Whitepaper

Medical Canvassing vs.
Record Retrieval

When Is It Necessary To Obtain A Patient Authorization?

In the world of insurance, and as part of the discovery & evaluation process, obtaining a medical canvass and/or medical records may be required to uncover information about the claim. While there are elements of each type of request that are similar, there are many differences. This white paper aims to demonstrate the differences between medical canvassing and record retrieval and to distinguish how and when HIPAA applies to each.

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Differences Between Medical Canvassing and Record Retrieval

A “medical canvass” is a survey of medical facilities in a specific geographical area to uncover WHERE & WHEN a claimant may have received treatment.

  • The insurance company provides INTERTEL (medical canvassing provider) with the claimant’s information, and INTERTEL calls medical facilities within a specified geographic area to determine whether or not the facility ever treated the claimant, and if so during what time period.
  • In conducting these canvasses, INTERTEL is only looking for a “yes” or “no” answer from the facility as to whether a claimant received medical treatment.
  • No medical information about the claimant is exchanged when conducting a canvass – in fact, if the answer is “no,” then no Protected Health Information (PHI) even exists because the individual was never treated at the facility.
  • In instances where the canvassing returns a “yes” answer from the facility, the claimant did go to the facility for treatment, the insurance carrier may later decide to pursue obtaining the medical records.

Record retrieval is the process of legally obtaining patient records from a facility/custodian of records. Ontellus works with the insurance carriers, claims adjusters, and law firms to obtain records on their behalf.

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