To prove the extent of your injuries in a personal injury claim, it is beneficial to get a copy of your medical records. Assuming that your medical providers have been appropriately thorough with their notes, you can use those records to show where your injuries originated and the hardships that they have caused you. Of course, before you can use your medical records to your advantage, you need to get a copy of them, which is a process that might be more intricate than you first expect.
HIPAA Gives You the Right to Your Records
The Health Insurance Portability & Accountability Act – more often called HIPAA – gives you the right to get a copy of your medical records whenever you want from any of your medical care providers. In most cases, you will be required to fill out a HIPAA request form specifically drafted for the medical facility you contact. Before you order a copy, you should also double-check if you can fax or email the HIPAA form to them instead of mailing or hand-delivering it, which can save everyone time and resources.
Not all facilities and clinics keep medical records in filing cabinets or hard drives onsite, though. Some will need to request a copy of the forms from a secondary office. You should expect slight delays if this is the case, but the delay cannot be unreasonable. Hospitals and individual doctors usually have only 15 days to respond to your HIPAA request form. Long-term care facilities like nursing homes might have as little as 2 days to respond, though.
You should also be aware that you can be charged for getting a copy of your medical records. State-specific statutes determine the maximum amount someone can be charged per copy or page, but the amount must always be deemed “reasonable.” Nursing home facilities cannot charge more than the community standard for copies, i.e. what a post office or library would charge you for using a copy machine there. In any case, you should always see if you can be sent an electronic copy on a flash drive or CD, depending on your preference. Electronic copies tend to have a much lower price per copy cap, saving you money.
Requesting Copies of Your Medical Records from a Hospital
In Texas, Health and Safety Code Section 241.154(b) through (d) outlines what you should know about the price of requesting paper copies of your medical record from a hospital or large medical group. Going through sheets of legalese is not a fun pastime for most, so we will try to simplify the key points here.
To start, you can be charged up to $48.77 as a basic retrieval fee for the first 10 pages of your medical record. You can be charged $1.64 for each page between the 11th and 60th pages, and $0.80 for each page between the 61st and 400th page. Any page after that can be charged at $0.44 each per copy. It is rare to have a medical record that extensive, though.
You can also be charged the full cost of shipping and delivering your copies. Additionally, retrieval fees escalate to $74.30 for the first 10 pages and $1.69 for any additional page after if the records are only available in microform. With all of this considered, you could be looking at $150 for the average paper copy of medical records sent from a hospital in Texas.
On the other hand, if you request electronic copies, then the retrieval fee is capped at $88.36 plus the cost of mailing the flash drive or CD to you. When you have a lengthy medical record or just want the convenience of having everything saved electronically, you should definitely consider requesting an electronic copy first.
Requesting Copies from Individual Physicians
The rules regarding requesting copies of your medical records change if you make the request with an individual physician, not a medical group or hospital. What might surprise is you is that the fee regulations typically change to benefit the patient.
When you request a paper copy of medical records from a physician, you can be charged up to $25 for the first 20 pages and only $0.50 for every page after. Electronic copies can be charged up to $25 for the first 500 pages and $50 for any higher page count. If an affidavit is required, then an additional fee up to $15 can be charged. Copies of an imaging study can be charged up to $8 per copy.
Lastly, a physician is not allowed to charge you at all if you need a copy of your medical or mental health record related to a disability benefits claim. With these rules outlined, it is often better to see if you can get all necessary medical records copied by your physician, not a hospital or medical group.
To get request a copy from a physician, you need to use certified mail with a return receipt requested. The physician has 15 business days to comply.
Have More Questions? We Have Answers
Maloney Law Group, P.L.L.C. in San Antonio can help you decide how to request a copy of your medical records for a pending personal injury or disability benefits claim. If we are representing you for a personal injury claim, then you can choose to authorize us to request the copies on your behalf. While you focus on yourself and your rest, we can deal with all aspects of your claim, including dealing with any medical providers that might try to complicate the records retrieval process.
Call us at (210) 361-2997 to get more information about our legal services available in San Antonio.
