Charging for Sending Medical Records to Attorneys, et al

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Here is a past discussion from a couple years ago on charging for sending records.I have a form my staff fills out to determine the allowed amount to charge.  Locke, MD

---------- Forwarded message ----------

Date: Fri, Apr 3, 2009 at 1:52 AMSubject: Re: fee for records for SSDTo:

Here are my forms I use in Colorado to help my staff add up the cost

for the records...

       

http://lockefamilymedicine.com/Intranet/Forms/Administrative/MedicalRecordsRequestFee.doc

       

http://lockefamilymedicine.com/Intranet/Forms/Administrative/MedicalRecordsReleaseGuidelines.doc

        See attached files.

Although, interestingly, I don't believe this is a State Law like in

Ohio, but rather a Medical Board " guidance " or directive.

Also, my interpretation is that there is a 2 tier system in Colorado --

a higher fee schedule for non-patient requests and a lower fee for

copying for the patient request.

==========================================================

       

http://www.cdphe.state.co.us/hf/download/PatientMedicalRecordFees.pdf

The new fee schedule applies to insurers, attorneys, and other

individuals or entities requesting copies of a patient's medical

records and allows a reasonable cost not to exceed $16.50 for the first

ten or less pages, 75~ per page for 11- 40 pages, and 50~ per page for

41 pages or more.

There is no change to the fee charged the patient or personal

representative and, as in the past, no fees shall be charged by a

health care provider of patients records for requests for medical

records received from another health care provider or to an individual

regulated pursuant to §25-1-802(1), C.R.S., solely for the purpose of

providing continuing medical care to a patient.

The revised rule is located at 6 CCR 1011-1, Chapter II, §5.2.3.4 and

may be accessed at the Department's home page through the following

link

http://www.cdphe.state.co.us/regulations/healthfacilities/10110102generallicensuresstandards.pdf

============================================================

Reasonable

Fees For Copying Medical Records – Colorado

 

Based

upon State

of Colorado

agency Guidance, Locke Family Medicine charges 2 separate fee schedules.

Fee

Schedule #1 is for a

representative of the patient, other than a “personal representative”

with the

patient’s written authorization

 

Fee

Schedule #2 is for the patient or a “personal

representative” with

the patient’s written authorization

 

Guidance

on these

fees are listed below:

 

C.R.S. 25-1-802.

Patient records in custody of individual health care providers.

 

Colorado State Board of Medical Examiners

Policy - http://www.dora.state.co.us/medical/policies/40-07.pdf

POLICY NUMBER: 40-07  Title: Guidelines

Pertaining to the Release and Retention of Medical Records

 

http://www.cdphe.state.co.us/regulations/healthfacilities/10110102generallicensuresstandards.pdf

 

http://www.sos.state.co.us/CCR/

Department Of Public Health And Environment -- Health Facilities And

Emergency Medical Services Division

6 CCR

1011-1 -- Standards For Hospitals And Health Facilities

(Promulgated By The State Board Of Health)

Chapter II General Licensure Standards

Department: 1000 Department Of

Public

Health And Environment                                                

Agency:

1011 Health Facilities and Emergency Medical Services Division -

Rules Promulgated By The Colo Bd Of Health

CCR Sub Document:

Chapter II

General Licensure Standards

Standards  5  Access To Patient Medical Records

 

     5.2.3 Discharged Inpatient

Record à

14369855.2.3.4  Unless otherwise prohibited by law,

a representative of the patient, other than a “personal representative”

as

defined in the Federal Health Insurance Portability and Accountability

Act

(HIPAA)  § 164.502(g), with the patient’s written authorization, shall

pay

for the reasonable cost of obtaining a copy of the patient’s record,

which

shall be $16.50 for the first ten or fewer pages, $.75 per page for

pages

11-40, and $.50 per page for every additional page.   Eff 03/01/2008

1436986

The discharged patient or

personal

representative (as defined under HIPAA  § 164.502(g)) shall pay for the

reasonable cost of obtaining a copy of his/her patient record, not to

exceed

$14.00 for the first ten or fewer pages, $.50 per page for pages 11-40,

and

$.33 per page for every additional page. Actual postage or shipping

costs and

applicable sales tax, if any, also may be charged. The per-page fee for

records

copied from microfilm shall be $1.50 per page. No fees shall be charged

by a

health care provider of patient records for requests for medical

records

received from another health care provider or to an individual

regulated

pursuant to Section 25-1-802(1) solely for the purpose of providing

continuing

medical care to a patient.   Eff

03/01/2008

850494

For one

or more specific classes of records or

services, institutions may charge additional sums upon presenting a

justification therefore acceptable to the Department.

