NP wants 50 bucks to send me patient records

[Atreides]

Saw a new patient this week with diagnosis of ADHD. I asked for previous records and she said she saw a psych NP. Requested records from that NP and he responded by sending me a request for $50. Said he'd send the records when I send the check.

Am I crazy or is this highly atypical? I know you can charge patients $0.25 per page (at least in California) for their records but I've never been asked to pay to get patient records from another provider.

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[PikminOC]

Saw a new patient this week with diagnosis of ADHD. I asked for previous records and she said she saw a psych NP. Requested records from that NP and he responded by sending me a request for $50. Said he'd send the records when I send the check.

Am I crazy or is this highly atypical? I know you can charge patients $0.25 per page (at least in California) for their records but I've never been asked to pay to get patient records from another provider.

One time a therapist pulled this with me. I told her I'd have the patient pay for it. She was unhappy. I ended up reporting her to her board. And they got me the records for free.

 

[splik]

It is always unacceptable to charge to send records to another clinician (as opposed to lawyers etc). That said, there is no law in california that prevents them for charging and the boards are not interested in this. But you should have the patient pay the NP directly or better still, contact them requesting their records. The patient can leave them a bad review if they charge them for this. Also, if the pt requests it, they have to provide them within 15 days. I actually always have patients request records themselves. much simpler.

 

[allantois]

What do you think you'll find in NP records? lol

The request is absolutely absurd

 

[dantt]

What do you think you'll find in NP records? lol

The request is absolutely absurd

I was recently told you can charge/have to pay in texas as long as it's not an emergency.

 

[TexasPhysician]

You absolutely CAN charge for records in my state. There is no requirement to work for free. That said, very few practices charge this for patients and even fewer for other clinics. In my opinion, it is free marketing for other clinicians to see my name everywhere.

I always charge if these requests are from life insurance, disability, or there are multiple requests in a short period.

 

[WisNeuro]

Yes, many states allow this, but they'll often have some guardrails put up. E.g., X per page, and so much for time spent.

 

[WisNeuro]

To join with @TexasPhysician , I have never charged records fees to other providers. I use e-fax, so I can literally do this in about 30 seconds paper-free. And, as said, it's good to have your name around as a provider on their minds for referrals, though most of us don't need much help in that department. If records need to be sent to lawyers, insurance, disability, sure, I'll charge at that point.

 

[docksan]

I would laugh if they dared ask me for that much money for records. This isn't the 80s.

 

[Stagg737]

Ridiculous and frankly pathetic. If they're trying to charge that much to send records I feel like that says a lot more about their character and/or quality of their practice than anything. Unless he's sending you 20 years worth of records and that's the per page cost, imo that's unethical.

 

[Candidate2017]

Medical records belong to the patient, who may be required to pay a reasonable fee to have them copied or sent. But these are nursing records, as they are generated by a nurse. As far as I know, there are no laws regulating nursing records. So, there we go. NPs for the win once again, yay!

 

[WisNeuro]

OP

Medical records belong to the patient, who may be required to pay a reasonable fee to have them copied or sent. But these are nursing records, as they are generated by a nurse. As far as I know, there are no laws regulating nursing records. So, there we go. NPs for the win once again, yay!

Pretty sure these would be categorized under regular healthcare records in most, if not all states.

 

[whopper]

It's completely legal in most states to have a fee for records. Trust me. If you own your own office and your patient wants a few hundred pages of records heck yes it's completely fair for you to charge the patient especially given those hundreds of pages are going to be at least $20 of paper and ink not to mention about $20 of your assistant's time and effort. I generally will not charge if I could easily send the patient's records within a few keystrokes of using the EHR but if it's paper, then heck yes I will charge.

Now all that said there's state guidelines (often times and depending on the state) on how much you're allowed to charge.

Nursing records legally would be the same as any medical records.

If the patient owes the office money and they request records that will be charged, the office could always say they're not going to send it out unless all expenses owed are paid.

