Medical Records and Your Rights
Following a car accident or some other personal injury action an individual will eventually find themselves being treated for their injuries. In order to substantiate your injuries and pursue your case, your lawyer needs to obtain a copy of your medical records. The process is relatively simple—we will send a letter to the medical provider requesting your records, along with a HIPAA authorization, signed by you, giving the provider permission to release your records to us. In a perfect world, we should have the records within a few weeks, but, as you know, it is not a perfect world. Here’s where the battle begins.
Producing medical records has turned into big business, which means there is a profit to be made, so the medical providers are going to charge what they can to maximize their profit. Some of the hospitals, and other healthcare facilities, outsource the work to record retrieval companies who partner with the medical providers to facilitate the transfer of your records. These third-party companies are in business to make a profit as well, so they are playing the fee game too.
Over the years, the cost for obtaining medical records has become excessive, and prohibitive for the average person, or their representative, to obtain the records for a reasonable fee without unnecessary marked-up charges. The various states have responded by enacting laws which prohibit medical providers from charging outrageous fees.
The laws for copying medical records vary from state to state. There are numerous fees which can be charged for just one request. For instance, there may be a search or retrieval fee; a per page fee, a storage fee; a certification fee; an expedite fee; and/or a postage and shipping fee. In Maryland, a medical provider can charge $22.88 for a search fee, plus .76 cents per page, plus the actual cost for shipping the records. An extended hospital stay can result in several thousand pages of records. A 1500 page medical chart can cost $1,140, plus the other ancillary fees, such as searching and shipping fees. Some states have a graduated fee structure. For instance, Delaware charges $2 per page for the first 10 pages, $1 per page for 11-20 pages, .90 for 21-60 pages, and .50 for 61 plus pages, and the actual cost of reproduction. The fees apply to each individual provider. In 99% of the cases, we need to request records from multiple providers. It is not unusual for the cost of obtaining medical records to cost thousands of dollars.
North Carolina’s law prohibiting excessive copy fees is found in N.C.G.S. § 90-411.
NC Record copy fees:
A health care provider may charge a reasonable fee to cover the costs incurred in searching, handling, copying, and mailing medical records to the patient or the patient's designated representative. The maximum fee for each request shall be seventy-five cents (75¢) per page for the first 25 pages, fifty cents (50¢) per page for pages 26 through 100, and twenty-five cents (25¢) for each page in excess of 100 pages, provided that the health care provider may impose a minimum fee of up to ten dollars ($10.00), inclusive of copying costs.
Everyone has a right to get a copy of their medical records in a timely manner, and without excessive fees charged by the medical provider or anyone acting on their behalf. The Health Information Technology for Economic an Clinical Health Act (HITECH Act) provides that a person has the right to obtain their medical record in electronic format, 42 USC § 17935(e)(1), and the medical provider is allowed to bill “only the cost of…[c]opying, including the cost of supplies for labor and copying, 45 CFR 164.524(c)(4). However, HITECH covers electronic records but not paper copies.
Because HITECH only applies to records in electronic format, the cost for paper copies is mandated by state law. The medical providers are taking advantage of this and providing paper copies unless expressly requested otherwise. Some of the medical providers and record retrieval companies are even charging per page fees although they are providing the records in electronic format. Other medical providers, or their agents, are claiming that the statutory limitation of fees only applies to the patient; therefore, anyone requesting records on their behalf are not subject to the fee limitation. That is simply not true because the Department of Health and Human services made it very clear that “[t]he final rule adopts the proposed amendment Sec. 164.524(c)(3) to expressly provide that, if requested by an individual, a covered entity must transmit the copy of protected health information directly to another person designated by the individual.” Federal Register January 25, 2013 Vol 78 No. 17, Page 5634.
We have curtailed some of the battle by specifically requesting records in electronic format, but we still spend countless hours scrutinizing the invoices that precede the records to ensure that the charges are not exceeding what is allowable by law. I’ve lost count of how many invoices I have received for paper copies when the records were actually provided in electronic format.
With few exceptions, people are in business to make money and nothing is wrong with that when it is done in good-faith. What’s a few dollars here and there, right? Wrong, it goes against the foundation of our firm. We are here to advocate for you to right the wrong you have suffered. There are many degrees of injustice, none of which we stand for. Please contact us to discuss your case. You will speak directly with a personal injury attorney who can answer your questions.