CO-PAY RISING: Getting Your Medical Records — Don’t Take No for an Answer

healthcare-recordsby Lisa Zamosky

There are few things for which we feel a greater sense of ownership than our own personal health information. Medical records — files containing information about our health conditions, the treatments we’ve had and the medical diagnoses we’ve received — are about as personal as it gets. Yet, gaining access to medical records, and our own health history, is often more trouble than it should be. In fact, it’s among the most common patient complaints consumers file with state medical boards.

What You Need to Know
You have the right to see, get a copy of and make changes to your medical records. And generally, health care providers must give you your records in the format in which you request it. Your rights to your medical records are protected under the federal Health Insurance Portability and Accountability Act (HIPAA). You can read a full listing of consumer rights guaranteed by HIPAA at the Health and Human Services website: www.hhs.gov/ocr.

Most states also have laws that guarantee access to your medical records. They also outline how much time your doctor has to make your medical records available to you. In California, for example, patients should be granted access within five business days of a written request and receive a copy of their records within 15 business days.

Here is a great resource for learning about the laws governing medical records in your state: http://medicalrecordrights.georgetown.edu/records.html

Behind the Scenes
Despite federal and state laws outlining a consumer’s right to his or her medical records, people are denied access all the time. Why? First, federal and state laws sometimes conflict, creating confusion for health care providers, who are required to follow whichever law offers the consumer greater protection. Yet, many don’t realize that.

Often, when health care providers deny a patient access to his or her medical information, they do so believing they are complying with HIPAA privacy laws. HIPAA outlines how  health information, protected under privacy laws, can be shared. Doctors are frequently so concerned about the liability associated with inappropriately sharing protected information, patients’ rights to medical records are sometimes inadvertently violated.

Another common complaint consumers make is that their doctor charges them for retrieving and copying their medical records. In some states this is allowed under law. But there are limits to the dollar amount a provider can charge, and it’s unfortunately common for patients to feel as though they are being gouged. Confirm the charges allowable in your state and bring the law to your doctor’s attention to see if you can reduce the cost. You can find out what the laws are in your state here: http://medicalrecordrights.georgetown.edu/records.html

Put it in writing
If you’re having trouble accessing your medical records, first send your physician a certified letter with your request. Do some research ahead of time, so you can include the particular state law or code that demonstrates you have the right to a copy of your records.

If you get no response, it’s time to get some help. Contact your state medical board, which will help you obtain your records if your doctor won’t comply with your written request, often bringing about a quick resolution.

If the board determines your rights have been violated, it will usually make contact with your doctor on your behalf, explaining your circumstances and what the law requires of him or her.

If the doctor still won’t relinquish your records, many state medical boards will fine the doctor, which becomes public record, appearing on the doctor’s profile. Most doctors would prefer to avoid this, which works in your favor.

If state medical board assistance doesn’t help, you can file a complaint with the Office for Civil Rights, U.S. Department Health and Human Services, either through the national or regional office. You can find out about how to file a complaint and the forms required to do so online at www.hhs.gov/ocr. HHS requires you to file your complaint within 180 days of the incident.

If none of these measures work, some states allow you the right to sue. They are your medical records, after all…
Good luck!

lisazamoskyLisa Zamosky is a writer specializing in healthcare, and a former executive who worked for years in the health insurance industry. Visit her online at Writtenarts.com. E-mail Lisa at lisa@writtenarts.com. Follow Lisa on Twitter: Twitter.com/lzam

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