Attorneys, insurance companies, patients, and others may request medical records. Between patient care and daily operations, it can be hard to keep up with all these requests and to know what fees to charge for medical record copies. There are three fee options for record requests.
Actual Labor Costs
First, you can calculate the actual labor costs of fulfilling the request (ex. How long it takes for an individual at your organization to copy/send the record). The patient might only request a hard copy, or they might request a summary or explanation of the record. The labor fee for copying medical records should match the time needed to photocopy, scan, convert or transfer electronic files, mail, or summarize/explain the medical records.
In addition to labor costs, you can add the approximate cost of supplies, such as paper, CDs, or postage. Furthermore, you must be prepared to tell patients in advance what their approximate charge will be.
Schedule of Average Labor Costs
Instead of calculating the costs per request, you can develop a schedule of the average labor costs to fulfill various types of requests. However, the types of labor costs must be permitted by the Privacy Rule. You may also charge for supply costs. An example of average costs would to charge per page for paper-only requests.
Lastly, you can charge the flat rate of $6.50. However, there isn’t a maximum charge for medical record copies. According to the Health and Human Services (HHS) 2016 Clarification of Permissible Fees:
“$6.50 is not the maximum amount that can be charged for all individual requests for a copy of PHI under the right of access. Rather, charging a flat fee not to exceed $6.50 is an option available to those entities that do not want to go through the process of calculating the actual or average costs for requests for electronic copies of PHI.”
Besides federal regulations for medical record fees, most States have their own regulations. Furthermore, State regulations can become quite sticky, as charges vary State by State. However, some provisions in the federal law supersede State laws. For example:
“The fee may not include costs associated with verification; documentation; searching for and retrieving the PHI; maintaining systems; recouping capital for data access, storage, or infrastructure; or other costs not listed above even if such costs are authorized by State law.”
-HHS (emphasis added)
Make sure you know your State’s fee regulations and double-check them with the State’s website.
For more information, contact HIPAAtrek at firstname.lastname@example.org.