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Whose Tests Are They??

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What is the name of your state (only U.S. law)? California
I hope this question is posted in the right forum, I was unsure.
My physician recently sent me to the lab for some blood tests. I recently heard that one should always request a copy of your medical test results for your own records. When I called my doctors office they told me that I would have to pay 45.00 to them for their time if I wanted a copy of them. Aren't they MY test results? I contacted the physiscians network my doctor belongs to and they agreed this was an excessive amount.
Is my do Doctor legally allowed to charge me for my own test results? Do I as a patient have any other options short of changing doctors?

Thanks, Debbie :confused:
 


lya

Senior Member
Is my do Doctor legally allowed to charge me for my own test results?
confused:
Yep.

Contact the Office of Civil Rights for your state and they can tell you how much is allowed for record copying fees. You can make initial contact with the OCR through the HIPAA website.

$45 does seem excessive.
 

ecmst12

Senior Member
They're only supposed to charge you a REASONABLE copying charge, the cost of ink/paper, not for their time.

You COULD try contacting the lab directly to request a copy.
 
Certainly, they can charge just for what you said their "service", or materials. Who they belong to is irrelevant. They can just consider it a service to provide them. I went through this many time while on disability having to pay fee's for the notes from each exam. The notes where a little cheaper than having them fill out disability continuance paper work, and luckily my disability provider would take either because they can be quite costly, and insurance does not cover them either.


oops, I forgot to mention that I do agree however that 45 bucks is a bit high I'd be a little ticked too. I only had to pay 10 bucks, or 15 I needed to have them fill out disability paperwork. That on top of my co-pay made it hard for me to get them sometimes, so I see your point on how steep it is for them to do a very limited amount of facsimile.
 
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lealea1005

Senior Member
The records belong to the Physician. You are entitled to a copy and, yes, they are permitted to charge a fee. Each state has their own fee schedule. Usually there is a fee for the Physician to review your records, a per page fee for the copies, & the postage. I also agree that $45 is a bit excessive to copy one date of service's lab test....or were you requesting copies of labs from several dates of service?
 
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justalayman

Senior Member
as others have stated, $45 is too much.

To eliminate this problem in the future, when you go to a lab, request they provide you with a copy of the tests along with a copy to the doc. I have several docs and have pertinent tests sent to each of the doctors that may have use of them as well as a copy to me. The labs I use do not charge anything extra for this.
 
The records belong to the Physician. You are entitled to a copy and, yes, they are permitted to charge a fee. Each state has their own fee schedule. Usually there is a fee for the Physician to review your records, a per page fee for the copies, & the postage. I also agree that $45 is a bit excessive to copy one date of service's lab test....or were you requesting copies of labs from several dates of service?
How do I find out what the fee schedule is for my state ? I contacted the lab directly and was told in California they can not legally give me my results it has to go through the physician. They also thought 45.00 was excessive for a two page lab result.
All I want is a copy for my own records..... ugh !!:(
 

justalayman

Senior Member
I contacted the lab directly and was told in California they can not legally give me my results it has to go through the physician.
!!:(
With all the pro consumer laws out there and they do this to you? What a shame especially since the patient is paying for the service, not the doctor.

well, here is the applicable statute concerning charges for med records:

(b) Additionally, any patient or patient's representative shall be
entitled to copies of all or any portion of the patient records that
he or she has a right to inspect, upon presenting a written request
to the health care provider specifying the records to be copied,
together with a fee to defray the cost of copying, that shall not
exceed twenty-five cents ($0.25) per page or fifty cents ($0.50) per
page for records that are copied from microfilm and any additional
reasonable clerical costs incurred in making the records available.
The health care provider shall ensure that the copies are transmitted
within 15 days after receiving the written request.
and the entire statute:

WAIS Document Retrieval

must those "reasonable" clerical costs that run it up to $45.

