Thursday, November 25, 2010

Questions about Signing Release Forms

As a patient, the following are important to me in order of priority re the recall:
·         Getting the required medical attention.
·         Not being stuck with any bills ever for this problem.
·         Not having to deal with repeated questions by claims adjusters which I can’t answer.
·         Compensation for what attorneys refer to as “pain and suffering” should I need revision surgery.
My position can be summarized from a clip I found on one of the legal sites:
It should go without saying that a patient in no way should waive any rights to any kind  of medical attention that he or she might need for existing problems or for problems that should arise in the future.  The patient should accept nothing less than complete payment of all current and future medical expenses.”
I see quite a bit of conflicting information  regarding what forms should and shouldn’t be completed by the patient to ensure that your position for complete payment for all medical claims now and in the future is not compromised. The forms that you will be asked to sign:
·         Forms provided by the physician from Depuy
·         Forms provided directly by Depuy re your hip
·         Insurance company forms re your hip
The major conflict I see is the advice from almost every attorney attempting to secure a class action suit vs the Depuy position.  Depuy’s position appears  specifically request to see all of your medical records in order to evaluate your condition for reimbursement if treatment is required.
The Lawyers seem to all have similar opinions:
“By Signing the [Depuy ] Form You Waive Your Federally Protected Right to Medical Privacy. Any Information You Release Can Be Used as Evidence Against You and Affect the Outcome of Your Hip Recall Claim
I have not explored the implications of this and I don’t even know at this point, if by signing the Depuy form, any rights are waived.  Nor do I understand yet whether refusing to sign a Depuy for will delay any required medical attention.
This  is what the Depuy site says about registering your claim with them:
This recall means additional testing and treatment may be necessary to ensure your hip implant is functioning well. DePuy intends to cover reasonable and customary costs of testing and treatment, including revision surgery if it is necessary, associated with the ASR recall. Even if you do not have out-of-pocket medical expenses, please contact the DePuy ASR Help Line so that you may be assigned a claim number. This will allow DePuy to process other reasonable out-of-pocket costs, such as lost work time and travel expenses, which may be reimbursed. These costs will be more clearly defined shortly and are subject to review on a case-by-case basis.
  • On its Web site, DePuy identifies the following steps to be taken by ASR recipients seeking reimbursement:
    1. Call the ASR Call Center.
    2. Confirm whether you were implanted with an ASR device (to find out this information, you should contact your surgeon or the hospital where your surgery took place).
    3. Speak to a Call Center representative, who will initiate a claim on your behalf.
    4. Wait to be contacted by a claims representative who will send you a letter of payment authorization, an ASR claim number, and a medical authorization form.
    5. Visit your orthopedic surgeon for evaluation and/or treatment.
    6. Submit expenses and documentation to the DePuy claims processor for review for eligibility
3 Excerpts explaining the implication of these Depuy directives taken from other law firm sites who are pursuing litigation on behalf of their clients:

1.      “In plain English, this means DePuy may pay lost work time and travel expenses but apparently is refusing to pay other damages associated with this product failure, such a pain, suffering, disfigurement, or disability associated with yet another hip surgery and recovery.”

2.      “While the process described [by Depuy]appears to be straightforward and well-intentioned, a closer look reveals that aspects of the claims process could prove to be very sticky for ASR injury victims. In order to help you understand why this is true, it is useful to take a closer look at one particular component of the DePuy hip replacement claims process and the reimbursement policy itself.
The Medical Authorization Form
According to DePuy, signing a medical release form allows your surgeon to share information about your case with DePuy and the claims processor (a third party hired by DePuy), as well as allowing DePuy to share information with you about your ASR hip. Ostensibly, this will help the claims processor handle your claim more efficiently while access to testing data (such as the results of your blood test, imaging [MRI, ultrasound, X-ray] and revision data [related to your follow-up hip replacement procedure, if it is necessary]) will assist DePuy in its efforts to understand why the ASRs have an abnormally high revision rate.
You should be wary of signing this medical authorization form without first letting a hip replacement lawyer review it. DePuy may be telling the truth when it states that the form provides a means to “…share information about the patient’s case…”. You, however, have no guarantees that DePuy won’t try to use information in your medical records to devalue your claim. A lawyer can make sure you do not sign away any important rights.
Reimbursement
You should know that even if you obey DePuy’s wishes and carefully follow every step in the claims process, DePuy alone has discretion over whether you are reimbursed, and in what amount. DePuy admits as much when it states that costs borne by patients, such as co-pays, lost work time, travel expenses and other reimbursable expenses are “…subject to review on a case-by-case basis.”  In other words, you have no way of knowing whether you will be reimbursed for out-of-pocket expenses, not to mention that DePuy has yet to address compensating ASR victims for pain, suffering, and other non-monetary losses.
To be fair, DePuy states that it is still working out the particulars of its reimbursement process, and that more information will be available soon.”

3.       “In our opinion, DePuy's 'offer' may deceive potential claimants into believing that the company has actually agreed to advance or reimburse their costs for medical monitoring or revision surgery. In fact, no specific offer to pay medical costs has been made and no specific plan for reimbursement has been announced. Moreover, DePuy has stated that before reimbursement of expenses will be provided, it will review the patient's medical records to determine if the patient meets DePuy's criteria for payment. According to DePuy, the medical records must confirm that the revision is related to the ASR recall and 'not some other type of cause, such as a traumatic fall.' Blaming the device failure on a fall, or another cause, such as physician error, patient misuse, pre-existing condition or underlying diseases is a standard litigation defense in these types of cases. Thus a patient who releases medical records to DePuy may do nothing but provide DePuy with a jump start on litigation defenses.”
My first appointment with my surgeon will occur on the 30th of November.  
·    Once I see the forms I am asked to sign by the physician, I will post them.
·    Following that first visit but prior to signing anything, I will talk to some of the law firms who are accepting recall claims to determine how to protect my rights for obtaining the appropriate medical care without having to compromise my rights.
·    Finally, I will call Depuy to understand their position on both evaluating information for claims payment and determining whether there is any chance that by accepting any reimbursement will jeopardize my rights now and in the future for reasonable medical compensation for needed surgery.
Hopting  to have all of this completed by mid December.
Connie

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