Notice of Pricing for Medical Records

In keeping with the Office for Civil Rights Guidance our practice is posting the following fees for Access Requests by patients. Requests for medical records through valid Authorizations are based on the state approved rates.

FEES FOR ACCESS REQUESTS

Paper Copies:

1 to 5 Pages: No Charge.

For records of 50 pages or less we charge a flat fee of $6.50.

For records request of over 50 pages we charge $0.25 per page for the actual cost and a labor fee* based on the time required for photocopying paper PHI; Scan paper PHI into an electronic format; Converting electronic information in one format to the format requested by or agreed to by the individual; Transferring (e.g., uploading, downloading, attaching, burning) electronic PHI from a covered entity’s system to a web based portal (where the PHI is not already maintained in or accessible through the portal), portable media, email, app, personal health record, or other manner of delivery of the PHI; Creating and executing a mailing or email with the responsive PHI. You may request an estimate based on your individual request.

Electronic Records:
Email of records: flat fee of $6.50

Records requests to be placed on a CD: flat fee of $6.50.

Transfer to App or Health Record (if we have the capability and security considerations are in place): $6.50

Thumb Drive** or Other Supported Media: Actual cost of the media, labor involved as described above and postage if the device is mailed. (Approximate Cost is $25.00)
.
Films and Other Non-Standard Paper Requests
Actual cost to produce plus labor as described above and postage.

Should the above pricing for copies to medical records present a financial hardship, please let our office know.

*Our practice uses Average Costing to determine labor costs. The Average Fee Labor Cost Worksheet of our charges is available from our HIPAA Compliance Officer.
**For security purposes our practice is not allowed to accept patients’ thumb drives or other portable media because they must be attached to our network to transfer the files and pose a security threat to our network.