Now here is a statute that is interesting:

123148. (a) Notwithstanding any other provision of law, a health
care professional at whose request a test is performed shall provide
or arrange for the provision of the results of a clinical laboratory
test to the patient who is the subject of the test if so requested by
the patient, in oral or written form. The results shall be conveyed
in plain language and in oral or written form, except the results
may be conveyed in electronic form if requested by the patient
and if
deemed most appropriate by the health care professional who
requested the test.
(b) (1) Consent of the patient to receive his or her laboratory
results by Internet posting or other electronic means shall be
obtained in a manner consistent with the requirements of Section
56.10 or 56.11 of the Civil Code. In the event that a health care
professional arranges for the provision of test results by Internet
posting or other electronic manner, the results shall be delivered to
a patient in a reasonable time period, but only after the results
have been reviewed by the health care professional. Access to
clinical laboratory test results shall be restricted by the use of a
secure personal identification number when the results are delivered
to a patient by Internet posting or other electronic manner.
(2) Nothing in paragraph (1) shall prohibit direct communication
by Internet posting or the use of other electronic means to convey
clinical laboratory test results by a treating health care
professional who ordered the test for his or her patient or by a
health care professional acting on behalf of, or with the
authorization of, the treating health care professional who ordered
the test.
(c) When a patient requests to receive his or her laboratory test
results by Internet posting, the health care professional shall
advise the patient of any charges that may be assessed directly to
the patient or insurer for the service and that the patient may call
the health care professional for a more detailed explanation of the
laboratory test results when delivered.

(d) The electronic provision of test results under this section
shall be in accordance with any applicable federal law governing
privacy and security of electronic personal health records. However,
any state statute, if enacted, that governs privacy and security of
electronic personal health records, shall apply to test results under
this section and shall prevail over federal law if federal law
permits.
(e) The test results to be reported to the patient pursuant to
this section shall be recorded in the patient's medical record, and
shall be reported to the patient within a reasonable time period
after the test results are received at the offices of the health care
professional who requested the test.
(f) Notwithstanding subdivisions (a) and (b), none of the
following clinical laboratory test results and any other related
results shall be conveyed to a patient by Internet posting or other
electronic means:
(1) HIV antibody test.
(2) Presence of antigens indicating a hepatitis infection.
(3) Abusing the use of drugs.
(4) Test results related to routinely processed tissues, including
skin biopsies, Pap smear tests, products of conception, and bone
marrow aspirations for morphological evaluation, if they reveal a
malignancy.
(g) Patient identifiable test results and health information that
have been provided under this section shall not be used for any
commercial purpose without the consent of the patient, obtained in a
manner consistent with the requirements of Section 56.11 of the Civil
Code.
(h) Any third party to whom laboratory test results are disclosed
pursuant to this section shall be deemed a provider of administrative
services, as that term is used in paragraph (3) of subdivision (c)
of Section 56.10 of the Civil Code, and shall be subject to all
limitations and penalties applicable to that section.
(i) A patient may not be required to pay any cost, or be charged
any fee, for electing to receive his or her laboratory results in any
manner other than by Internet posting or other electronic form.

(j) A patient or his or her physician may revoke any consent
provided under this section at any time and without penalty, except
to the extent that action has been taken in reliance on that consent.
a snippet from a website (http://www.medbd.ca.gov/consumer/complaint_info_questions_records.html#4) concerning this:

Health and Safety Code section 123148 requires the health care professional who requested the test be performed to provide a copy of the results to the patient, if requested either orally or in writing. When the patient requests his/her lab results, the health care provider should provide the results to the patient within a "reasonable" time period after the results are received by the provider. Depending on the results of the tests, some physicians may want the patient to schedule an appointment to review and discuss the results and any follow-up testing or treatment that might be required. The test results cannot be released by the lab performing the test and must be released by the provider requesting the test(s).
Not sure but the way I read that is; when you have a test performed, the doctor is required to provide you with the results, in one of several forms of your choice. I read it as this is at no charge. Where I see the charges is when you are requesting a copy of records already within your file.

For a better and more accurate explanation I believe I would contact the Medical Board of California, Department of Consumer Affairs.
 
