As a patient, you have the right to access your own medical records. Your medical records can be important in a medical malpractice lawsuit to show which doctors and staff were involved in your treatment and identify any suspicious treatment notes. Unfortunately, doctors and hospitals can make it difficult to get your records. This page has important information about how to get a copy of your medical records and what you can do if the hospital won’t cooperate.
If you have questions about the care you received and believe a medical error may be responsible for your injuries, talk to a medical malpractice attorney for advice. A medical malpractice attorney can get a copy of your medical records, have them reviewed by medical experts, and identify any possible malpractice. Reach out and contact an experienced medical malpractice team for legal advice.
Access to Medical Records
According to the Department of Health and Human Services (HHS), with few exceptions, you have the right to inspect, review, and receive a copy of your medical records and billing records that are held by health plans and health care providers. Only you or your personal representative has the right to access your medical records.
Healthcare records are supposed to be kept private. They should only be accessed by you or in direct relation to your health care by doctors, hospitals, and others involved in your care. Health care records privacy is covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The HIPAA Privacy Rule provides a national standard to protect individual medical records and personal health information.
What Is HIPAA?
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that created national privacy standards for patient health care. For patient privacy and access, HIPAA laws include the Privacy Rule and the Security Rule.
Under the HIPAA Privacy Rule, protected health information (PHI) is subject to privacy and there are standards for the use and disclosure of this information by covered entities. Covered entities include hospitals, health plans, academic medical centers, doctors, clinics, nursing homes, and pharmacies. The Privacy Rule also provides standards for an individuals’ rights to understand and control how their health information is used.
Under the HIPAA Security Rule, covered entities must have safeguards in place to secure individuals’ electronic protected health information. There are financial penalties and potential liability for known, intentional, or even unintentional violations of the HIPAA privacy and security rules. HIPAA rules are enforced by the HHS Office for Civil Rights.
Rights to Access Health Records?
Part of the HIPAA Privacy Rule gives patients the right to examine and obtain a copy of their health records. Patients can even request the records to be corrected if there is incorrect information in their records. According to a memo from the HHS Office for Civil Rights, “consumers face barriers to getting their health information — and the first barrier is that many do not know their rights.”
The right to access your personal medical records is fundamental to your participation in the health care system. Patients have the “right to access,” to see and get a copy of their health records from doctors, hospitals, and health plans. Patients can get a paper copy or electronic copy if they are stored electronically. Patients can also have their doctor or health care plan send a copy to a personal representative.
If you want a copy of your health information, you may have to put a request in writing and pay for reasonable costs of copying and mailing. In most cases, your health care provider must give you a copy within 30 to 60 days. Patients can understand how their information is shared and if there is any information the patient does not want to share.
First, you can see if your health care provider has a standard form for requesting copies of your medical records. If the doctor’s office doesn’t have a form, you can make a request in writing. Your request should contain the necessary information to make a records request, including:
- Name
- Date of birth
- Contact information
- Social Security Number
- List of records requested
- Date range for requested records
- Format for delivery (electronic or paper)
- Signature
My Provider Is Blocking My Records for Unpaid Bills
According to HHS, “a provider cannot deny you a copy of your records because you have not paid for the services you have received.” A provider can charge a reasonable cost for copying and sending records but cannot charge a fee just to search or access your records. If your provider is denying access to your records, you can report them to the HHS Office of Civil Rights for HIPAA violations.
Why Is My Hospital Delaying Releasing My Medical Records?
Delays and ignoring requests are common problems for patients looking for access to their own medical records. Some of the reasons why it can be so hard to get your medical records. The medical office administrator may simply claim that they don’t keep the records on-site or refer the patient to a 3rd party storage service to get a copy of their records. However, these attempts to pass the buck may not line up with HIPAA privacy laws.
The most common reasons why patients want a copy of their medical records are because:
- The patient has questions about the medical billing and insurance coverage for medical care; and
- The patient suspects there was a medical error and they want to review their records for medical errors.
Because of these issues, is it any wonder why medical providers and health care plans are reluctant to give patients open access. To make it more difficult, the doctor’s office may try to charge unreasonable fees to access the records or make copies. Medical records keepers may try to charge outrageous amounts just to get access to a few pages of medical records.
Access to Medical Records for a Malpractice Lawsuit
If you have a medical malpractice attorney on your side, the doctors and hospitals will suddenly take your records request much more seriously. It may not be fair but the healthcare industry may not be very concerned about one patient’s HIPAA requests. However, when they are facing potential liability for medical errors, the doctors and health plans may be more cooperative in turning over records requests because they risk sanctions by the court.
