TN 3 (02-01)

DI 22505.021 Developing Evidence from Hospitals and Clinics

A. Procedure - the Request

Use the instructions below to develop evidence from hospitals and clinics.

1. Claimant Identification Information

Provide the following information:

  1. Name

  2. Address

  3. Date of birth

  4. Hospital number

  5. SSN, if required by vendor.

2. Specific Information Needed

Specify the information needed:

  1. Summaries

  2. Test results, e.g., laboratory, X-ray reports, pathology reports, etc., as appropriate.

  3. Tracings, e.g., EKG, Spirometric, etc.

  4. Progress reports.

  5. Consultative reports.

3. Specific Time Periods

Indicate specific dates for:

  1. In-patient records

  2. Out-patient records

    • General clinics

    • Specialty clinics

B. Procedure - Special Issues

Follow the instructions below in the identified special issues situations.

1. Specialized Clinics, Hospitals, or Wards

Include in the request:

  1. Information in DI 22505.021A., as appropriate.

  2. Specific medical evidence required per medical listing and evaluation guides.

2. Current Hospitalization

Because records of current hospitalizations are hard to get:

  1. Request the needed evidence from the treating source, or

  2. Contact the hospital's social service or patient resources department to request assistance.

3. Clarification of Records

  1. Identify the specific issues requiring resolution.

  2. First try to obtain clarification of those issues from the treating source.

To Link to this section - Use this URL:
DI 22505.021 - Developing Evidence from Hospitals and Clinics - 07/28/2014
Batch run: 07/28/2014