HIPAA FAQs - Patient Access

       


 
Do physicians have to allow patients to read their own charts?
 No. A patient has the right to read his/her own record, but you have the right refuse this request for the reasons listed below. You may also provide the patient with a chart summary instead of the actual chart. There are specific provisions under HIPAA that give patients the right to inspect or obtain a copy of their medical record. In most states, this is already in place under state law.
Are there any exceptions to the provisions allowing patients to read their own charts?
Yes. 
  • Psychotherapy notes. 
  • Information compiled in reasonable anticipation of or for use in a civil, criminal, or administrative action proceeding. 
  • Protected Health Information (PHI) maintained by a practice subject to Clinical Laboratory Improvements Amendments (CLIA) (to the extent access to an individual would be prohibited by law). 

Can physicians deny patients access to their charts?
 Yes, in certain circumstances, which are listed below.

  • Unreviewable denial: 
    • As limited in exceptions. 
    • Correctional facility can deny part or total access. 
    • In research situations. 
    • If the information was obtained from someone other than a health care provider and if access would compromise an individual providing information under a promise of confidentiality. 
  • Reviewable denial:
    • If a licensed health care professional determines that the requested access would endanger the life or physical safety of the individual or another person. 
    • If the record makes reference to another person and the licensed health professional believes the access could cause substantial harm to that person. 
    • Request has been made by patient’s personal representative and the licensed professional believes it could cause harm to that individual or another person. 

Does the patient have the right to appeal a denial?
 Yes. They have the right to review by another licensed health professional designated by the practice and who was not a part of the original decision to deny access.

Are there exceptions to the right to appeal a denial?
 Yes. There are several circumstances including correctional facilities, Clinical Laboratory Improvements Amendments (CLIA) required information, and certain research situations if access would compromise an individual providing information under a promise of confidentiality.

If access is denied, are there any other requirements to be met by the practice?
 Yes, the individual must be informed of how to make a formal complaint to the practice and the Secretary of Health and Human Services (HHS).

Can a summary of the information instead of the complete record be provided and meet the access requirement?
 Yes, if you believe the information would be difficult to interpret (e.g., billing codes).

Can I charge patients for copies of their medical record?
 Yes, you can charge reasonable, cost-based fees. The fee, however, may only include the cost of copying (supplies and labor) and postage (if germane). The fee may not include the cost of retrieving the record. You may want to check your respective state statutes or an existing law on charging for copies.

Can I provide access to information from another health care provider that is part of my medical record?
 Yes, there is no exclusion.

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