When Brenay Torres, a mother of two children in West Virginia, found a lump in her chest, she was sent to an ultrasound after her mammogram was not conclusive. But when she tried to set the ultrasound date, she came across an unexpected roadblock.
“Then the nightmare started,” said Torres. She was sent to another medical office to do the ultrasound. But before she could be seen, they needed the pictures from their mammogram – and the fee to receive a copy of these records, was $ 175.
Torres said she tried to negotiate a more appropriate fee, but the mammogram facility would not move.
“The fee was too high for me to pay it – and I couldn’t do the ultrasound. Every day I was extremely concerned that I could have cancer and he spread out in my body,” said Torres.
Since there is a limited number of providers in her city, Torres needed a while to find another imaging center for which the previous records were not necessary, and they had to wait over three months until they had an opening.
“The entire situation was extremely stressful and began because of the fee for exploitative records – why can’t I have a picture of my own body without paying a high fee? These fees can limit the access of a patient to their medical information and the ability to coordinate their care,” said Torres.
Torres’ experience is not unusual.
While people are legally entitled to their medical documents under the federal law, many touching fees meet when they request electronic or hard copies of their records.
Online patient portals have increased access to medical information, but patients may still need hard copies of their documents if they are transferred to a new doctor, dentist, imaging center or a specialist. Patients may also need hard copies for their personal recording.
“You can’t rely on the portal, especially when imaging,” said Torres.
According to the law on the portability and accountability of health insurance (hipaa), the providers can collect an “adequate, cost -related fee”, which includes working copy for copying the protocol (paper or electronic) and supplies (paper, CD, postage). However, there can be no costs for checking, searching for and calling up to search for, search and call up medical documents. Requested records should also be sent in time, usually 30 calendar days.
Read: Health Insurance 101 For women: What you are entitled to as a woman >>
The fees of the medical files vary depending on the state
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The concerns about increasing health costs – including unexpected fees – are growing. Despite the hipaa guidelines on fees for medical documents, the costs can still vary significantly depending on the facility, provider and state in which they practice.
Several states regulate which providers can invoice and in some patients patients can receive a free copy of their documents. Other countries such as Idaho, Kansas and Alaska have no laws that regulate the fees of the records. Some states charge a flat fee, while others calculate between 50 cents and $ 2 per side.
In some cases, even if a state permits certain fees, it may not correspond to the hipaa right to access regulations. If there is ultimately a conflict between state laws and hipaa for these fees, the law is cheaper for patients and offers a cheaper option in general a precedent.
This nationwide patchwork of different rules for different states can lead to limited monitoring of compliance with providers and fees, which can lead to an expensive and challenging process for patients.
The patients may not be aware of the hipaa fee regulations and may not know that they have the right to question providers that demand excessive or forbidden fees.
Caitlin Donovan, Senior Director of Patient Advocate Foundation, said that it is an administrative burden for the providers to process records. However, the accessibility for patients should continue to be a priority and access to maintain records should not depend on the solvency of a patient.
“The patients are entitled to their medical documents in the format that they demand, but at a certain point in time, these records are no longer accessible if they are not affordable,” said Donovan.
What can you do if you control high medical documents
When patients encounter fees for medical documents that are a difficulty, Donovan recommended that the fee are permitted in their state and are talked to the Billing Office about their concerns. Patients also have the right to report exorbitant fees to the general office of their state and the consumer protection office of their state.
If a provider does not comply with government laws or hipaa regulations, patients can submit a hipaa complaint to the Office for Civil Rights (OCR). If a patient has insurance, he can also submit a complaint to his insurance company.
Donovan added that practical protocols can vary from the provider, but suggested asking whether the provider/facility can apply for the records directly from the provider who has – sometimes the provider of providers does not lead to inquiries to a fee.
Vulnerable patients can be more affected
Marginalized communities and patients with complicated medical history, in which health differences already occur, can be influenced by these fees.
“Fees can be another obstacle to marginalized communities,” said Faith Ohuoba, MD, an OB-GYN in Texas and professor for clinical staff at the University of Houston. Ohuoba said that the administrative work for the office employee can lead to an increase in inquiries from the office, but the providers must be aware of the effects of these fees on the patients.
Women who already spend more for health care compared to men can also pay more in the record fees. According to Ohuoba, women often have preventive examinations (mammogram and papal tests) and these tests can be carried out in various facilities, which means that they may be able to pay even more fees in order to obtain their records from any medical office.
For patients who are unable to pay for an imaging CD, Ohuoba should bring a new provider to a copy of the imaging report, as they can normally be printed by the patient portal.
Read: A guide to medical imaging for women >>
Transparency is the key
Ohuoba said that transparency was critical and that it is important for providers to disclose all fees that they collect in advance. If you receive an excessive fee for the recording, Ohuoba said to request a detailed bill and ask more information about what you are collected for. She noticed that some facilities could say that they have a flat fee for each recording request, but according to this specific information, an important part of increasing transparency in billing can still be an important part.
“The providers have to work for how fees affect patients, offer different payment options and work with patients to solve the problem,” said Ohuoba.
