Get HIPAA with the Times!
An update on HIPAA regulations about releasing patient records.
Recently, a hot topic among dental management professionals has been the rules surrounding releasing patient records. Since our primary goal is always to strive to provide the patient with the best care possible, I’ve gathered some information to ensure our offices stay compliant and avoid hiccups in transferring records. Allowing patients access to their health records is a powerful tool in managing their care. It will enable them to ask better questions and make more informed choices regarding their treatment.
The three most commonly asked questions are:
Does the patient need to sign a records release before documents can be sent?
HIPAA (Health Insurance Portability and Accountability Act of 1996) gives us the right to access our health information. But, since 2013, it has not required a signed records release when sending patient records to another provider. The HIPAA Privacy Rule permits a healthcare provider to disclose protected health information about an individual, without the individual’s authorization, to another healthcare provider to treat the individual.
HIPAA does allow a practice to have a policy requiring written consent, so long as it doesn’t delay the release of those records. The form must be available electronically, and patients cannot be required to come into the office. The Cures Act states that if records are electronic, they must be sent as soon as possible and without delay. Producing electronic records within a day is typical.
So when IS a record release required? When someone else is trying to access records like a lawyer, a spouse or a family member not listed on the patient’s allowable releases, auto insurance company, or workers comp company.
Can I withhold sending records if the patient owes a balance?
You cannot refuse patients access to their health information for any reason, especially from an account balance. If a patient feels they have had their rights to health information violated, a complaint can be filed with the Office for Civil Rights (OCR). The OCR is the departmental component responsible for implementing and enforcing the HIPAA Rules.
Can I charge for duplication?
You may charge your actual cost of records duplication or a flat fee of $6.50. Calculating your actual cost of duplication requires a breakdown of what each sheet of paper costs and the ink used to print on them. You may not charge for your time in researching or duplicating records, regardless of whether they’re paper or digital. If choosing this billing method, be prepared to provide proof of the cost of duplication. If the records or X-rays are digital and they’re being emailed, there is no cost to duplicate the records. Charging an outrageous “duplication fee” equivalent to an outstanding balance to recoup funds for previous treatment is not considered legal.
On a closing note: if an office requests X-rays be sent to them, you’re to provide X-rays. If the office requests patient records, the chart in its entirety is to be sent. Some things included in the entire chart are the patient ledger, billing and payment records, correspondence with specialists, X-rays, clinical notes, and other information that could be used to make decisions about that individual’s care.
I hope this information proves helpful in keeping our offices HIPAA compliant and aids in our patients getting the care they need without delay.
- Important Notice Regarding Individuals’ Right of Access to Health Records…Click to open link in new tab…
- Filing a Complaint…Click to open link in new tab…
- Office for Civil Rights (OCR)…Click to open link in new tab…
- Your Medical Records…Click to open link in new tab…
- Information Blocking…Click to open link in new tab…
- About ONC…Click to open link in new tab…
- What personal health information do individuals have a right under HIPAA to access from their health care providers and health plans?…Click to open link in new tab…
Also included are a handful of social media groups graciously sharing their wealth of knowledge to keep us all compliant. As always, a huge thank you to AADOM for providing us access to the outstanding experts in our field so that we may continue to learn and grow.
About the Author
Brooke Paul, MAADOM, is the practice coordinator at Beaver Creek Dental in Knoxville, TN. She has been an AADOM member since 2019 and became a lifetime member in 2022. Brooke received her Fellowship (FAADOM) designation in 2022 and was inducted into the 2023 class of AADOM Masters (MAADOMs) in September.