Complaint/Difficult patients/Negative Clinical Outcomes

   • Be respectful, do not overpromise. Listen attentively to the concerns. 

   • Do not make any admissions of negligence or wrongdoing.

   • Be consistent with response to the family or patient and educate your practice manager or staff on how to handle. 

   • Document thoroughly and carefully in the medical record as to patient complaint or demands and your response.

   • If patient becomes abusive or threatens violence to you or your staff, notify police immediately.

   • If you need to discuss further with one of our claims’ attorneys, please call the claims department at (866) 520-6896.

3. Calls from an Attorney

   • If you receive any calls from an attorney representing a patient or state/federal agency requesting an interview, please notify us PRIOR to any discussion or interviews.

4. State Board Complaints

   • We may cover certain board investigations if your policy allows and if the board complaint is regarding quality of care. You must report to us with a copy of the board letter, medical records in your possession, and any other documentation that you have received. 

FOR REPORTING CLAIMS OR PROBABLE CLAIM EVENTS, please see Report a Claim.