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45 C.F.R. § 164.524 (c)(4) requires medical providers to make our records available to you upon request, for a reasonable fee to reflect their cost of preparing

45 C.F.R. § 164.524 (c)(4) requires medical providers to make our records available to you upon request, for a reasonable fee to reflect their cost of preparing it. “Fees. If the individual requests a copy of the protected health information or agrees to a summary or explanation of such 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 agreed to by the individual as required by paragraph (c)(2)(iii) of this section.” Despite this language, actual costs for getting medical records varies widely. “Fees range very widely, from $2-55 for short records of 15 pages to $15-585 for long ones of 500 pages. Times also range widely, from 1–30 days (or longer for off-site records)” from a survey study on the topic. No one has been investigated on this that I have ever heard of.

AnthonyMouse 8y ago
> Despite this language, actual costs for getting medical records varies widely. “Fees range very widely, from $2-55 for short records of 15 pages to $15-585 for long ones of 500 pages. Times also range widely, from 1–30 days (or longer for off-site records)” from a survey study on the topic. All of those numbers are in line with the actual costs of producing information like that. The problem scenario is the one where the company claims everything costs a zillion dollars just so they don't have to provide the information at all, which the rules appear to be successfully preventing from happening.
- arkades 8y ago
  Since meaningful use regulation has strong-armed almost all providers in the country into EMRs, it costs absolute pennies to provide those documents. And for most people, 500$ for a medical record is effectively zillions.
  - AnthonyMouse 8y ago
    > Since meaningful use regulation has strong-armed almost all providers in the country into EMRs, it costs absolute pennies to provide those documents. The reproduction cost is not the dominant factor in processing costs. Someone has to review the information, e.g. to make sure the file actually belongs to the requesting party and some clerical error doesn't cause them to receive someone else's records, the information may be in multiple independent systems, the request may be for a subset of the information which then has to be separated out, etc. Not all of that happens all of the time, which is why it costs $2 sometimes and $500 other times. > And for most people, 500$ for a medical record is effectively zillions. $500 is <1% of the median income in the US.
    - arkades 8y ago
      What’s sad isn’t how far off you are in your conception of what the process looks like; what’s sad is that what you’re describing sounds like an entirely reasonable security effort, and it’s disappointing that it has almost no reflection in reality. 500$ is also more than the majority of Americans have in their saving accounts. (http://money.cnn.com/2017/01/12/pf/americans-lack-of-savings/index.html http://money.cnn.com/2017/01/12/pf/americans-lack-of-savings...)

AnthonyMouse 8y ago

> Despite this language, actual costs for getting medical records varies widely. “Fees range very widely, from $2-55 for short records of 15 pages to $15-585 for long ones of 500 pages. Times also range widely, from 1–30 days (or longer for off-site records)” from a survey study on the topic. All of those numbers are in line with the actual costs of producing information like that. The problem scenario is the one where the company claims everything costs a zillion dollars just so they don't have to provide the information at all, which the rules appear to be successfully preventing from happening.

arkades 8y ago
Since meaningful use regulation has strong-armed almost all providers in the country into EMRs, it costs absolute pennies to provide those documents. And for most people, 500$ for a medical record is effectively zillions.
- AnthonyMouse 8y ago
  > Since meaningful use regulation has strong-armed almost all providers in the country into EMRs, it costs absolute pennies to provide those documents. The reproduction cost is not the dominant factor in processing costs. Someone has to review the information, e.g. to make sure the file actually belongs to the requesting party and some clerical error doesn't cause them to receive someone else's records, the information may be in multiple independent systems, the request may be for a subset of the information which then has to be separated out, etc. Not all of that happens all of the time, which is why it costs $2 sometimes and $500 other times. > And for most people, 500$ for a medical record is effectively zillions. $500 is <1% of the median income in the US.
  - arkades 8y ago
    What’s sad isn’t how far off you are in your conception of what the process looks like; what’s sad is that what you’re describing sounds like an entirely reasonable security effort, and it’s disappointing that it has almost no reflection in reality. 500$ is also more than the majority of Americans have in their saving accounts. (http://money.cnn.com/2017/01/12/pf/americans-lack-of-savings/index.html http://money.cnn.com/2017/01/12/pf/americans-lack-of-savings...)