Worried about Echo results. Need help interpreting whether normal or abnormal.

[somessage]

somessage
I hope this the right place to post this question. A doctor had performed an EKG, 2D echo, & aorta duplex without my knowledge during an annual physical. I was misled to believe whatever she was doing was routine and part of the preventative exam. I don't even know how all of these were performed along with a full physical when I was in the exam room for no more than 30mins. I was later informed by my ins company that the doc submitted CPT codes for the following symptoms that she claimed I complained about:
'shortness of breath, palpitations, hypertension, & non-rhuematic mitral valve disorder'. I don't have heart issues nor a history of it. My wife went in for an physical the same day and Dr. performed the same tests and submitted same exact symptoms. My wife does not have heart issues or history of it. We are both in our early 30's. According to the office manager, these tests are part of every physical. They are trying to bill us for these tests one year later. Doc office finally gave me part of my medical records. I don't know if any of the results are accurate or even mine since the Dr. told both of us during our exams that our hearts were fine. I'm concerned she may have altered or added to my results to validate the symptoms she submitted with claims since ins company is investigating. Can anyone help with interperting these results? Does this show an abnormal echo?

Echo report:
Left atrium: 3.7cm
Right atrium: 2.5cm
Left Ventricle: 3.8cm
Right ventricle: NML
Mitral valve: Normal Excursion
                    Possible prolapse of posterior mitral leaffet
Aortic Valve: Normal Excursion
Tricuspid valve: Normal Excursion
Left Ventricular Function: 69% NML
Valvular function: Trace ml

On another sheet (looks like copy of printout from machine)
HR: 50 BPM
P Dur: 102 ms
PR int: 144 ms
QRS Dur: 93 ms
QT/QTC int: 379/346 ms
P/QRS/T axis: 79/91/78
RV5/SV1 amp: 1.361/0.774 mV
RV5+SV1 amp: 2.135 mV
RV6/SV2 amp: 1.650/0.806 mV
Diagnosis Information:
811: Sinus Bradycardia
415: Third-degree Atriventeicular Block
203: Right Axis Deviation

I'm not a doctor but after reasearching some of these things, they sound serious. She gave no indication that anything with my heart was wrong during or at the end of my exam.
Also, none of these reports are signed. The echo report looks like something they could have filled out after learning of my dispute. Should I ask for the actual 2D images that were taken of my heart? Does anyone know what documents I should ask for to confirm an EKG and the aorta duplex tests were actually done? They did not include my medical chart. No surprise.

[achillea]

It may vary from state to state.  In California, the old rule stated that records be kept for 7 years, though that seems to have been changed. In general, insurance rules and so on seem to dictate that doctors keep records for 2-3 years at least.  It's been a year for you and your wife, so stay on top of this.

Also in my state, if the patient makes a *written* request for copies, the doc must comply within a specified period, though you may have to pay for copies (BTW, the date of any exam plus the signature of the doctor should at the bottom of each report).

To see what the rules are in your state, type something like 'medical records Nevada (or wherever) FAQ '

For faster and clearer answers, though, you could (ahem) see a lawyer.

[erijon]

I think you're getting worked up about nothing. It is not unusual to have these done as part of an annual physical, some doctors are more thorough than others. The fact that she did the same for your wife makes me think this is her policy but in any case it's a good idea to include. All of these would be done with the echo, did the do a any kind of procedure on you during those 30 mins? They would have put some lube on your upper abdomen and use a scanner like object over it. The EKG would have come from that as well as the duplex.

There's nothing alarming in these numbers that I see, but I'm not a doctor. To me everything looks to be within a normal variant but you need to ask her to explain this report to you.

[somessage]

Thanks for your comment. It would be great if the doctor could explain these results but unfortunately she never returns calls. Also, it's one thing if the Dr. says these tests are all part of her physicals but isn't she required to inform patients of what tests they are undergoing instead of misleading us to believe it's covered under the preventative exam. This way we can decide whether we want them done or not. Whenever I asked if something was covered, she told me "oh yeah, don't worry about it". Irregardless, it doesn't explain the fact that neither me nor my wife complained of the symptoms she submitted to insurance. Two unique individuals with no history of heart issues just happened to present her with the same EXACT heart related symptoms? Something's not right here. We don't even know what primary pulmonary hypertension and non-rhuematic mitral valve disorder means. If these were routine screening tests, why were they submitted as diagnostic and not preventative to insurance? My wife had no complaints and only went in to take advantage of her free annual wellness exam. We were both quite flaberghasted to then see the Dr. billed our insurance $4,000 each for our visits. They still have not provided her with her medical records.

[achillea]

The thing that is unclear to me is whether or not you actually underwent an echo during your 25 minute visit.  

Did anyone come in, put gel on your chest, and scan you with a wand thingy?  If so, an echo or something like it was performed.  By the way, doctors do not usually have the training for this.  The actual test is done by a tech with specialized knowledge of 3-D anatomy.

[somessage]

No tech came in. It was only the Dr. the entire time. I don't remember a wand but it was a year ago. I remember laying on my back at one point while the Doc and I engaged in chit chat but it was for 10mins or less. If these reports and results are accurate, fine. Even before they provided the Echo results, I already paid the bill because they threatened collections and I wanted to protect my credit. What I'm most concerned for me and my wife now is having inaccurate symptoms written in our record and how it will affect us (if at all) in the future. Is there any point to disputing symptoms they claim we both said when they control and can easily alter records? The fight seems futile.

[achillea]

It is not futile.  Come up with the fee for a consult with a lawyer who deals with malpractice. When you see him/her, bring all the records you have with you, and in the space of an hour, you will know what your legal standing is and whether or not your medical record is endangered, and if it is, how to bring the doctor into line.

People get really frightened about seeing an attorney, but a lawyer is your friendly local hired gun.  You want one on your side when you need help.  The fee will be less than you think, and the course your life takes at this point will be much clearer.  

I have a very moderate income, but have used attorneys twice in my life for extremely important matters, and I congratulate myself almost every day for my good sense in doing that.

[somessage]

Thank you for your advice, much appreciated. I had one more question, would you happen to know if the provider would have to keep image documentation of an echocardiogram? I was charged for a 2D, M-mode with doppler & color flow echocardiogram but no image copies were provided, just a hand written report..... I figured if ultrasounds were performed, images of the scans need to exist and be kept with medical records.