Fee Schedule #1 is for a

representative of the patient, other than a “personal representative”

with the

patient’s written authorization

 

 

Page #

Cost

 

Page #

Cost

 

After

50 pages, take the total # of pages – subtract 50 and multiply this #

by $0.50.

Then add $44.00 to this number.

This will give the total fee.

For example:

120

pages total à

subtract 50 = 70.

Multiply 70 by 0.50 = $35.00

Add $44.00 to $35.00  = $79.00 total fee.

Then add any postage, shipping, and sales tax to give the copying fee

total.

10 or less pages

$16.50

 

 

 

 

11 à $0.75/page

17.25

 

31

32.25

 

12

18.00

 

32

33.00

 

13

18.75

 

33

33.75

 

14

19.50

 

34

34.50

 

15

20.25

 

35

35.25

 

16

21.00

 

36

36.00

 

17

21.75

 

37

36.75

 

18

22.50

 

38

37.50

 

19

23.25

 

39

38.25

 

20

24.00

 

40

39.00

 

21

24.75

 

41à $0.50/page

39.50

 

22

25.50

 

42

40.00

 

23

26.25

 

43

40.50

 

24

27.00

 

44

41.00

 

25

27.75

 

45

41.50

 

26

28.50

 

46

42.00

 

27

29.25

 

47

42.50

 

28

30.00

 

48

43.00

 

29

30.75

 

49

43.50

 

30

31.50

 

50

44.00

 

 

Fee

Schedule #2 is for the patient or a “personal

representative” with

the patient’s written authorization

 

 

Page #

Cost

 

Page #

Cost

 

After

50 pages, take the total # of pages – subtract 50 and multiply this #

by $0.33.

Then add $32.30 to this number.

This will give the total fee.

For example:

120

pages total à

subtract 50 = 70.

Multiply 70 by 0.33 = $23.10

Add $32.30 to $23.10  = $55.40 total fee.

Then add any postage, shipping, and sales tax to give the copying fee

total.

10 or less pages

$14.00

 

 

 

 

11 à $0.50/page

14.50

 

31

24.50

 

12

15.00

 

32

25.00

 

13

15.50

 

33

25.50

 

14

16.00

 

34

26.00

 

15

16.50

 

35

26.50

 

16

17.00

 

36

27.00

 

17

17.50

 

37

27.50

 

18

18.00

 

38

28.00

 

19

18.50

 

39

28.50

 

20

19.00

 

40

29.00

 

21

19.50

 

41à $0.33/page

29.33

 

22

20.00

 

42

29.66

 

23

20.50

 

43

29.99

 

24

21.00

 

44

30.32

 

25

21.50

 

45

30.65

 

26

22.00

 

46

30.98

 

27

22.50

 

47

31.31

 

28

23.00

 

48

31.64

 

29

23.50

 

49

31.97

 

30

24.00

 

50

32.30

 

 

Kennedy, Jim wrote:

In Colo.,

this is not true, there is a set amount per page, but they have to pay.

From:

[ ]

On Behalf Of Gretchen Reis MD [greis@...]

Sent: Thursday, April 02, 2009 9:44 AM

To:

Subject: fee for records for SSD

I just received a letter from an attorney

requesting records for my pt who is applying for Social Security

disability.

 

The attorney cites a state (Ohio) law that “a

health care provider…shall provide one copy of the patient’s medical

record WITHOUT CHARGE…to his/her authorized representative if the

records are necessary to support a claim for Social Security

disability.”

 

I’ve always charge the standard $20 fee when

the request came from SSA directly (and they pay it). I’ve never given

records to an attorney for free!! 

 

I realize this may be a quirk in Ohio law

(another reason not to practice here

J), but has anyone else had

this experience?

 

Gretchen Reis MD

Wellspring Family Medicine

Circleville, OH

 

2 of 2 File(s)

MedicalRecordsRequestFee.pdf

MedicalRecordsReleaseGuidelines.pdf