Medical Record Request Policy

According to Health Insurance Portability and Accountability Act (HIPPA) regulations:
A patient can request their own medical records simply by signing and dating a release. The patient’s signature is on file in their chart and is compared to the signature on the signed request.
If the patient is not able to sign for their records, their legal (proven) representative can sign, with proper ID.

Medical Record Fee

All requests for Medical Records must be in writing, signed, and dated by the patient.
A reasonable length of time to copy records must be allowed.

No fees will be charged to copy a patient’s medical for another physician. If a patient requests a copy for an agent of their records there is a charge.

Fees for copies of a patients medical records – under HIPPA guidelines
In accordance with the Medical Records Access Act 47 of 2004. Legislative Council, State of Michigan 333.26269, the office can only charge for the supplies, the labor and any postage required. There is no charge for the time it requires to comply with request. However, if the patient wants more than just a single copy, perhaps a summary or an explanation of their medical record, the office may charge for preparing that.
General guidelines:
The initial fee for a copy of the record is $20 per request

Paper Copies as Follows:

Supplies: $1.00 per page for the first 20 pages
$0.50 per page for pages 21-50
$0.25 per page for pages 51 and over
(copies, wear on equipment, paper and envelopes)
Postage: If required

Workers Compensation

In accordance with the Workers Compensation Health Care Service Rules R 418.10118 there will be a charge to copy medical records for a workers compensation claim.
General guidelines:
The maximum fee for providing copies shall be 45 cents per page, plus the actual cost of mailing. In addition an administration charge for the staff’s time to retrieve and copy the records shall be paid as follows:

1-15 minutes $2.50
16-30 minutes $5.00
Each additional 15 minutes increment $2.50
Postage: If required

Note: Any films or CD’s must be requested directly from Providence Hospital.

The party who requests the records shall pay the coping charge.
If an agent of a carrier or an employee requests a copy of the case record, than the agent shall indicate the date of injury. Only the records for a specific date of injury covered by the act and these rules are available as specified in sub-rule of this rule