How much should a dentist charge for reproducing and transferring the dental record?
State Board of Dentistry regulations require that record reproduction in a private office should be provided either gratuitously or for a “reasonable” fee reflecting the cost of reproduction. Charges made to patients for the reproduction of records should not be more than the cost of the reproduction of the records.
In cases involving reproduction of records by request or subpoena for a legal matter, the Department of Health recently announced new fees that health care facilities and health care providers may charge. Effective January 1, 2016, the following fees may be charged by a health care provider or facility for the reproduction of patient records needed in a legal proceeding only. In addition to the below costs, a provider may charge the patient for the cost of postage and shipping of patient records.
- Amount charged per page for pages 1—20: $1.46
- Amount charged per page for pages 21—60: $1.08
- Amount charged per page for pages 61—end: $.036
- Amount charged per page for microfilm copies: $2.16
- Flat fee for production of records to support any claim under Social Security or any Federal or State financial needs based program: $27.48
- Flat fee for supplying records requested by a district attorney: $21.69
- Search and retrieval of records: $21.69
The previously listed fees shall apply for paper copies or reproductions on electronic media whether the records are stored on paper or in electronic format. In addition to the amounts listed previously, charges may also be assessed for the actual cost of postage, shipping and delivery of the requested records.
The previous charges, however, are subject to the following exceptions:
- An insurer shall not be required to pay for copies of medical records required to validate medical services for which reimbursement is sought under an insurance contract, except as provided in: (a) the Workers' Compensation Act (77 P. S. §§ 1—1041.4 and 2501—2506) and the regulations promulgated thereunder; (b) 75 Pa.C.S. Chapter 17 (relating to Motor Vehicle Financial Responsibility Law) and the regulations promulgated thereunder; or (c) a contract between an insurer and any other party.
- The charges listed in this notice do not apply to an X-ray film or any other portion of a medical record which is not susceptible to photostatic reproduction.
- The charges for the production of medical records by a health care provider in response to a request made by either an individual who is the subject of the health information or the individual's personal representative is governed by the Health Insurance Portability and Accountability Act (HIPAA) and Federal regulations enacted under HIPAA, including 42 U.S.C.A. § 17935(e) and 45 CFR 164.524 (relating to access of individuals to protected health information), as follows:
Electronic health record. Under 42 U.S.C.A. § 17935(e), if a health care provider uses or maintains health records in an electronic format with respect to protected health information of an individual, the individual shall have a right to obtain from the health care provider a copy of the information in an electronic format. The individual also has a choice to direct the health care provider to transmit electronically a copy of the health record directly to an entity or person designated by the individual, provided that any choice is clear, conspicuous and specific. Any fee that the health care provider may impose for providing this information (or a summary or explanation of this information) in an electronic format shall not be greater than the labor costs in responding to the request. The Department of Health and Human Services has stated that the labor costs may not include costs associated with searching for and retrieving the requested information.
Health record used or maintained in other types of format (for example, paper). Under 45 CFR 164.524(c)(4), if the individual requests a copy of the protected health information or agrees to a summary or explanation of the information, the covered entity may impose a reasonable, cost-based fee, provided that the fee includes only the cost of: (i) labor for copying the protected health information requested by the individual, whether in paper or electronic form; (ii) supplies for creating the paper copy or electronic media if the individual requests that the electronic copy be provided on portable media; (iii) postage, when the individual has requested the copy, or the summary or explanation, be mailed; and (iv) preparing an explanation or summary of the protected health information, if the individual agrees in advance to a summary or explanation and the fees to be imposed, in accordance to 45 CFR 164.524(c)(2)(iii). Similarly, the labor costs under 45 CFR 164.524(c)(4) shall not include the cost attributable to search and retrieval of the records.
Answer is informational only and not intended as legal advice. Answer may contain excerpts from The ADA Practical Guide to Frequently Asked Legal Questions.