What to Do if You are Denied Access to Your Medical Records

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What to Do if You Are Denied Access to Your Medical Records

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Just because the law says you have a right to get copies of your medical records doesn't mean all covered entities are willing to supply them. Your doctor or your insurer may deny you access for reasons that make no sense to you, but for some reason are important to them. In most cases, it's illegal for them to deny you access, according to Health Insurance Portability and Accountability Act of 1996 (HIPAA) laws. Here are the steps to take to determine whether you have a legal right to your medical records, and what to do if you are denied access to your medical records:

Step One - Do you have the right to access your records? Are they available?

Be sure you have a right to get those records, and that the records are available. There are some circumstances under which you do not have a right to them. Also, there are medical records storage time requirements which vary by the state you live in, the type of record, your record of medical problems, and where the records are being kept.

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Have you followed the protocol for getting copies of your medical records?

Be sure you have followed the right protocol for getting copies of your medical records.

Simply making a phone call may not be enough. There are certain steps you may need to take, including letter-writing and signatures. Included in the protocol is payment for the records.

You may be required to pay for the copies of your medical records before they are provided. The amount you can be charged will vary by state. If you can't afford them, each state also provides a procedure for reducing the cost.

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Did you make your medical records request from a covered entity?

Be sure you have made the request from a covered entity. These are designated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and include providers who transmit health information in electronic form, health plans and health care clearinghouses.

If you make your request from a non-covered entity then your request will not fall under HIPAA laws and requirements. Find one of the covered entities that has your records and make the request there.

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Have you waited long enough to get the records?

Be sure you have waited the entire length of time the organization has, by law, to delay fulfilling your request.

By federal law, the maximum amount of time they can delay is 60 days.

Some states provide for less time than that. Check with your state's laws to learn what your wait time will have to be.

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How to make a complaint if you are denied access to your medical records

Be sure you have followed all these steps:

  1. Being sure you have a right to those records
  2. Following the right steps and protocol to getting your medical records
  3. Double checking that you have made the request of a covered entity
  4. You have waited long enough...

Once you are sure you have them completed, if you are still being denied access to your health records, you can make a complaint to the US Department of Health and Human Services. Follow their complaint process against the covered entity that is denying you access.

Important: this complaint must be filed within 180 days of the denials. Also, the law prohibits retaliation on the part of the covered entity.

These medical records laws do have teeth. They were tested by Cignet Health, a Maryland health center, when it denied records to 41 patients in 2008 and 2009. In 2011 $4.3 million worth of fines were levied against Cignet Health for violating the law. That action came as a result of complaints made by patients through the complaint process described above.

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