Who Will Pay for Copies of Medical Records? - Industry Trend or Event

Health Management Technology, March, 1999

The concept of charging patients, their advocates, or certain other parties for copies of medical records and other health information is a controversial issue. However, the process of storing and releasing this kind of information is complex and expensive and warrants reasonable charge.

The complicated process of making records available to patients who request them is an important part of patient care. But who will absorb the costs associated with the release of information (ROI)?

In a practice brief on this issue, the Journal of American Health Information Management Association (AHIMA) lists some of these costs:

* labor costs involved with ensuring that the party making the request has the appropriate authorization;

* labor costs and software associated with logging requests into a database;

* labor costs involved in physically retrieving the information, copying, then re-filing that information;

* expense costs for paper, toner, and maintenance for copying equipment;

* capital costs associated with acquiring copying equipment;

* invoicing, postage and handling expenses;

* bad debt "write off" and "non-billable" request expenses;

* real estate costs for copier and copier work space;

* developing organizational policies regarding fees for release of information.

Author of the brief, Harry B. Rhodes, MBA, RRA, also includes recommendations for developing organizational policies regarding fees for ROI. Rhodes writes," It is necessary to investigate and become knowledgeable about state laws addressing patients' rights to access and acquire copies of their health information."

Points to consider during the policy setting process include meeting the needs of continued patient care, legal requirements, research, education, and other legitimate uses. The policy should comply with state and other legal and regulatory requirements. The Joint Commission on the Accreditation of Healthcare Organization's Information Management standards address granting agents and contractors of the enterprise access to patient information.

Health informatics professionals should be actively involved with administration when negotiating managed care contracts to ensure adequate reimbursement for copies of records.

When dealing with out of state requests for health information, the ROI laws or regulations where the healthcare provider is located should prevail, unless state law or legal counsel advises otherwise.

The American Health Information Management Association has developed a matrix of state laws governing fees for medical records and other health information. It is available on their website at www.ahima.org. Follow links to "Publications Online", "Journal of AHIMA", and "Practice Briefs."