Pulmonology Coding Alert

Question: Our practice discharged a patient due to non-payment, and one week later a new pulmonologist requested the patient’s records from our office. My doctor wants to me to bill the patient for the records transfer. Is this something we can do?

Indiana Subscriber  

Answer: No, you cannot bill the patient, the other provider, or anyone else for a records transfer from one doctor to another. Regardless of the reason your provider is no longer seeing the patient, that patient is allowed to have her entire record transferred to another provider.

Here’s why: The HIPAA final rule included some specifics about medical record transfers. You need to ensure you are working under the following requirements:

The patient must be able to easily request transfer of records to another provider or a copy for herself. Upon request, you must give the patient a copy of the full record in the HIPAA Designated Record Set, which is any records used to make decisions about the patient’s care or payment for services, including records received from other providers.

You can charge the patient reasonable fees to cover your labor and supplies costs for making paper or electronic copies if you are providing the records to the patient. Reasonable fees do not include the capital costs of any systems or equipment needed, only the costs for labor and supplies.

You have only 30 days to respond to and complete the request. You can ask for a one-time extension of 30 days if your practice provides a written explanation to the patient explaining the reason for the delay and the expected date of completion

Remember: You also need to check your state laws, as some states have specific laws governing fees and timing for record transfers. Whichever rules provide for the lower cost to the individual prevail.