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Medical Records Request Letter (HIPAA Right of Access)
By Serdar Arslan, editor · Last reviewed · How we research
An adjuster can't value an injury claim without your medical records and bills. Under the HIPAA Privacy Rule, 45 CFR 164.524, you generally have a right to inspect and get a copy of your own health information held by most health care providers and health plans. The provider generally must act on your request within 30 days of receiving it, and may take one extension of up to 30 more days only if it tells you in writing why and when it will finish.
You can ask for copies in a specific form and format, such as electronic copies, if the provider can readily produce them. Providers may charge only a reasonable, cost-based fee for copying labor, supplies, and postage. Some providers use their own request form; it is fine to use it, but they generally cannot make you visit in person or use a patient portal as the only option.
Send a separate letter to each provider, including the hospital, ER physician group, radiology provider, and therapists, since each keeps its own records. Ask for itemized bills too, because billing is often handled by a separate department.
[Your full name] [Your mailing address] [Your phone number] [Your email address] [Date of this letter] [Department] [Provider name] [Provider address] Re: Request for access to my protected health information under 45 CFR 164.524 Patient: [Your full name] Date of birth: [Your date of birth] Other names used: [Other names used at the provider (if any)] Dear Records Custodian: I am requesting copies of my own health information under my right of access in the HIPAA Privacy Rule, 45 CFR 164.524. Dates of service: [Dates of treatment requested] Records requested: [Records requested] Billing records requested: [Billing records requested] Please provide the records in this form and format: [Format requested]. If that format is not readily producible, please contact me so we can agree on another format. Please send the records to: [Where to send the records] If there is a fee, please tell me the amount before processing so I can arrange payment. If any part of this request will take longer than 30 days, please let me know in writing the reason for the delay and the expected completion date. If any part of the request is denied, please explain the reason in writing. I can be reached at [Your phone number] or [Your email address]. A copy of my photo identification is enclosed to verify my identity. Thank you, [Your full name] Signature: ______________________________
Tips
- Sign the letter and include a copy of your ID; providers must verify your identity.
- Request itemized bills as well as records; insurers usually want both.
- Ask for imaging on a disc or download if a doctor or expert may need to review the actual images.
- Review your records for errors, such as an incorrect description of how the injury happened, and ask how to request a correction (an amendment under 45 CFR 164.526).
- If a provider does not respond, you can file a complaint with the HHS Office for Civil Rights.
Sending it and keeping proof
Keep a copy of everything you send. If a deadline or a response time matters, send letters by a method that gives you proof of delivery, such as certified mail with a return receipt, or email with a read receipt, and note the date in your claim file. Many insurers and agencies also accept uploads through an online portal, so save the confirmation screen or email.