Copy Requests and Charges for PHI APPLICABILITY: I. Description

COPY

Current Status: Active PolicyStat ID: 7944396

Origination: 07/2018

Effective: 06/2020

Last Approved: 06/2020

Last Revised: 06/2020

Next Review: 06/2023

Owner: David Behinfar: HCS Exec

Dir Privacy

Policy Area: HIPAA - Privacy

Policy Tag Groups:

Applicability: UNCHCS - All except

Pardee

Copy Requests and Charges for PHI

APPLICABILITY:

✓ UNC Health Care System / UNC Medical Center* ✓ Johnston Health

✓ UNC Physicians Network ✓ Lenoir Memorial Hospital

✓ UNC Physicians Network Group Practices / UNC Physicians

Group Practices II

Margaret R. Pardee Memorial

Hospital

✓ Rex Healthcare / Rex Hospital ✓ Nash Healthcare System/Nash

Hospitals

✓ Chatham Hospital ✓ Wayne Memorial Hospital

✓ Caldwell Memorial Hospital

✓ UNC Rockingham Health Care / UNC Rockingham Hospital

I. Description

II. Policy

A. Cost-based Fees for Copies of PHI

This policy applies to the following entities (collectively referred to as "UNC Health" in this policy):

*UNC Medical Center includes all UNC Hospitals' facilities and the clinical patient care programs of

the School of Medicine of UNC-Chapel Hill (including UNC Faculty Physicians).

UNC Health shall uphold the right of patients, or their authorized representatives, to examine and obtain

copies of their medical records, including an electronic copy if the medical record is an electronic health

record.

Included within the scope of this policy are the patient care programs of the UNC School of Medicine (UNC

SOM). As a result, this policy shall apply to all UNC SOM personnel, including but not limited to faculty, staff,

students, trainees, interns and volunteers who may be full-time, part-time, paid or unpaid who create, store,

transmit, access or use any patient information in support of clinical purposes for UNC Health or any other

healthcare entity.

Copy Requests and Charges for PHI. Retrieved 11/2021. Official copy at http://unchealthcare.policystat.com/policy/7944396/.

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If a patient or authorized representative makes a request for a copy of all or part of the medical record,

UNC Health may charge the patient or authorized representative a reasonable, cost-based fee.

A reasonable, cost-based fee is subject to applicable state law limitations and may include only the costs

of: (1) labor for copying the PHI, whether in paper or electronic form; (2) supplies for creating the paper

copy or electronic media, if the individual requests that the electronic copy be provided on portable media;

(3) postage, when the individual requests that the copy, or the summary or explanation, be mailed; and

(4) preparation of an explanation or summary of the PHI, if agreed to by the individual. This fee may not

include costs associated with verification; documentation; searching for and retrieving the PHI;

maintaining systems; recouping capital for data access, storage, or infrastructure; or other costs not listed

above even if such costs are authorized by state law.

Alternatively, UNC Health may charge a flat fee for such requests of no more than $6.50.

B. Permissible Copy Charges

Sample of permissible UNC Health charges for providing copies of PHI to patients/legal guardians as

follows:

Patient and Patient Directive Requests

◦ Electronic to electronic (CD/USB/Portal):

$6.50 flat fee

◦ Hybrid (paper AND electronic) to electronic:

$6.50 flat fee for the portion of the record maintained electronically

Plus $0.07 per page representing average labor cost to create and deliver the portion of the record

maintained in paper for a standard request

Plus sales tax as applicable

◦ Paper to electronic:

$0.07 per page representing average labor cost to create and deliver the portion of the record

maintained in paper

Plus sales tax as applicable

◦ Electronic to paper:

$0.90 representing average labor cost to create and deliver the portion of record maintained

electronically

Plus $0.05 per page for supplies (paper and toner)

Plus actual postage if mailed

Plus sales tax as applicable

◦ Hybrid (paper AND electronic) to electronic:

$0.07 per page representing average labor cost to create and deliver the portion of the record

maintained in paper

Plus, if applicable, $0.90 representing average labor cost to create and deliver the portion of record

maintained electronically

Copy Requests and Charges for PHI. Retrieved 11/2021. Official copy at http://unchealthcare.policystat.com/policy/7944396/.

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Plus $0.05 per page for supplies (paper and toner)

Plus actual postage if mailed

Plus sales tax as applicable

◦ Paper to paper:

$0.07 per page representing average labor cost to create and deliver for a standard request

Plus $0.05 per page for supplies (paper and toner)

Plus actual postage if mailed

Plus sales tax as applicable

C. Fees for Copies of PHI for Workers Compensation

With respect to claims for Worker's Compensation, UNC Health may charge the fees set forth under the

current North Carolina Industrial Commission fee schedule.

D. Fees Associated with a UNC Health Medical Lien

With respect to claims for which UNC Health is seeking a medical lien for payment of services rendered

on any award the patient may receive, a copy of the medical record should be provided to the patient or

the patient's attorney free of charge.

E. Cost Estimate to be Provided to the Patient

UNC Health should inform the patient or authorized representative of the approximate fee that may be

charged for the requested copy at the time that details of the form and format of the requested copy are

being negotiated or arranged, in advance of providing a copy.

F. When Fees for Copying PHI Should be Waived

UNC Health should not charge a fee where doing so would impede the ability of an individual to access or

obtain copies of his/her PHI. A fee will not be imposed for providing the medical record for or to a

medically indigent patient. A patient or authorized representative may be required to provide proof that the

patient is medically indigent. A medically indigent patient, or authorized representative representing a

medically indigent patient, is limited to receiving one (1) set of copies at no charge. Any additional

requests for the same medical record within a six (6) month time frame shall be subject to the fee

provision.

III. Definitions

IV. References

Electronic Health Record – means an electronic record of health-related information on an individual that is

created, gathered, managed, and consulted by authorized health care clinicians and staff.

45 C.F.R. § 164.524(c)(4)

OCR Guidance, "Individuals' Right under HIPAA to Access their Health Information"

N.C. Gen. Stat. §§ 90-411, 97-26.

Copy Requests and Charges for PHI. Retrieved 11/2021. Official copy at http://unchealthcare.policystat.com/policy/7944396/.

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V. Related Policies/Forms

Attachments

No Attachments

Approval Signatures

Step Description Approver Date

Jerylyn Williams: Chief Audit & Compliance Ofcr 06/2020

SYSTEM Site Administrator Emilie Hendee: HCS Attorney Sr 06/2020

David Behinfar: HCS Exec Dir Privacy 06/2020

Applicability

Caldwell Memorial Hospital, Chatham Hospital, Johnston Health, Nash UNC Health Care, UNC Health Care

System, UNC Lenoir Health Care, UNC Medical Center, UNC Physicians Network, UNC Rex Healthcare, UNC

Rockingham Health Care, Wayne Memorial Hospital

UNC Health Patient Right to Access to Inspect and Obtain a Copy of PHI Policy

Copy Requests and Charges for PHI. Retrieved 11/2021. Official copy at http://unchealthcare.policystat.com/policy/7944396/.

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