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Under HIPAA, an individual has the right to request their protected health information. This right is granted to patients, allowing them to access and review their medical records.
You can request your protected health information from your healthcare provider or health plan, and they are required to provide it to you within 30 days. This includes medical records, test results, and any other information related to your care.
The request must be in writing and can be made in person, by mail, or electronically. Your healthcare provider or health plan must respond to your request within the specified timeframe.
You can also request a copy of your protected health information, which can be provided in a format of your choice, such as paper or electronic.
Right to Access Own Health Record
Under HIPAA, an individual has the right to request access to their own health record, which includes a wide range of information.
You have the right to access, inspect and receive a copy of your protected health information (PHI) in the Covered Component's Designated Record Set, except in limited circumstances.
To request access, you don't need to write a formal letter, but it's recommended to use a written request on the approved Authorization form to ensure you get the information you want in a timely manner.
If you request a copy of your complete medical records, the Covered Component should refer to its Designated Record Set procedure to ensure disclosure of all documents subject to disclosure.
Other requests should be fulfilled as soon as practicable, but if the Covered Component is unable to provide the requested records or respond to the request within 30 days, they must contact the BU HIPAA Privacy Officer.
You have the right to request your records in the format you prefer, and the Covered Component should accommodate this request if reasonably possible. If not, they will contact the BU HIPAA Privacy Officer for guidance.
Here are some examples of records that are subject to the right of access:
- Medical records
- Billing and payment records
- Insurance information
- Clinical laboratory test results
- Medical images (such as X-rays)
- Wellness and disease management program files
- Clinical case notes
- Decisions about individuals
The Covered Component may not charge a fee for electronic copies, but may charge a flat fee of $6 for unusual requests. For paper copies, they may charge reasonable fees based on labor and supply costs.
You have the right to inspect your records rather than receiving a copy, and the Covered Component should arrange for a mutually convenient time and place for you to do so.
Grounds for Denial
Under HIPAA, an individual has the right to request access to their medical records. However, there are certain grounds for denial that are subject to review by a licensed healthcare professional.
Denials of access are made by a licensed health care professional who has determined that the access requested is likely to endanger the life or physical safety of the individual or others.
The Covered Component and BU HIPAA Privacy Officer must notify the individual in writing of the denial, including an explanation/reason for the denial and a statement of the individual's rights.
If a licensed health care professional determines that PHI makes reference to another person (unless such other person is a health care provider), and providing access to that information is reasonably likely to cause substantial harm to such other person, the request for access can be denied.
Denials of requests for access made by the individual's personal representative are also subject to certain conditions. If a licensed health care professional determines that providing access to such personal representative is reasonably likely to cause substantial harm to the individual or another person, the request for access can be denied.
Here are the grounds for denial under HIPAA:
- Denials made by a licensed health care professional who has determined that the access requested is likely to endanger the life or physical safety of the individual or others;
- PHI that makes reference to another person (unless such other person is a health care provider) and a licensed health care professional has determined, in the exercise of professional judgment, that the patient’s access to that information is reasonably likely to cause substantial harm to such other person;
- Denial of a request for access made by the individual’s personal representative when a licensed health care professional has determined, in the exercise of professional judgment, that the provision of access to such personal representative is reasonably likely to cause substantial harm to the individual or another person.
Request Process
To request access to your medical records, you can submit a written request to your healthcare provider. This can be done in person, by mail, or through an online portal if available.
Your request should include your name, date of birth, and any other identifying information to help your provider locate your records. This is to ensure that your request is processed accurately and efficiently.
A request for access to your medical records can be made at any time, and there is no specific timeframe for when you can request access. However, your provider may need some time to gather and prepare your records for you to review.
Your request should be submitted to the person or department responsible for handling medical records at your healthcare provider's office. This is usually the health information management (HIM) department.
Accounting
Under HIPAA, an individual has the right to request an Accounting of disclosures of their health information, which includes disclosures made without their authorization within the past 6 years.
You can request an Accounting in writing to the Covered Component, using the "Request for an Accounting of Disclosures" form or providing substantially the same information in another writing.
The Covered Component must respond within 60 days of the request, providing an Accounting in writing that includes the date of disclosure, receiving party and address, description of PHI disclosed, purpose of the disclosure, and number of times the disclosure was made.
Disclosures included in an Accounting are those made for public health reporting, government entities or law enforcement, research purposes, treatment, payment or health care operations, and more.
Here are some examples of disclosures that are included in an Accounting:
- Disclosures made for public health reporting;
- Disclosures made to government entities or law enforcement;
- Disclosures for Research purposes;
- Disclosures for treatment, payment or health care operations;
- Disclosures made to the individual (or authorized personal representative of the individual) who is the subject of the PHI;
- Disclosures made pursuant to a valid Authorization.