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lealea1005

Senior Member
With all the pro consumer laws out there and they do this to you? What a shame especially since the patient is paying for the service, not the doctor.


A lay person may not be able to properly interpret the lab results. The ordering Physician is responsible for properly interpreting and reporting the findings and recommendations to the patient. He/she knows why the test(s) are being ordered, and is able to see the "big picture" with regard to the patient's health. I've seen patients both ingore potentially dangerous lab findings and flip out over a finding that means nothing before the Doc reviewed the labs with them.

As for the copies, I agree that a copy of the results should be offered to the patient at no charge at the time of report or office visit (we usually give them 48-72 hours from report of findings). IMHO, once the patient's chart is filed, it is reasonable to expect a nominal charge. The chart has to be pulled again and the Physician reviews the request and labs again (especially if the labs are older), pays an employee to copy the requested paperwork and refile the chart.
 
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You Are Guilty

Senior Member
One correction. This section:
(i) A patient may not be required to pay any cost, or be charged
any fee, for electing to receive his or her laboratory results in any
manner other than by Internet posting or other electronic form.
merely states that the doc can't charge (another) fee for choosing to get your copies via snail mail, as opposed to via email. This section does not say that they have to provide it via email/fax for free.

However, you ought to be able to find some help from these folks. $45 is ridiculous.
http://www.mbc.ca.gov/forms/07I-61.pdf

See, also:
http://www.mbc.ca.gov/consumer/complaint_info_questions_records.html#3
 

justalayman

Senior Member
One correction. This section:

merely states that the doc can't charge (another) fee for choosing to get your copies via snail mail, as opposed to via email. This section does not say that they have to provide it via email/fax for free.

However, you ought to be able to find some help from these folks. $45 is ridiculous.
http://www.mbc.ca.gov/forms/07I-61.pdf

See, also:
Welcome to the Medical Board of California - Medical Records Frequently Asked Questions
agreed and not arguing that point BUT as I read the statutes as a whole, the doc MUST provide a copy of the results to the patient in one of several forms of media at the patients discretion. Since this appears to be a part of the actual test (administrative duties), I cannot see how an additional charge would be appropriate. IF it is a chargeable task, I would see it as part of the test and should be included in the total charge for the tests, not a separate process charge. Administrative costs are built into office calls and typically all regular actions within a doctors office. You don't pay $25 to talk with the receptionist, do you? I can see no need or reason to separate out the charges for a copy of the test results that must be provided to the patient.

I also suggested contacting the California med board, consumer affairs division as it, to me at least, is not totally clear that it is allowed to charge for the initial test results as they are required to be provided to the patient.

lealea1005 : A lay person may not be able to properly interpret the lab results
In many cases, you are totally correct. Even if one is able to determine if a result is within normal parameters, there is a totality of the results that often play into other information and the doctors diagnostic procedures in determining the patients malady. Regardless of that fact, I believe all patients should have total access to their results with no restrictions. After all, it is their own body that is of concern, not the doctors. On top of everything else, since the doctor has no requirement to provide the results to another med pro, it could make a second opinion much more work, and depending on what tests are involved, impossible, should the initial doc refuse to forward the results.

Often (usually) insurance will not pay for a duplicate test merely for a second opinion. They expect the test results to be able to be viewed by a second practitioner rather than have new tests performed.

On top of that, I like seeing my test results. I often see things that some doctors would not be concerned with. While not a med pro in any way, I do understand a lot of what is going on within me. I actually requested a specific test to be done that resulted in a diagnosis after 8-10 doctors over a period of 15 or so years failed to see.

In the hands of a hypochondriac, the internet can be a bad thing. In the hands of a reasonably intelligent patient, it can be salvation.
 
All of your points are well taken.
Ironically, the reason I requested a copy of my tests for my own record was on the advice of an attorney speaking on one of the major news broadcasts.
They simply stated it is always wise to request a copy of any test results like blood work etc.
I had NO idea it would be such an issue.
I am using all the advice I have been provided here to follow up.
Keep you posted.

Debbie
 

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