Your Right To Access Medical Records: Hospitals And Beyond

Patients have a right to access their medical records, and federal privacy laws such as HIPAA allow patients to request and receive copies of their medical records. However, there are some exceptions and limitations. For example, patients cannot access psychotherapy notes or the records of their spouse or child. Additionally, there may be fees associated with obtaining medical records, and the retention period for medical records varies by state. Patients can request medical records in person, online, by phone, or fax, and hospitals are required to provide access within a reasonable timeframe, typically around 10 to 30 days.

Patients' right to access their medical records

Patients have a right to access their medical records, which is protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This right, known as the HIPAA Right of Access, allows individuals to access their health information, including medical records, billing and payment records, insurance information, clinical laboratory test results, medical images, and more. This information can be accessed electronically or through paper records.

Under HIPAA, patients can request to receive a copy of their health information or direct it to a designated third party, such as a physician or a personal health record. This request can be made in writing or through an online patient portal, which offers secure access to medical records. The healthcare provider is required by law to provide the requested information within a reasonable timeframe, usually within 30 days.

However, there are some limitations to the patient's right to access. Patients do not have the right to access a provider's psychotherapy notes, which are kept separate from medical and billing records. Additionally, providers may charge a reasonable fee for copying and mailing the records, but they cannot charge a fee for searching for or retrieving the records.

In the case of minors or individuals who are unable to make healthcare decisions, the patient's personal representative, such as a parent or court-appointed guardian, may authorize the release of medical information. This representative must have the legal authority to act on behalf of the patient and make healthcare-related decisions.

Overall, the HIPAA Right of Access gives patients control over their health information and ensures they can access their medical records upon request. This right is protected by law, and patients can file a complaint if they believe they have been wrongly denied access to their records.

Hospitals' right to physical records

The right to access physical health records is a complex issue that varies across different jurisdictions. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) provides individuals with the right to access their medical and other health records, including billing and payment records, insurance information, clinical laboratory test results, and medical images. This right is further reinforced by the HIPAA Privacy Rule, which allows individuals to inspect, review, and obtain copies of their medical records and billing information. However, it's important to note that psychotherapy notes, which are the personal notes of a mental health professional, are generally excluded from the patient's right to access.

While patients have the right to access their health information, the physical record itself is the property of the hospital or healthcare provider. This distinction is important because it clarifies that while patients may request and obtain copies of their medical records, the original physical record remains with the healthcare provider. Additionally, patients cannot be denied access to their records due to unpaid medical bills, and providers are not allowed to charge a fee for searching for or retrieving the records. However, providers may charge for the reasonable costs of copying and mailing the records, with certain exceptions, such as when the records are requested for government benefit programs.

The process of requesting medical records may vary, but it generally involves submitting a written request to the healthcare provider or facility. Some states, like New York, require that the request be signed and notarized. The request should specify the information being sought and provide relevant details, such as the name and address of any third parties who will receive the information. Healthcare providers typically have a limited timeframe, often around 10 to 14 days, to respond to such requests.

It is worth noting that there are circumstances under which a hospital or healthcare provider may disclose medical records without explicit patient consent. This includes situations where disclosure is mandated by a subpoena or court order, to specific government and regulatory bodies, to an individual with power of attorney, to a designated healthcare surrogate, to another healthcare provider for continued care, or to a healthcare insurer for reimbursement purposes. In the case of minors, parents or legal guardians are generally authorized to access their children's medical records.

The HITECH Act's Electronic Health Record (EHR) Incentive Program further incentivizes eligible hospitals and critical access hospitals (CAHs) to provide patients with online access to their health information, promoting transparency and patient-centered care. This program offers monetary incentives and helps patients take control of their health-related decisions.

Accessing records for minors

The Health Insurance Portability and Accountability Act (HIPAA) grants minors the same rights as adults to access their medical records, provided they have the legal capacity to consent to their own medical treatment. However, the age at which minors can consent to their own treatment varies across jurisdictions and healthcare providers. In some places, minors as young as 12 or 14 years old can consent to their own treatment and access their medical records without parental consent. In other cases, only those aged 14 and above can access their records.

For children under 14, a parent or guardian typically has the right to access their child's treatment records and may need to provide consent for the child to receive their records. However, a parent or guardian who does not have custody of the child may not have access to their records. Additionally, if the child is 14 or older and has a developmental disability, they can deny their parent or guardian access to their protected health information by filing a written objection.

Once a minor is legally emancipated, they gain independence from their parents or legal guardians and can request and access their medical records without parental consent.

To access medical records, individuals should contact the healthcare provider where the treatment was received and be aware of any required documentation or identification needed to establish their identity. Healthcare providers typically have a reasonable timeframe, often around 30 days, to fulfill the request.

Fees for obtaining records

The fees for obtaining medical records vary across different states in the US. While some states have specific statutes regarding the fees for medical record copying, others do not. Here is a breakdown of the fees in some states:

Alabama

For paper records, Alabama charges $1 per page for the first 25 pages, 50 cents per page for each additional page, and a search fee of $5.

Arizona

Arizona does not have specific copying fees but does charge a search fee of $15 for the first 25 pages, 50 cents per page, and 25 cents for each additional page. There is also a $25 labor charge and an additional charge for postage. For electronic records, there is a flat fee of $75 plus postage.

Arkansas

Arkansas charges 50 cents per page for the first 25 pages, 25 cents per page for each additional page, and a $25 labor charge. Postage costs are also applicable.

California

California provides one free copy of a patient's medical records to the patient or their legal representative.

Delaware

Delaware charges a search fee of $18.53 for the first ten pages, 85 cents per page for pages 11-40, and 57 cents per page for pages 41 and above.

Pennsylvania

Pennsylvania allows healthcare providers to charge a fee for medical records requests, which is adjusted annually by the Secretary of Health based on changes in the Consumer Price Index.

Rhode Island

Rhode Island does not charge for medical records furnished to a patient or their attorney if it is necessary for supporting an appeal under the Social Security Act.

It is important to note that the fees mentioned above may not include all possible charges, and there might be additional costs for special media, postage, or other services. The fees for medical records are subject to change, and patients should refer to the latest guidelines provided by their state or the specific healthcare provider.

Sharing records with third parties

Under the Health Insurance Portability and Accountability Act (HIPAA), patients have the right to access their medical records, including billing and payment records, insurance information, clinical laboratory test results, and medical images. This right is also provided by the HITECH Act's Electronic Health Record (EHR) Incentive Program, which allows patients to view, download, and transmit their health information.

While patients have the right to access their medical records, the physical record is the property of the hospital. Patients must give permission for anyone outside their healthcare team to access their records. This can include a legally designated representative, such as a court-appointed guardian or an individual with power of attorney. For children under 18, only a parent or court-appointed guardian may authorize the release of medical information.

In certain circumstances, medical records may be disclosed without the patient's permission. This includes in response to a subpoena or court order, to government and regulatory bodies, to someone with power of attorney, to a healthcare surrogate, to another healthcare provider for continued care, and to a healthcare insurer for reimbursement.

Patients can request that their medical records be transmitted to a third-party app or entity of their choice. This is becoming increasingly common, with doctors and health systems routinely sharing health data electronically with other healthcare providers, labs, and pharmacies for treatment and reimbursement.

There may be fees associated with obtaining medical records, such as the cost of copying and mailing the records, but patients cannot be denied access to their records due to non-payment for services. Patients also have the right to request changes or amendments to their records if they believe the information is incorrect.

Frequently asked questions