State-by-State Guide of Medical Record Copying Fees | MediCopy

The Omnibus Rule, effective September 23rd, 2013, allows for the identification of labor costs for copying PHI, whether in paper or electronic form, which can include a reasonable cost-based fee for time spent creating and copying the file, defined by Federal Law and vary state by state. Read on...

medicopy.net

 

[annoyedpsychiatrist]

would reply by sending him a bill for the time you spent reading his stupid request

 

[erg923]

My opinion is that is that there are certain things that are not captured in billable work and ethics code that separate healthcare professionals from lawyers, accountants, etc. Not everything you do is a money making venture.

I think one should just suck it up, frankly. Optimize the process and maybe charge a "processing" fee? But charging "per page" or 50 bucks to another healthcare provider who is just trying to work with you and/or the patient?! Absolutely ridiculous! Headaches all around. Delays and risk going around there too.

 

[Atreides]

It's completely legal in most states to have a fee for records. Trust me. If you own your own office and your patient wants a few hundred pages of records heck yes it's completely fair for you to charge the patient especially given those hundreds of pages are going to be at least $20 of paper and ink not to mention about $20 of your assistant's time and effort. I generally will not charge if I could easily send the patient's records within a few keystrokes of using the EHR but if it's paper, then heck yes I will charge.

Why on earth would I request paper records? It probably took him longer to type up this idiotic request and fax it to me than it would have to export his former patient's chart and fax/email it to me.

I would laugh if they dared ask me for that much money for records. This isn't the 80s.

I just sent a fax back, "Lol, are you kidding me?" Not very professional but whatever.

What do you think you'll find in NP records? lol

Lack of a proper ADHD evaluation. Patient wants to be continued on stimulants, I told her that I would need to review the ADHD evaluation she already had and if the evaluation is not convincing, we would need to start with scratch for the diagnosis.

 

[erg923]

Why on earth would I request paper records? It probably took him longer to type up this idiotic request and fax it to me than it would have to export his former patient's chart and fax/email it to me.



I just sent a fax back, "Lol, are you kidding me?" Not very professional but whatever.



Lack of a proper ADHD evaluation. Patient wants to be continued on stimulants, I told her that I would need to review the ADHD evaluation she already had and if the evaluation is not convincing, we would need to start with scratch for the diagnosis.

I would further challenge the NP on standards of care followed for evaluating this diagnosis in this patient. Records, collateral informant, teacher reports if applicable, standardized behavioral/symptoms rating scales for the diagnosis (of which are a dozen or so, many free/open).

 

[whopper]

My opinion is that is that there are just certain things that are not captured in our billable work and ethics code that separate healthcare professionals from lawyers, accountants, etc.

In many patient portals the patient if they made an account can download the records for free. I always tell the patient they have that option. Despite this less than 5% of my patients actually make the patient portal account when the invite is sent to their e-mail.

Look up the cost of records in the link I provided. If the cost is supposed to be under $50 you can report this NP to the state medical board.

 

[allantois]

In many patient portals the patient if they made an account can download the records for free. I always tell the patient they have that option. Despite this less than 5% of my patients actually make the patient portal account when the invite is sent to their e-mail.

Look up the cost of records in the link I provided. If the cost is supposed to be under $50 you can report this NP to the state medical board.

nursing board

 

[the5thelement]

In the land of End Stage Capitalism, profits soared while fairness took a spasm.

 

[docksan]

nursing board

Some state medical boards govern NPs and PAs under the same umbrella as physicians.

 

[VA Hopeful Dr]

Some state medical boards govern NPs and PAs under the same umbrella as physicians.

Man that must be nice

 

[hallowmann]

Yeah that's ridiculous. I would tell the patient that the NP is requiring $50 for processing of medical records, and that she should rather request the records herself and bring them to you. Be sure to emphasize that its highly unusual for another clinic to charge for transmission of medical records for the sake of continuity of care. Alternatively, if she gets charged the same and refuses, then you can just start over with the diagnosis and make it clear this is because NP is not providing continuity of care.

Some state medical boards govern NPs and PAs under the same umbrella as physicians.

Most (all?) states govern PAs under the medical boards, but most states have nursing boards that also govern NPs. Which states actually govern NPs under the medical board?