Getting Copies of Your Medical Records

Getting Copies of Your Medical Records

            Patients have a right to obtain copies of their medical records under provisions of the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), as well as West Virginia Code 16-29-1 and 16-29-2. These records are most often obtained from the patient’s primary care physician but may be requested from any health care provider.

            Obtaining these records may be important to updating your personal information, or to understanding test results or prescriptions involved in your treatment plan. Records also may include doctor’s notes, medical test results, lab reports and billing information.

            To obtain records, a patient, his or her personal representative as defined by HIPAA, or his or her authorized agent or authorized representative must submit a written request with the health care provider. The provider must furnish a copy of the records within 30 days of receiving the request. The copy may be a paper copy, or if requested and the provider routinely stores records electronically, may be provided in downloadable format from a secure website, or by computer disk, portable memory device or email.

            There are exceptions. In the case of a patient receiving treatment for psychiatric or psychological problems, a summary of the record must be made available upon request to the patient, personal representative, authorized agent or authorized representative following termination of the treatment program.  

            Furnishing a copy of the reports of x-ray examinations, electrocardiograms and other diagnostic procedures is considered compliance with the patient request.

            State law does not require a provider treating a minor for birth control, prenatal care, drug rehabilitation or related services to release records to a parent or guardian without prior written consent from the patient. It also does not apply to records subpoenaed or otherwise requested through the court process, or to health care records maintained by providers governed by the AIDS-related Medical Testing and Records Confidentiality Act.

What are the costs?

            A health care provider may charge a patient or patient representative a fee consistent with HIPAA, plus any applicable taxes. A person other than a patient / patient representative requesting records must submit a request and HIPAA compliant authorization form, and pay a fee at the time of delivery. The fees cannot exceed: a search and handling fee of $20; a per-page fee of 40 cents for paper copies; and postage, if mailed, plus any applicable taxes.

            Unless the person requesting the record specifically requests a paper copy, the records can be delivered in electronic or digital form and the per page fee cannot exceed 20 cents per page, not to exceed $150 inclusive of all fees, except for applicable taxes. If the record must be certified by affidavit, a $10 fee can be charged.

            If the patient or patient representative agrees to an explanation or summary of the records, the provider may charge a reasonable cost-based fee for labor, supplies and postage (if mailed), plus any applicable taxes. If the records are stored with a third party or a third party responds to the request for records, the provider may charge additionally for the actual costs incurred from the third party.

            The per page fee for copying can be increased or decreased by the proportional consumer price index as published every October.  

            A provider cannot impose a charge on an indigent person or his or her authorized representative if the medical records are necessary to support a claim or appeal under any provisions of the Social Security Act.

            A person is considered indigent if represented by an organization or affiliated pro bono program that provides legal assistance to indigents; or verifies on a medical records request and release form that the records are requested for purposes of supporting a Social Security claim or appeal and submits with the release form reasonable proof that the person is financially unable to pay full copying charges because of unemployment, disability, income below the federal poverty level, or receipt of state or federal income assistance.

            The indigent patient is entitled to one set of copies per provider.

What happens when your doctor leaves practice?

            If a doctor closes his or her practice because of retirement, relocation or other circumstances, they remain obligated to make medical records available to patients or a subsequent provider. Typically, following American Medical Association guidelines, the physician will provide current or recent patients with a written notice of the closing at least 30 days in advance, possibly even by certified mail.

            This notification should provide patients with clear information about how to obtain medical records. Some closing practices may enter into an agreement with another local practice to be designated as the records custodian for unclaimed patient records, so the records may be safeguarded and appropriately distributed after the final closure date.

            Some providers also may work with patients to identify another physician with the same practice specialty to whom records can be transferred upon signed authorization.