Charging Fees for Medical Records

Charging Fees for Medical Records

 Many practices are not aware that there is often a difference in state law and HIPAA regulations regarding how much you can charge for copies of medical records. Your practice can face investigations by the Office for Civil Rights (OCR) or experience state medical board licensing problems if you incorrectly calculate the amount to charge patients for copies of medical records. So what is a reasonable amount to charge for medical record copies and does it really matter?
 
HIPAA specifies that the fees for copying medical records must be reasonable and cost-based. They do not set a fee schedule. Even if your state allows a “search and retrieval fee”, this is not allowed by HIPAA. You should not be taking state law regarding maximum fees at face value. When calculating your practice fees,  you can include all of the following and still be in compliance with both your state law and HIPAA:
  • Labor for copying and/or preparing an explanation or summary of the patient information upon request
  • Office supplies (including paper, CD or an external hard drive)
  • Postage
 
Remember, HIPAA is limited to patient requests or those who request medical records on a patient’s behalf. In most instances this includes malpractice attorneys or health insurance claims investigations. HIPAA regulations may not apply to other outside entities such as workman’s compensation disputes. Your state medical society is a good place for guidance regarding state-specific regulations.
 
Does any of this matter? With the increased focus on patient engagement in the Meaningful Use program, patients may come to expect direct, immediate, and free access to their medical records. The recent law allowing patients to obtain their laboratory results directly from the lab is beginning to spur interest. MU Stage 2 requires the ability for patients to “view, download or transmit” (VDT) their medical information and sets thresholds for access and use.
 
This has significant implications for pediatric p
ractices. Make sure that your office policies regarding the release of medical records are in compliance with both state law and HIPAA regulations. As you implement your patient portal, give full consideration to your office workflow. How will you make sure that patient information is kept up-to-date and accurate? How will you handle patient questions about abnormal lab values or perceived inaccuracy of information in their medical record? Don’t wait until this becomes a problem. Be proactive and create office policies and procedures that support patient access to appropriate and accurate information.