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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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Patient's Right to Access Their PHI

An individual has a right of access to inspect and obtain a copy of protected health information about the individual in a designated record set, for as long as the protected health information is maintained in the designated record set, except for:

  • Psychotherapy notes; and
  • Information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.

Requests for Access and Timely Action

    • What is required in the notice of denial?
    • What responsibilities does a provider have after making the denial?
    • What does the provider need to do if the patient requests a review?
    • What obligations do providers have with respect to patient requests for PHI?
    • When does the provider need to act on the request?
    • What kind of access does the provider need to give the patient?
    • What does the provider need to do if the request is for an electronic copy?
    • What does the provider need to do when a copy is requested?
    • Can a provider charge for copies?


Unreviewable and Reviewable Grounds for Denial

    • When can a provider deny access but still must provide the individual an opportunity for review?
    • When can a provider deny access to without providing the individual an opportunity for review?
    • Does the patient have to have the denial reviewed?

Denial of Access

    • What is required in the notice of denial?
    • What responsibilities does a provider have after making the denial?
    • What does the provider need to do if the patient requests a review?


About Us

Zachary Edgar JD, LLM is the managing partner for Therapy Comply.  Zachary is a healthcare attorney that specializes in federal and state healthcare regulatory issues particularly for physical, occupational, and speech therapy practices.  

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