Indiana Sample Letter for Request for Medical Records
Description
How to fill out Sample Letter For Request For Medical Records?
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FAQ
Yes, it is obligatory for doctors, hospitals to provide the copy of the case record or medical record to the patient or his legal representative.
Health care providers must maintain the original health records or microfilms of the records for at least 7 years.
Who can see my medical records? Anyone authorised to see your medical records has a legal, ethical and contractual duty to protect your privacy and confidentiality.
Before you write a request letter, one should know to whom the letter is addressed....Here is the simple format of the request letter:Date.Recipient Name, designation and address.Subject.Salutation (Dear Sir/Mam, Mr./Mrs./Ms.)Body of the letter.Gratitude.Closing the letter (Your's Sincerely)Your Name and Signature.
The subject line of your request should be "FOIL Request". Please inform me of the cost of providing paper copies of the following records include as much detail about the records as possible, including relevant dates, names, descriptions, etc..
Your Right to Your Medical Records According to Indiana law, charges for copying medical records may not exceed: One dollar per page for the first 10 pages. 50 cents per page for pages 11 through 50. 25 cents per page for page 51 and higher.
If the patient wrote a personal letter requesting records, make sure the following patient information was in the original request:Date of birth.Name.Social Security number.Contact information (address and phone number)Email address.Dates of service and specific records requested (tests, discharge notes, etc.)More items...
What information should be included in a patient's medical records?The initial health history and physical examination from the doctor.Consultation reports from specialists, as well as any notes.Operative reports / Medical procedure reports.More items...?
New!New! Make a request online.Make a request via MyChart.Call our Release of Information line at 317-355-5802.Email your request to ROIRequests@eCommunity.com.Fax a signed and dated request to 317-351-7728.Mail a written request to Community Health Network, Attn: HIM, 1500 North Ritter Avenue, Indianapolis, IN 46219.
