Tracking Details - #147

Tracking Information
Case No: 92
Order Date: 09/11/2025
Due Date:
Template Packet: HIPAA Authorization Packet
Scope:
Location: 100% Chiropractic - Decatur
1605 Church St. Suite 665
Decatur, GA 30033
Phone: (404) 343-3304 • Fax: 2122131715
Patient: Nicole Kidman
DOB: 05/28/1957 • SSN: ***-**-7500
100% Chiropractic - Decatur
1605 Church St. Suite 665
Decatur, GA 30033
Phone: (404) 343-3304 • Fax: 2122131715
Nicole Kidman
DOB: 05/28/1957 • SSN: ***-**-7500
Requested Records
Record Status
Films Fulfilled
Medical Pending
File Name Uploaded Date Uploaded By
HIPAA_Authorization_147_20250911220605.pdf 2025-09-11
Tracking Step Log
Step Due Date Remarks Publish Entered
Received Order, In Progress Yes 9/11/2025 10:02 PM
Generation Dept - Printed Packet 9/12/2025 Yes 9/12/2025 2:06 AM
Sent - Fax to Custodian 9/12/2025 Sent Fax to none@concordsends.com. File=D:\RecuperaRSFiles\CaseFiles\92\RequestPackets\Tracking_147_RequestPacket.pdf No 9/12/2025 2:06 AM
Assigned To: 10/27/2025 Assigned To: UserNo=1006 [INITIAL] No 10/25/2025 8:50 PM
Fax delivery confirmed 10/25/2025 Fax delivered (manual) No 10/25/2025 8:50 PM
1st/2nd/3rd Follow-up with Client Yes 1/13/2026 3:23 AM
Received - Portion of Records Received - Portion of Records Yes 2/26/2026 10:03 PM
Called Facility 3/5/2026 Called 100% Chiropractic - Decatur at (404) 343-3304. Facility staff advised Let them know we'd received the Films & still awaiting Meds. Yes 2/26/2026 10:04 PM
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