How to Charge Patients for Copies of their Medical Images, According to HIPAA

Posted by Tilden Bowditch on Jul 10, 2019 10:32:00 AM

If you've been following our blog, you know by now that providing patients with electronic access to their medical images is much cheaper and more efficient than burning and delivering a CD. Giving patients online access to their images also brings many additional marketing benefits for your practice and easier access for your patients. However, there's still a cost for this service, though minimal in comparison to providing CDs. In either case, an increasing number of providers are integrating a HIPAA prescribed cost-based fee to help cover the expenses incurred by providing patients with copies of their images.

But how much can you charge for this service? HIPAA makes the guidelines pretty simple while also giving you some flexibility to choose what works best for you and your practice.

According to HIPAA’s Privacy Rule, providers can charge patients to help cover the costs of sharing images, regardless of the way they are delivered. Certain restrictions ensure this fee covers the actual cost of materials and labor used.

Here are three ways to determine how much you can charge your patient for this service, according to HIPAA:
  1. Charge the actual cost of providing the image to the patient.

    Offset the actual cost incurred to copy and mail the images to your patient. This may include the time and materials required to accomplish this task.

  2. Take the average of these costs across the practice.

    You can tally up the average of the costs incurred across your practice for providing medical image copies to patients, and use this number as the standard patient fee, disregarding the specific cost for each patient.

  3. Use a flat fee (or "safe harbor" fee) not to exceed $6.50 per study.

    For electronic access to medical records, rather than doing the math and tallying up the actual costs, you can simply charge any fee up to $6.50 per study.

What if my state has a different fee regulation?

States may have their own fee regulations or allowances, which you will need to consider depending on where you practice. If the patient fee allowances prescribed by your state are higher than those set forth by HIPAA, HIPAA’s restrictions override the state rule. If your state subscribes that each patient receives one free copy of their medical images, you must comply. Basically, a good rule of thumb is that HIPAA does not override any State law that gives the patient greater or cheaper access to their health information.

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What can be included in this cost?

  • Labor for copying the PHI (medical images) requested by the individual, whether in paper or electronic form
  • Supplies for creating the paper copy or electronic media (e.g., CD or USB drive) if the individual requests that the electronic copy be provided on portable media
  • Postage, when the individual requests that the copy, or the summary or explanation, be mailed to them
  • Preparation of an explanation or summary of the PHI, if agreed to by the individual

What may not be factored into the fee?

There are certain aspects you may not include in the fee, including any costs associated with:

  • Verification of the medical imaging data
  • Searching for and retrieving the data
  • Maintaining systems associated with this process
  • Recouping capital for data access, storage or infrastructure
  • other costs not listed above (even if these costs are authorized by the State)

Thanks to these guidelines, providers can become more comfortable integrating a patient-based fee to help cover the costs associated with patient imaging. This fee has the potential to offset increasing costs that may invisibly be reducing the practice's profitability.

When providing copies of medical images to patients electronically, Purview offers flexible options to ease the burden and cost of this necessary administrative task. Contact us to learn how this could work for your practice.

Topics: patient medical images, patient access, HIPAA,

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