All the information provided below can be found in the HIPAA Privacy Rule (45 CFR § 164.524).
- Will my doctor charge me a fee for medical records?
- Can my doctor charge me for paper copies of my records?
- Can my doctor charge me for electronic copies of my records?
- Can my doctor charge me if I request my records through a third party?
- Does my doctor have to tell me if there's a fee for my records before charging me?
- How much can my doctor charge me?
- What can they charge me for?
- What can they NOT charge me for?
- What if my state law contradicts HIPAA’s law?
- What if I can't afford their fee?
- What should I do if my doctor charges me an outrageous amount?
Will my doctor charge me a fee for medical records?
Most doctors probably won’t charge you a fee for your medical records, especially if they are more recent medical records (within the past five years). From our experience requesting records at Guava, more than half of providers tend to give their patients a free copy. That said, this is not the case for ALL doctors so it’s important to know your rights and be prepared in case your provider does try to charge you with a hefty fee.
Can my doctor charge me for paper copies of my records?
Yes, your doctor can charge you a fee for your medical records. However, there are strong limitations around what your doctor can charge you for.
Can my doctor charge me for electronic copies of my records?
Your doctor is allowed to charge a fee for medical records, even in an electronic form. But again, there are limitations to this. For example, if you request your records in an electronic format that involves physical storage such as CDs and USBs, your doctor may charge you for that cost.
That said, your doctor may not charge you for things that don't require labor or supplies. For example, you cannot be charged a fee if you access your records through a Certified Electronic Health Record Technology or, in simpler terms, your patient portal (e.g., MyChart).
Can my doctor charge me if I request my records through a third party?
If a third party requests your records on your behalf, your doctor must follow the same laws used when you request your records directly. Additionally, this rule applies regardless of who the third party is.
Does my doctor have to tell me if there's a fee for my records before charging me?
Yes. They must tell you there's a fee and how much it will be in advance. If they fail to do so, they are violating HIPAA law and you may file a complaint through the U.S. Department of Health and Human Services.
How much can my doctor charge me?
The fees for both electronic and paper records are calculated based on the different costs your doctor faces while copying your records.
If you've requested your records in a paper format, these costs can be charged per page, generally between $0.25 and $2.00 per page, which can end up costing hundreds of dollars depending on the record’s size. However, this is not the case for electronic records; the cost should not depend on the number of pages present in the electronic document.
It's important to note that if your records are being sent electronically and are already available in an electronic format, your provider cannot charge you over $6.50. If your medical records are from the past five years, this should be the case since most providers now use digital EHR (electronic health record) systems.
What can they charge me for?
Your doctor is only allowed to charge a fee to cover cost-based charges (e.g., any action throughout the process that costs the provider money, like supplies or labor). Things that your doctor can charge you for include labor costs involved in the creation and delivery of the copy (labor such as photocopying, scanning, transferring and converting electronic information, and creating the email or mailing it). They can also charge for the labor cost of summarizing or explaining your records only if you request either action. Lastly, they can charge for supplies (e.g., printer paper, printer ink, and stamps).
What can they NOT charge me for?
Doctors are not allowed to charge you for labor costs involved in reviewing your request, finding your records, or preparing them. They also cannot require your records to be only sent by mail, portable electronic media (like CDCs or USBs), or any other method. So, if you're trying to avoid high costs, it's probably easiest to have your records securely emailed to you (if they are already in an electronic format).
Doctors also can't charge for costs related to the upkeep or updating of records. This means that your doctor can't have the fee cover system maintenance or data storage. In addition, if they are using a third-party company to fulfill your record request, it's important to note that they can't charge you for the third party's labor cost.
What if my state law contradicts HIPAA’s law?
State laws that lower or waive fees for records override the Privacy Rule. Therefore, if your state requires providers to give you one free copy of your medical records, they must do so. If your state prohibits charging for medical records or has a set fee lower than HIPAA’s set fee, your state’s law will trump the Privacy Rule.
However, the Privacy Rule overrides any state laws that could increase a doctor's fee for records.
What if I can't afford their fee?
The Privacy Rule advises that doctors waive their fees if you cannot afford to pay them. However, the law does not require it. That said, you should let your doctor know that you can't afford to pay. Most should be understanding. You can also politely bring up the Privacy Rule's advisory if they are not.
If none of these approaches work, there are ways to get copies of your records without paying.
What should I do if my doctor charges me an outrageous amount?
If your doctor insists on charging an outrageous amount for a copy of your medical records, there are some tips to get your records for free or, at the very least, lower the cost. First, check your state laws (or the state laws where your doctor's practice resides). For example, Kentucky requires your provider to give you one free copy of your medical records. Some states may also have set fees that are even lower than HIPAAs. State laws that prohibit or limit fees override the Privacy Rule, so you can inform your provider if their price is larger than the state that their practice resides in allows.
Another way to potentially fight the outrageous fee is to ask for an itemized list of all the costs incorporated in your fee. You can then review the costs and see if your doctor may be charging you for costs they are not legally allowed to charge you for. It is also likely that your doctor could find a mistake in the fee calculation. Those running the medical record departments are only human, after all.
Lastly, you can legally review your records in person for no cost. While reviewing, you are allowed to take notes or use your smartphone/camera to take pictures of your records. You can also copy your records using your own resources.