The Covered Component may extend the time to provide the Accounting by an additional 30 days if it appears that the Accounting may take longer than 60 days.
You have the right to request an Accounting of disclosures of your health information, and the Covered Component must provide it to you in writing within 60 days of your request.
Secure Communication
Under HIPAA, individuals have the right to request confidential and alternate modes of communication. This means they can ask for a change in how they receive communications from healthcare providers.
If an individual wants to receive bills about a particular procedure at a P.O. Box instead of their home address, the Covered Component must consider this request and make reasonable attempts to accommodate it.
The Covered Component should not agree to any request it cannot reasonably implement. Before denying any such request, the Covered Component’s HIPAA Contact must consult with the BU HIPAA Officers.
The individual will be informed of the decision to accept or deny their request. If a Business Associate of the Covered Component may communicate with the individual, the Covered Component must inform that Business Associate.
Examples of alternate communication requests include:
- Patient bills sent to a P.O. Box instead of home
- No phone calls to a cell phone, instead secure email
Patient Access to Medical Records
As an individual, you have the right to access your medical records under HIPAA. This right allows you to request a copy of your protected health information (PHI) from your healthcare provider or health plan.
To request access, you don't need to submit a written request, but it's recommended to use a written request on the approved Authorization form to ensure you receive the correct information in a timely manner.
You can request access to your medical records in person or through a written request. If you request inspection of the records rather than a copy, your healthcare provider will arrange a mutually convenient time and place for you to inspect the designated record set.
Your healthcare provider may provide a summary or explanation of your PHI in lieu of providing access to the PHI, but only if you agree in advance to the summary and any fees imposed.
You have the right to request your medical records in the format you prefer, and your healthcare provider will try to accommodate your request. If they are unable to provide the records in the format you prefer, they will contact the BU HIPAA Security Officer for guidance.
Here are some examples of records that are subject to the right of access:
- Medical records
- Billing and payment records
- Insurance information
- Clinical laboratory test results
- Medical images (such as X-rays)
- Wellness and disease management program files
- Clinical case notes
- Decisions about individuals
Your healthcare provider is not required to create new information that does not already exist in the designated record set. They must provide you with access to the PHI in the designated record set, which includes medical records and billing records about you maintained by or for your healthcare provider.
If your healthcare provider is unable to provide the requested records or respond to your request within 30 days, they must contact the BU HIPAA Privacy Officer and provide you with written notification of the reasons for the delay and the expected date of fulfilling the request.
No fee may be charged to you if you request your record for the purpose of supporting a claim or appeal under any provision of the Social Security Act or any federal or state financial needs-based benefit program. If your healthcare provider charges a fee for other copies, it must be reasonable and based on the labor and supply costs of copying.
HIPAA Scope and Exclusions
Under HIPAA, an individual has the right to request access to their protected health information (PHI) for as long as it's maintained by a covered entity or its business associate.
This right includes the ability to inspect or obtain a copy of their PHI, or both, and to direct the covered entity to transmit a copy to a designated person or entity.
The scope of this right is quite broad, and it doesn't matter where the information was created, whether it's maintained in paper or electronic systems, or where it originated.
In fact, individuals have a HIPAA right of access to their PHI regardless of the date it was created, which means they can request access to information from years ago.
Two categories of information are specifically excluded from this right of access: psychotherapy notes and information compiled in anticipation of or for use in a civil, criminal, or administrative action or proceeding.
Here are the excluded categories:
- Psychotherapy notes
- Information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding
Psychotherapy notes are personal notes of a mental health care provider documenting or analyzing the contents of a counseling session, and they're maintained separate from the rest of the patient's medical record.
This exclusion is in place to protect sensitive and confidential information that's not typically shared with patients.
Frequently Asked Questions
Does an individual have a right to request a change to information in their PHI?
Yes, individuals have the right to request changes to their protected health information (PHI) under the Privacy Rule. This right is based on the Correction Principle in the Privacy and Security Framework.
Sources
- https://www.bu.edu/policies/hipaa-individual-rights/
- https://www.clarkhill.com/news-events/news/hhs-ocr-proposes-updates-to-the-hipaa-security-rule-to-respond-to-emerging-threats/
- https://www.hopkinsmedicine.org/institutional-review-board/hipaa-research/faq-research
- https://compliancy-group.com/hipaa-right-of-access/
- https://www.healthit.gov/topic/privacy-security-and-hipaa/your-health-information-rights
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