In the United States, HIPAA generally lets you request and inspect health information held by covered health care providers and health plans—including records used for clinical care, billing, payment, and claims. Ask each organization that may hold your information for the specific records and date range you need, then compare them with your own notes, bills, prescriptions, and insurance Explanation of Benefits (EOB) statements. An unfamiliar entry is a reason to investigate, not proof of fraud.
What records can you request?
HIPAA’s access right generally applies to protected health information in a covered entity’s designated record set. That can include clinical records and billing, payment, claims, enrollment, or insurance records held by a provider or health plan. It is not limited to what appears in a patient portal or a single electronic health record; paper records may also be covered. See the HHS explanation of which information individuals may access and its guidance on paper and electronic records.
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The right belongs to the individual or an authorized personal representative, subject to HIPAA’s rules and limited exceptions. Separately maintained psychotherapy notes are generally excluded from this access right, and HIPAA does not require an organization to create new information or analyses in response to a request. An access request also does not necessarily cover every internal business record.
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How to request your records
- Identify the organizations. List the providers, hospitals or other facilities, pharmacies, laboratories, and health plans that may hold records relevant to the care or charge you are checking. Request records from each separately; one organization may not have another’s files.
- Specify what you need. Name the categories—such as visit notes, diagnoses, prescriptions, procedure records, itemized bills, claims, or payment records—and give a date range or identify a particular encounter. A focused request can make it easier to compare documents against a specific concern.
- Choose a delivery format. State whether you want electronic or paper copies and, if useful, a particular file format. HHS says an organization should provide the requested form and format when readily producible. If it is not, the organization and individual should agree on a readable alternative. See HHS guidance on readable formats.
- Send and document the request. Use the organization’s records or privacy office process, and keep a copy of what you sent and evidence of when it was delivered. Ask for a fee estimate if copying or mailing charges may apply.
You can’t be denied access under HIPAA simply because you have not paid your medical bill. Reasonable copying and mailing costs may apply. The federal access rules are summarized in HHS’s Your Medical Records guidance.
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How long should the request take?
A covered entity must act on an access request within 30 calendar days. It may take one additional 30-day period if it provides a written explanation for the delay and the expected completion date within the initial 30 days. These are federal HIPAA time limits; keep the delivery date and any written delay notice with your request records. See HHS’s access-response timing guidance.
If an organization refuses access or says it cannot locate the records, ask it to explain the reason in writing. HIPAA has limited grounds for denial, and available review options depend on the reason. HHS describes the rules in its medical records guidance.
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How to check records for errors or suspicious activity
Review documents alongside your own calendar, appointment reminders, personal notes, pharmacy records, bills, and insurer statements. An EOB generally identifies the provider, service date, services, costs, plan payment, and amount assigned to you. The FTC explains how to read the signs of possible medical identity theft in What To Know About Medical Identity Theft.
- Dates and providers: Check whether the appointment, facility, clinician, or pharmacy matches your records.
- Care and prescriptions: Look for diagnoses, procedures, tests, medications, or supplies you do not recognize.
- Charges and claims: Compare billed services and amounts with bills and EOBs. Check whether the plan’s payment and your stated responsibility make sense for the care you received.
- Identity details: Note incorrect identifying information or records that appear to combine your information with someone else’s.
A discrepancy can be a coding or billing mistake, a timing or identity mismatch, or misuse of your information. Contact the provider and insurer to ask what an unfamiliar entry means before concluding that fraud occurred.
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How to request a correction
If a record is inaccurate or incomplete, ask the organization that maintains it to amend it under HIPAA. Identify the specific record and entry, explain what is wrong or missing, and include a copy of the relevant excerpt or supporting information. Send the request in writing and keep a copy and proof of delivery. The FTC also recommends reporting errors in writing with an explanation and the record excerpt; see its medical identity theft guidance.
The organization must respond through the amendment process, but it is not required to adopt your preferred wording in every case. If it denies the amendment request, you may submit a statement of disagreement for inclusion in the record. HHS explains these options in Your Medical Records.
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What to do if you suspect medical identity theft
Take suspicious records seriously, but verify them with the organizations involved. The FTC identifies warning signs such as bills or EOBs for care or prescriptions you did not receive, unfamiliar medical debt collection, or notice that your insurance benefits have reached their limit.
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- Request and review records from each potentially affected provider and plan, then report inaccurate entries to the relevant organization in writing.
- Check your credit reports for unfamiliar medical billing collection entries, and dispute errors with the relevant parties.
- Use IdentityTheft.gov to create a personal recovery plan. The FTC directs complaints about company or provider misuse or privacy practices to ReportFraud.ftc.gov.
Keep a dated timeline of calls, letters, and responses, along with copies of records and dispute documents. Retain materials needed for an active dispute; shred sensitive medical documents before disposing of them.
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What an access request or disclosure log will not show
An accounting of disclosures is not a complete log of every person who viewed your information or every disclosure. HIPAA excludes categories that include many disclosures for treatment, payment, and health care operations; HHS describes a maximum accounting period of six years in its Summary of the HIPAA Privacy Rule. If your concern is a particular claim or visit, requesting the underlying records from the provider and plan is more directly useful than treating a disclosure accounting as a comprehensive activity log.
This article covers federal HIPAA guidance, not state-by-state law. State rules may provide additional rights or use different procedures.
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