Every patient has the right to access his medical records under federal and most state laws. There is no legal basis for refusing to turn over a patient’s medical record because he owes money to the practice. 7.Record requests can be refused if the patient owes money to the practice.
I recommend you always obtain a signed, written release in a nonemergency situation, whether required by law or not. However, most state laws require record requests to be in writing and signed by the patient. HIPAA generally allows for disclosure of medical records for “treatment, payment, or healthcare operations” absent a written request. Record requests can be honored without a patient’s signature. HIPAA allows providers to charge a reasonable, cost-based fee for medical records (i.e., labor and supply costs of copying and postage), with a state’s per-page copy charge considered presumptively “reasonable.” HIPAA, which trumps state law, does not allow charging a “handling” fee for processing or retrieving medical records. Some states allow physicians to charge “handling” fees for medical records. This is one tradition that routinely gets physicians in trouble.
5.Physicians can charge patients a flat fee for medical records. Guess what? The physician was sued for failing to provide patients with copies of their medical records! Unless otherwise limited by law, a patient is entitled to a copy of his or her medical record and a physician may not refuse to provide the record directly to the patient in favor of forwarding to another provider. I spoke to a physician who routinely refused to provide medical records directly to patients out of concern that the records could be used in malpractice lawsuits. Physicians are not required to provide patients directly with a copy of their medical records. If state law addresses an issue on which HIPAA is silent or does not conflict, physicians must comply with state law. In the event HIPAA and state law conflict, HIPAA generally controls. In addition, most, if not all states maintain laws regarding disclosure of medical records. HIPAA details a patient’s right to receive his or her medical records. 3.HIPAA always controls disclosure of records. Additionally, some test results may be subject to state-specific or other federal laws regarding disclosure (i.e., HIV tests or those rolated to substance abuse/treatment).
Physicians have some discretion to not disclose certain mental health or other records if they believe the disclosure may be harmful to the patient or another. This includes the physician’s progress notes, which must be provided as part of the medical record. Typically, a patient is entitled to access the entire contents of his medical record, including the physician’s notes, lab and test results, and notes from other physicians. Physicians do not have to provide patients access to their entire medical record. Unless a court order dictates otherwise (or there is some state-specific law on the issue) a noncustodial parent still maintains parental rights allowing access to the child’s records. It’s never fun to be in the middle of a pediatric office “divorce war” between a noncustodial parent who wants copies of medical records, and a custodial parent who wants to prevent such a request. A noncustodial parent has no right to access a minor’s record. Consider the following statements which many practices assume, incorrectly, to be true:ġ.
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Of particular concern is when and how to disclose patient health records. Several times a month I receive calls from physicians related to medical record management.