When a patient asks for copies of their medical records, you are required to give them to them – even if they can’t afford to pay the standard fees you charge for duplication.
Balancing a patient’s right to access their medical records with your desire to cover your costs for the extra time and effort spent preparing them can be tricky. Denying patients access to their medical records can cause can quickly lead to a HIPAA complaint, audit, violations, and massive fines.
The good news is that there are a few things you can do to ensure your practice remains HIPAA compliant when fulfilling a patient’s request for their records when they can’t pay your duplication fees.
Offer an Alternative Format
Just because HIPAA requires you to provide records in a format the patient requests (within reason), it doesn’t mean that you are barred from offering alternatives to patients for whom paying your medical records fee is a burden.
For example, your patient requests print copies of their medical record, which is quite large. Based on the volume of the documents in the files, you estimate the cost of duplication to be about $50. When you inform the patient that the duplication fee will be approximately $50, they tell you that the price is too high for them. At this point, suggest the alternative of receiving digital copies of the records. The work involved is minimal, so if there is a cost involved, it should be small. This meets everyone’s needs.
Provide Waivers (in Extreme Cases Only)
While you have the option to charge for copying medical records, there’s nothing that obligates you to do so. Certainly, it helps cover the costs that your practice incurs, but you’re well within your rights to waive your medical record duplication fee whenever you choose.
There is a catch. Charging some patients and not others can get people angry, and even a formal HIPAA compliant. Instead, develop a formal policy to include in your HIPAA documents that outlines when it is and isn’t appropriate to waive patient medical record duplication fees.
In addition to drafting a formal waiver policy, it is essential to document in the patient’s record that they weren’t charged and why. This way, if you are audited, you’ve got documentation to show that you are following clear-cut rules.
Some considerations to take into account when drafting your waiver policy might be whether the patient has insurance or not, if they have Medicaid or Medicare, or if you simply know they are financially having a hard time, etc.
Finally, when offering a waiver to medical record reproduction fees, it can be helpful to get it in writing. A simple form that allows your staff to write in why the waiver is being given and acknowledges the fact that, by receiving a waiver, it doesn’t mean that every request for records in the future will be handled in the same way should do the trick. Get the patient to sign the form and keep it in their record for future reference if needed.
Charge Reduced Amount for Records
If you feel uncomfortable giving waivers, reducing your records fees may be a good alternative that will help meet a patient’s financial needs. With that said, just like the waivers, it is important to have a standard in place so that everyone is treated the same.
Accordingly, develop an office policy that spells out when discounts might be appropriate, how much of a discount is allowed, and who in your practice can authorize such a transaction.
Note: It may be a good idea only to allow your practice manager to authorize discounts or waivers to ensure they are handled in a way that reduces your practice’s risk.
A discount on medical record duplication fees still covers most of your costs and shows that you are sympathetic to the patient’s needs, boosting their opinion of your practice.
Whether you choose to offer alternative formats, waive your record reproduction fees altogether, or offer a discount to those patients that are having a hard time, it’s important to be flexible and work with the patient as much as possible. Also, be sure to document all interactions you have with your patients, so your practice doesn’t get hit with a HIPAA complaint from a disgruntled patient, leaving you to fend off an investigation.
Charging medical records fees can be complicated, especially when you’re trying to figure out just what you can and can’t charge the patient for. That’s where Healthcare Training Leader’s online training session, Stop $85,000 Penalty: Comply With Medical Records Fees Rule, comes in. This 60-minute expert-led training walks you through what records you can charge for, and how much you can charge, to keep your practice HIPAA compliant. Sign up for this valuable training today.