Dear [Medical Provider's Name], I hope this letter finds you well. I am writing to request a copy of my medical records in accordance with state and federal laws pertaining to patient access to health information. I have been a patient at your facility and I would like to obtain a complete copy of my medical records for personal reference and continuity of care purposes. As per Louisiana state regulations, specifically the Health Insurance Portability and Accountability Act (HIPAA) laws, patients have the right to access their medical records upon request. Therefore, I kindly request that you provide me with the following documents: 1. A comprehensive copy of all my medical records, including but not limited to: — Physician note— - Consultation reports — Laboratory test result— - Radiology reports (X-rays, MRIs, CT scans, etc.) — Pathology report— - Medication history — Immunization record— - Hospital admission and discharge summaries — Surgical report— - Allergies and medication lists — Any other relevant documents or reports pertaining to my medical history and treatments Please ensure that the records provided cover the entire duration of my involvement with your facility, starting from [Date of First Visit] to the present. If there are any charges associated with obtaining these medical records, kindly inform me in advance. 2. If feasible, I would appreciate it if the records could be provided to me in an electronic format, such as a secure email attachment or CD-ROM, to facilitate easy access and storage. However, if hard copies are the only available option, I am willing to cover any reasonable photocopying and postage fees. In compliance with HIPAA regulations, I understand that there may be certain exceptions to my right of access, such as psychotherapy notes or information that may be deemed harmful. However, I request that you provide a written explanation if any part of my medical records is withheld based on such exceptions. To expedite this process, please find enclosed a completed Authorization for Release of Medical Records form, which includes all the necessary information for identification and record retrieval purposes. If there are any additional forms or steps required, please let me know, and I will promptly provide any requested information. I would appreciate your attention to this matter as soon as possible. Please inform me of any expected timeline or contact me if there are any issues or concerns regarding my request. Your assistance in providing me with access to my medical records will greatly aid in managing my health and ensuring continuity of care. Thank you for your understanding and cooperation. I look forward to your positive response and a prompt resolution to this matter. Sincerely, [Your Name] [Your Contact Information]
Louisiana Sample Letter for Request for Medical Records
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How to fill out Louisiana Sample Letter For Request For Medical Records?
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FAQ
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..
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...?
Public Record Requests can be made using one of the following:ELECTRONIC- CLICK HERE. Choose "Submit a Records Request". Choose "Health Standards Request". Upon receipt, the faxed document will be forwarded to the appropriate HSS personnel for processing.
Hospitals must keep your records for 10 years from the day that you were discharged. You have a right to see, get a copy of, and amend your medical record for as long as your health care provider has it. You have the right to see your medical record. You also have the right to get a copy of your medical record.
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.
Louisiana Revised Statutes 65.1$1.00 per page for first 25 pages. $0.50 per page for pages 26-350. $0.25 per page thereafter. Handling charge of $25.00.
How to Request Your Medical Records. Most practices or facilities will ask you to fill out a form to request your medical records. This request form can usually be collected at the office or delivered by fax, postal service, or email. If the office doesn't have a form, you can write a letter to make your request.
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...
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.
