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Getting Your Medical Records: Rights, Procedures, and Denials

If you cannot easily access your medical records online or need them for a personal injury case in Westchester County, you will likely have to request the records from your medical provider in writing. Here we discuss your rights, procedures, and what to do. 

Rights to Medical Records

Under the Health Insurance Portability and Accountability Act (HIPAA), only you or someone else you have approved (personal representative) can review or request your medical records in most instances. As a parent or legal guardian of minor children, you have the right to access their medical records. Additionally, in situations where you care for an adult who cannot make their own medical decisions and you have healthcare power of attorney or are their guardian, you can request their medical records. In situations where someone has died, you must be authorized by the court as their executor in order to see the deceased’s medical records. As a result, family members do not automatically have access in wrongful death cases.

Other Parties Who Can Access Your Medical Records

Your medical provider or health plan provider may also share your records with other insurance companies if they are trying to approve treatment or bill you for the medical services they provided. Law enforcement can also request access to your medical records in some cases, and public health agencies can request them if it is related to a public health emergency.

Steps for Obtaining Medical Records

1. Determine why you need or want the records. Depending on the situation (for example, if it’s a legal requirement for any litigation), you may need to include specific information in your request. Also, determine which medical office you need records from if you’ve been to more than one.

2. Draft a letter to your medical office to officially request your records, and you may need to include specific information as to why you are requesting them (e.g., legal case). Most medical providers have a records request form on their website. You will want to include:

  • The location where you were treated; 
  • When you were treated; 
  • Precisely which records you want; 
  • How and where the records should be sent; and,
  • Your signature. 

3. Under HIPAA regulations, your provider has 30 days to respond, and they can request a 30-day extension if necessary.

4. Check with your state’s government website to find the fees you may owe. Although patients can access medical records for free under HIPAA, there can be a fee for copying the documents, preparing a special report, and mailing out the records. 

5. Lastly, you must wait for your records to arrive. Follow up if you have not received them after 30 days. 

Can a Request for Medical Records Be Denied?

In some rare instances, you may be denied access to portions of your medical record if your healthcare provider determines that viewing them would harm you somehow. A denial may occur mainly in the field of mental health, as HIPAA does not cover psychotherapy or mental health notes as part of Right of Access regulations. Other situations that may result in a denial include if: 

  • You are not the patient and not legally responsible for the patient. 
  • The provider considers you as a threat to the patient (e.g., cases of domestic abuse or neglect). 
  • You didn’t follow the provider’s procedure.
  • You haven’t paid the associated fees.
  • Your request was received past the legal retention limit.

After a personal injury accident, pursuing a claim and obtaining medical records can be stressful. A Westchester County Medical Malpractice Attorney will be able to handle every aspect of your claim while you recover, including obtaining copies of the records you need.