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Submitting a New Records Request
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Create a New Request:
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From the dashboard, click “New Request” (top right corner).
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Enter Patient Information:
- Click “Add New Patient.”
- Fill out: First Name, Last Name, State, City, Date of Birth (required).
- Optional: Social Security Number, Comments, Date of Injury.
- Click “Save and Continue.”
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Search for the Provider:
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Use the filter to search for the provider needed.
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Click “Search.”
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Select one or more facilities by clicking “Select” next to each provider.
NOTE: You can make several requests for one patient at the same time. Be sure the check box is selected next to the providers needed.
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Choose Records Type:
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Pick one or more: Medical, Billing, and/or Imaging records.
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Upload Authorization Forms:
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Click “Add” under the Upload Documents section.
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There will be a “Saved” message once it is uploaded.
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Need to make a change? Click on the View button and make changes you need there.
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Once completed, click on the continue button on the bottom right to move to the next screen.
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Select Delivery Format:
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Choose Digital Download or Mail Delivery.
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Add all Record Options required for each individual request. Affidavit is auto selected.
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Add Start Date (auto-fills others), and optional End Date (defaults to today if blank).
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Review & Submit:
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Confirm that all information is correct.
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Check the confirmation box, then click “Checkout.”
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Payment:
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The HIPAA Compliant Digital Delivery amount is initially required to complete your request. Record fees are billed once records are made available by the provider.
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Click “Pay Now” to access the secure payment site.
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Pay with a credit/debit card.
