If getting medical records were as simple as asking nicely, nobody would need a retrieval service. In reality, one request can involve multiple departments, a few different provider fee schedules, and a records office that may or may not answer the phone. So by the time the records arrive, your invoice might include:
- A provider fee for copying, certifying, or sending the records, when they’re retrieved the traditional way rather than through electronic health records (EHR)
- A second provider fee if billing records come from a separate department
- A service fee from the record retrieval service that tracked it all down
While it may initially seem easier to simply combine all service and provider fees into one charge, there are several benefits to separating records, bills, and provider fee charges.
Why Separate Vendor Fees from the Provider Fee?
From improving financial transparency to creating clearer accountability, keeping fees separate makes accounting easier for your firm and provides clarity for your client. Vendor fees and provider charges come from two different sources. The question is whether your invoice shows them separately or rolls them into one total. Vendor fees, such as our $49.95 fee for medical record retrieval for lawyers, are set by the vendor. Provider charges, such as per-page copy or certification fees, are set by the provider within limits established by the state in which the provider practices. Medical records retrieval companies for lawyers do not have any control over whether the provider charges medical record fees or how much it charges. What firms can control is how those charges appear on their invoice, and that’s where separating them pays off.
Financial Transparency
A single price might look tidy on an invoice, but it prevents you from knowing how much you are being charged by vendors and providers. By keeping vendor fees and provider charges separate, you can see exactly what Records On Time charges and what the provider charges.
This makes billing errors easier to spot. It also makes it easier to itemize charges in the client’s closing statement. Nothing is buried in a single total, so you never have to guess what a charge was for.
Improved Cost Control
Separating vendor service fees and provider fees also allows for more accurate cost forecasting. Records On Time charges the same service fee for every request. Provider fees can vary depending on the state, record size, record age, and other factors. Consider this example:
| Request A | Request B | Request C | |
| Records On Time Service Fee | $49.95 | $49.95 | $49.95 |
| Provider Fee | $25.00 (short record, low-fee state) | $180.00 (long hospital record, high-fee state) | $0.00 (retrieved through EHR) |
| Total | $74.95 | $229.95 | $49.95 |
Request C shows another reason provider fees vary: when we retrieve records electronically through EHR, there are no provider fees. Provider fees apply only when records have to be retrieved the traditional way.
If vendor fees and provider fees are not separate, it appears as though our price has jumped from $74.95 per request to $229.95 per request with no notice. By separating and clearly labeling these fees, you can see that our service fee has not changed and that the higher cost is the result of the provider fees.
This provides better cost predictability because you can count on a fixed service fee and estimate provider fees based on what similar providers have charged in the past. While it is only an estimate, it will be more accurate than trying to budget based on the dramatic fluctuations of the total cost.
Clearer Auditing and Accountability
Each provider gets a separate request, which means each provider fee is already tied to that provider. This allows for clearer auditing and accountability. You can more easily track medical record fees and catch duplicate charges (such as if a provider send a bill to both the medical record retrieval service and your firm) so you don’t pay twice.
Provider fees are set by the provider, within limits capped by state law, which means they can vary between requests. The vendor’s fee doesn’t. Keeping the two separate shows exactly who charged what and avoids confusion about why one bill costs more than another.
Simpler Provider Fee Verification
Each state sets its own limits on what providers can charge for third-party requests. Fee schedules vary by state and change over time, so billing errors can happen. With provider charges listed separately, you can easily compare each one to the state’s maximum and catch any mistakes early.
Per 45 CFR § 164.524, providers can charge a reasonable, cost-based fee for a patient’s own medical records. In 2016, the U.S. Department of Health and Human Services (HHS) clarified that the HIPAA $6.50 fee is a flat fee that providers may choose to charge instead of calculating actual costs. It is not the maximum that they may charge.
In Ciox Health, LLC v. Azar (2020), a federal court ruled that patient rates, including the HIPAA patient-access $6.50 flat fee, do not apply when records are sent to a third party, such as a law firm. This means that providers can charge higher medical record fees for third-party requests, as long as they remain within any limits set by state law.
Easier Client Cost Accounting and Expense Recovery
In most contingency cases, your firm advances case costs, including record retrieval and provider fees, and is reimbursed from the client’s settlement. Because each request is tied to a specific case, and each charge is listed separately, every cost can be recorded under the right client from day one. When the case settles, you have a clear record of what was advanced, who charged it, and why.
You can pass on recoverable case expenses to your clients. Most state ethics rules, modeled on ABA Model Rule 1.5, require you to clearly state which expenses will be deducted from a client’s recovery in the contingency fee agreement. Itemized costs are easier to document as recoverable case expenses and to show in the client’s closing statement required by the same rule.
The ABA’s Formal Opinion 93-379 (1993) advises that attorneys may pass on third-party expenses only at actual cost with no markup unless the client agrees in advance. If you can’t show the actual provider charge, it’s harder to bill the client correctly. Itemized invoices make that easier.
Why Separate Medical Records From Billing Records?
So far, we’ve focused on separating medical record fees. Separating the records themselves helps, too.
Settlement demands need both medical records and billing records. But the two often come from different departments on different timelines. Tracking them separately shows exactly what’s still outstanding, so follow-up goes to the right place, and your team can start reviewing records and drafting the injury portion of the demand while the final bills are on their way. Separate tracking also ensures that you don’t send out the demand letter while something is still outstanding.
At Records On Time, you fill out one authorization form for both record types, and we track each one separately. That makes status updates clearer, so you always know what has arrived and what you’re still waiting on.
How Can Firms Compare Retrieval Vendors Using Separate Charge Categories?
Because provider charges are set by the provider within state limits, they’re generally the same no matter which vendor requests the records. By separating them, you can compare what each vendor actually charges for its own work. If a vendor rolls everything into one price, it can be hard to compare. There may also be a hidden markup when everything is rolled into one price.
How Records On Time Bills
At Records On Time, you can submit one request for medical records and medical bills, even when they go to different departments. We’ll track each independently, so you’ll always know the status of your request. You’ll always know exactly what you’re paying and why.
More importantly, we put our fees, and any provider fees, right into your CMS so you don’t need to keep track of separate invoices. If you do need an invoice for our retrieval fees, we’re happy to give you one.
If you’d like more information about our billing practices or to see a demo of how our medical record retrieval process securely delivers records directly into your case management system (CMS), contact us today.
