|Electronic Copies||$6.50 Flat Fee|
|Access to Medfusion Patient Portal||Free|
|Copies of Images and/or Disks||$10.00/Disk|
|Affidavit or Certification Statement||$15.00|
|*Please note, these fees apply to requests made by the individual or the individual’s agent (ex: Attorney).|
1. Overview of Patient Rights
- a. You have the right to obtain a copy of your medical record and to request that your records be provided to someone else. In order to protect your privacy, Pulmonary Associates of Mobile (PAM) requires your written permission before we will release your records. There are some cases where written permission is not needed, such as filing to your insurance or communicating with another provider in your care team. Please refer to ourNotice of Privacy Practices for a full description of disclosures and privacy policies.
2. PAM Policy and Pricing
- a. In accordance with federal Health and Human Services (HHS) policy, Pulmonary Associates of Mobile reserves the right to assess a nominal fee for the provision of medical records. (see fee schedule)
- b. Our fee schedule for medical records is listed below:
- c. Pulmonary Associates of Mobile will make reasonable accommodations to provide the medical record to you in the delivery method and format requested (paper/electronic, mail, fax, email, etc.)
- d. For security purposes, Pulmonary Associates of Mobile will not accept disks, USB drives, or other external media provided by an outside party for the purposes of copying medical records.
- e. Any requests for medical records will be fulfilled within 30 days from the date of the request in accordance with HHS guidelines. If for any reason your record cannot be produced within 30 days, you will be notified by our staff.
3. How To Make a Request
- a. If you would like to obtain a copy of your medical record, please follow one or both of the processes below:
- i. To review your health information electronically you may sign up for and log in to the Pulmonary Associates of Mobile patient portal, Medfusion, which is accessible from our home page. This is a free service available to you. You may view, download, and transmit visit summary data.
- ii. For a copy of your complete record, start by completing an authorization release form. A copy of this form is available in the office or can be completed on our website.
- b. If you have any questions about how to make a request, setting up your patient portal, fee schedules, or authorized disclosures, please do not hesitate to contact our office.