Unauthorized copying fees It`s equally important for doctors and staff to know when they can`t bill a patient for a copy of their medical records. Patients, former patients, or their representatives are entitled to a free copy of the relevant portion of the medical record required to support an appeal regarding eligibility for a nonprofit program such as Medi-Cal or Social Security benefits. For more information about providing medical records to patients while appealing the rejection of a nonprofit program, see Health and Safety Code §123110. Search fee: $20.00 Pages 1+ (paper): $0.40 per page Pages 1+ (electronic documents): $0.20 per page Maximum fee (electronic documents): $150 Workers` compensation: Pages 1 to 5: $15.00 (per entry) Pages 6+: $0.50 per page (per entry, plus fees over $15) Maximum fee: $50.00 per registration (excluding postage/handling and retrieval) Paper documents: Search fee: $27.46 Pages 1+: ]]> $0.63/page Storage fee: $27.51 (Additional fee if documents are retrieved remotely) Maximum electronic document fee: $120.32 Electronic records Reasonable fees may apply. Maximum fee: $150.00 per application Pages 1+: $0.60 per page X-rays and other media: Reasonable fees may be charged Electronic records: 50% of the fee per page for hard copies: Pages 1 – 40: $0.27/page Pages 41+: $0.16/page Knowing when to follow the right law is not always easy. But in the event that the patient requests their medical records, almost all doctors` offices must follow federal law under the confidentiality rule. The HIPAA Privacy Policy only applies when the patient requests their medical record. It does not apply if the request arises from a subpoena, health or life insurance, a request for a lawyer or any other situation. We all know that patients in California have the right to review their medical records and/or obtain a copy of it. It`s also not surprising that health care providers are generally allowed to charge a fee for this service. However, with all the different rules and exceptions, copying fees can be confusing. Fixed fee for electronic copies of electronically stored medical records An office may charge a flat fee to patients who request a copy of their medical record. However, these costs cannot exceed $6.50, including postage, labour and supplies.
This point — that HIPAA excludes state law to the contrary — was reiterated under the direction of the Department of Health and Human Services` (HHS) Civil Rights Office (OCR). These guidelines state that HIPAA`s access rights provisions limit the amount a covered facility can charge a patient requesting access to their medical records. With this Florida law in mind, a licensed hospital in Florida can`t charge more than $1.00 per page, $1.00 per year searched, and the actual cost of sales tax and shipping. However, I found the reference to „Non-Paper Record“ interesting. After some research, it is found that non-paper documents seem to refer to microfilm/microfiche. Patients often ask for copies of their medical records. Traditionally, state law has regulated the issue of fees for copying medical records. State laws generally allow providers to charge a copy fee per page of up to a certain dollar value, or charge a flat fee of up to a certain amount for the entire medical record. Many covered companies simply charge the maximum amount that state law allows for copies of medical records. However, the above law applies to hospitals and does not deal with fees incurred for doctors` offices, chiropractors` offices, physiotherapists, etc. To judge what other medical professionals may charge for medical records, we need to look beyond Florida`s laws. Recognizing that patient access to medical records is important and necessary to ensure continuity of patient care, the Council of Medicine encourages physicians to provide their patients with a copy of their medical records free of charge upon request, particularly if the patient is economically disadvantaged.
However, the Commission also recognizes that the cost of reproducing voluminous medical records may be a financial burden for some practitioners. Therefore, the following rule determines the eligible costs for the reproduction of medical records. Click here for the California Medical Association`s guidelines regarding permitted copying fees associated with attorney request, subpoena, and health insurer claim. This document is published by the California Medical Association (CMA) legal team in the CMA`s 2017 California Physicians` Legal Handbook (CPLH), available at www.cmanet.org. Written by Kimberly L. Danebrock, JD, BSN, RN, CPPS Director of Risk Management, CAPAssurance Pages 1 to 25: $0.75 per page Pages 26 to 100: $0.50 per page Pages 100+: $0.25 per page Minimum fee: $10.00 Fees are based on whichever is greater: Flat fee of $15 for the first 30 pages or $0.50 per page X-rays and other media: Reasonable fees may be charged Last but not least, Florida law also sets out maximum fees for workers` compensation claims; this is regulated by Florida Administrative Code 69L-7.601. In short, Florida law states that „health care providers and health care facilities must provide an injured employee or their attorney with a copy of their office records, records, and reports upon request. The health care provider or health care facility providing the records may charge the employee up to $0.50 per page for copying the records, or the actual direct cost to the health care provider or health care facility for x-rays, microfilms or other paperless documents. « Search fee: $20.00 fixed fee (first 20 pages) Pages 21 – 100: $1.00 per page Pages 101+: $0.50 per page Search/storage fee: $15.00 (charged only if records are retrieved from an off-site location) Certification fee: $25.00 The first copy of the records is FREE for the patient (depending on the desired service date). The second copy of records requested by the same patient for the same service data: $1.00 per page The importance of documenting your injuries after an incident is essential.
In some cases, for example: After a car accident, the law requires you to prove that you sustained an injury „in reasonable medical probability.“ Therefore, in Florida, post-accident medical documentation is not only important to prove your case, it is required by law. According to the HIPAA Privacy Policy`s right of access, fees for copying medical records must be reasonable and cost-based. Search fees: $25.01 Pages 1 – 100: $0.84 per page Pages 100+: $0.43 per page Social Security: No fee for an application to support an application under the Social Security Act. Must provide appropriate documentation. However, these state laws (and healthcare providers acting in accordance with them) cannot circumvent HIPAA access rights rules, which require that fees for copying medical records be reasonable. Medical records copy fees, which are fixed fees that are not related to actual reproduction costs, may be considered excessive under the access provisions of the HIPAA Privacy Policy. In the event of a conflict between the two laws, HIPAA, the federal law, shall prevail. If the patient requests their own medical records, California law (Health & Safety Code § 123110) allows health care providers to charge a patient or their legal guardian a maximum of $0.25 per page or $0.50 per page for records copied from microfilm.
Reasonable office expenses are also allowed, provided that the amount charged does not exceed the actual cost of preparing medical records. If the patient requests electronic health records or paper records in electronic format, the confidentiality rule does not allow the physician to charge more than the actual labour costs. In other words, per-page fees are not allowed for paper or electronic copies of electronically maintained medical records. The data protection rule also does not allow for charging a recovery fee for medical records if they need to be found. In total, the costs associated with updating or maintaining systems and data, the capital for storing and maintaining the data, and the work associated with HIPAA compliance (and other applicable laws) to respond to an access request (e.g., Verification, ensuring that only information about the right person is included, etc.) and other costs not included above, even if permitted by state law, are not eligible for calculation of fees that may be charged to individuals.