As part of the discovery phase in a medical malpractice lawsuit, the parties exchange records, which can include medical records, medical bills, treatment plans, and other information relevant to the patient’s case. If the hospital is still delaying a record request, your attorney can file a motion to compel the hospital to turn over the records. A subpoena is a court order that requires a party to release essential documents.
Your attorney will generally request and maintain all relevant medical records, including:
- Discharge reports
- Surgical records
- Initial diagnoses records
- Prescription drug records
- Anesthesia records
- Lab results
- Diagnostic test records
Requesting Medical Records in Chicago
Some states, counties, and cities have procedures in place for patients requesting copies of medical records from local healthcare facilities. For example, if a patient in Chicago was looking for a copy of their medical records from a local hospital, they could use the Cook County Health Department website for the process for requesting a copy of medical records. The process for requesting a copy of medical records includes:
- Filling out a Medical Record Authorization Release (English)
- Copy of a valid photo ID (driver’s license, passport, state ID, or school ID)
- Submit the request for records to one of the following hospital locations:
John H. Stroger, Jr. Hospital
1969 W. Ogden Ave, Room 1690
Chicago, IL 60612
Phone: (312) 864-6152
Fax: (312) 864-9890
Provident Hospital
500 E. 51st St., Room 1016
Chicago, IL 60615
Phone: (312) 572-1527
Fax: (312) 572-1524
A benefit of getting records that are available through the Cook County Department of Health is the transparency of the costs and process of requesting the records. For example, a copy of electronic medical records delivered on CD or USB generally has a flat fee of only $6.50. Records delivered on paper may have a per page fee that will depend on the extent of the patient’s medical records.
Medical Records Request for Malpractice Cases in Maryland
In addition to federal access rights laws, states like Maryland may have additional protections for consumers to gain access to their medical records. Patients may want a copy of their medical records for a number of reasons, including:
- Need records of past health care when changing doctors;
- Moving out of the area and want records for a new doctor or hospital;
- Review records or submit records to the health insurance company for reimbursement; or
- Need records for a medical malpractice lawsuit against a doctor or hospital.
Under Maryland law, “you have a right under Maryland law to obtain a copy of the record. To do so, you must make a written request. This signed and dated request must state your name, the name of your health care provider and the party who should receive your records.”
There are limits to how much the hospital can charge for providing a copy of your records. Under Maryland law, patients cannot be charged more than 76 cents per page for having records copied, and any additional costs for actual postage and handling. For copies of medical records in an electronic format, the costs cannot be more than the actual costs of labor for processing the request.
If you are having problems getting a copy of your medical records after submitting a written request, you can notify the Maryland Office of the Attorney General’s Health Education and Advocacy Unit by phone or online.
Philadelphia Medical Malpractice Record Requests
Pennsylvania also has rights to protect patients’ medical privacy and provide for access to their medical records. According to a summary of rights in Pennsylvania, “Your provider must make reasonable accommodations for you to view your medical records, or he must provide you with copies of your medical records within 30 days of receipt of your written request. Providers may charge reasonable copying fees, set by the Department of Health, and may also charge for shipping and postage.”
If you believe your medical provider has denied you the opportunity to access your medical record, you can file a complaint with the HHS Office of Civil Rights or the Pennsylvania Department of State Complaints Office.
Are There Any Medical Records That Are Not Available?
Most medical records are available for patient review. However, some types of records may be subject to exclusion under HIPAA laws. For example, a psychotherapist’s notes may not be available for the patient to access.
According to HIPAA, “psychotherapy notes means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual’s medical record.”
These notes are separate from other medical records a psychotherapist may keep, such as notes about medications, prescription monitoring, and clinical tests. If you want to know about accessing your mental health records, talk to a medical malpractice attorney to find out what records you can access and which may be unavailable.
Filing a Medical Malpractice Lawsuit
You can get a copy of your medical records without a lawyer if you want to review your records, see if there are any errors, and request corrections to your record. However, if you suspect there was a medical error that caused you to suffer injuries, talk to a medical malpractice lawyer for help. If you think the doctor is withholding additional information, your attorney can subpoena the records to make the hospital turn over all relevant documents.
Contact experienced trial attorneys who have successfully represented medical error victims and their families to recover financial compensation from doctors, hospitals, and insurance companies. Your attorney can also let you know how much your claim might be worth so you can move on with your life after a terrible injury. For a free consultation, contact Gilman & Bedigian online or at 800-529-6162.