Medical records and LNC subcontractors

A legal nurse consultant recently asked if she should allow one of her clients to send medical records directly to her subcontractor.

Does your client know your subcontractor?

The request of the attorney to send records to the subcontractor is tricky. If this person is an expert, the attorney would know the identity of the subcontractor and this should not pose a problem. However, if the subcontractor is consulting only to produce a work product, that is a different issue. Some legal nurse consultants let their clients know they use subcontractors, but do not reveal their identity. Does it make a difference?

As the legal nurse consultant using subcontractors, you should have an agreement in place that the subcontractor will not work directly with your clients to circumvent your involvement. In other words, the subcontractor will not accept future work from the attorney or law firm without going through your business.

Why would that happen? The client may believe he can get future work done by the subcontractor at a lower cost than you would charge. The unscrupulous subcontractor sees an oportunity to get a new client without having to market.

A noncompete agreement protects your relationship with the attorney and law firm so you are not worried about losing the attorney’s business to your subcontractor. I used to keep the subcontractor’s identity private but changed my thinking over time by focusing on the noncompete aspect of this agreement.

Medical records and LNC subcontractors – why medical records should come to you

A practical reason for having the records come to you first is that you can see the volume of records and be part of the process – checking to see if your retainer will cover the anticipated amount of work and knowing what is being asked of you/your subcontractor and the deadlines.

However, the attorney may ask to be able to send the records right to the subcontractor to save money on shipping. In explaining why you want to have the records come to you first, you could explain the benefits from your client’s perspective:

• so that you can organize the records for the sub (if this is your practice),
• so that you can get a sense of how many records there and set up expectations with the sub in terms of the amount of time it will take to review them
• any other reasons that make sense to you and the attorney.

Be sure to present this rationale from the perspective of your client. He is more likely to understand if he sees what is in it for him. I have found that most attorneys understand this logic. But for those who are really fixated on the shipping costs, from a customer relations perspective, it is usually important to give in on this issue.

Talk to your subcontractor

Make sure your subcontractor knows that she or he is expected to let you know if additional records arrive. Talk with your subcontractor, discuss the importance of you knowing if the attorney sends additional medical records.

If you have a practice of asking for replenishing retainers (and you should), you will need to know about additional records so you can be sure you have enough retainer. Having enough retainer enables you to pay the subcontractor sooner. You’ve explained the procedure in terms of what’s in it for the subcontractor. Then you, the attorney and the subcontractor are getting what each of you wants.

Pat Iyer MSN RN LNCC is president of the Pat Iyer Group. She ran an independent legal nurse consulting business until 2015. Pat is the past president of the American Association of Legal Nurse Consultants (AALNC). Pat coaches LNCs through www.LNCAcademyinc.com. She assists LNCs who want to get more clients, make more money and avoid expensive mistakes.