Records Fees


The process of releasing our Patient's Health Information —PHI, is a complicated, costly, and extremely tedious process in which many steps must be followed to ensure our patient's confidentiality. Many laws, including Federal, State, HIPAA, and HITECH exist and must be followed to protect the patient's proper disclosure.

The process of complying with records requests takes valuable time out of our highly skilled staff, therefore our time in making the requested records available must be compensated according to the California Evidence Code —Reasonable Cost:

California Code Evidence Code Section 1563

"Reasonable clerical costs incurred in locating and making the records available to be billed at the maximum rate of twenty-four dollars ($24) per hour per person, computed on the basis of six dollars ($6) per quarter hour or fraction thereof; actual postage charges; and the actual cost, if any, charged to the witness by a third person for the retrieval and return of records held offsite by that third person."

Third-Party Requesters

If records (digital, paper, storage) are found, a Final Invoice for the production cost of records, will be submitted to your office for approval. —This final reproduction cost must be made payable to our medical practice "William Ramirez, DC QME" for our valuable time in making records available.

Per the California Evidence Code, all clerical time spent shall be charged against the party serving the request. —From the moment our practice receives the request, including, but not limited to, the time that it takes our highly skilled staff to —Accept service, verify the validity of the request, verify the patient's information, enter the request information into a Tracking System for HIPAA Regulations, status phone calls, emails, correspondence, searching and collection of digital information, searching and collection of paper information from archived files, if any, processing one or more formats of documents, charts, records, documents compilation against specific dates of service requested, records review and certification, records upload and distribution, cd preparation, production of pages in hard copies, shipping, and handling, etc...

Final Production Check Must be payable to the "William Ramirez, DC QME"

PLEASE READ AND FOLLOW THE INSTRUCTIONS ON OUR FINAL PRODUCTION INVOICE

William Ramirez, DC QME

TAX ID: 12-3456789 ROI ID: 10001
William Ramirez, DC QME
TAX ID: ROI ID:
Medical Facility Legal Requestor
William Ramirez, DC QME Copy Service
302 Lemon Avenue 1142 S. Diamond Bar Blvd PMB 310
Walnut, CA 91789 Diamond Bar, CA 91765
Facility Requestor
William Ramirez, DC QME Copy Service
302 Lemon Avenue 1142 S. Diamond Bar Blvd PMB 310
Walnut, CA 91789 Diamond Bar, CA 91765
Invoice ID Invoice Date Record Type Reference ID
1001 01/01/2024 Medical 123456-01
ID Date Type ID
1001 1/1/24 Med 123456
Patient Doctor
Jane Doe Doctor Joe
Description Units Price Total
Production Cost 1 1 $24.00
Image Unit Cost 0 0 $0.00
Records Certification 0 0 $0.00
Upload/ Delivery Fee 0 0 $0.00
Invoice Total $24.00
Desc Units Price Total
Units 1 1 $24.00
Units 0 0 $0.00
Units 0 0 $0.00
Fee 0 0 $0.00
Total $24.00
YOUR REQUEST FOR RECORDS IS PENDING PAYMENT
MAKE YOUR CHECK PAYABLE TO MEDICAL FACILITY
William Ramirez, DC QME

MAIL YOUR FINAL PAYMENT TO REQUEST PROCESS CENTER

302 Lemon Avenue, Walnut, CA 91789

SAVE A PHONE CALL CHECK THE STATUS OF YOUR REQUEST ONLINE
https://walnutchiropractor.com
https://walnutchiropractor.com
ENTER REFERENCE ID: 123456-01 AND PATIENT'S DOB
IF YOU HAVE ANY QUESTIONS IN REGARDS TO THIS INVOICE —REPLY TO THE FOLLOWING EMAIL
invoices@walnutchiropractor.com
invoices@walnutchiropractor.com
PER THE CALIFORNIA EVIDENCE CODE, ALL CLERICAL TIME SPENT SHALL BE CHARGED AGAINST THE PARTY SERVING THE REQUEST —FROM THE MOMENT OUR PRACTICE RECEIVES THE REQUEST, INCLUDING, BUT NOT LIMITED TO THE TIME THAT IT TAKES OUR HIGHLY SKILLED STAFF TO —ACCEPT SERVICE, VERIFY THE VALIDITY OF THE REQUEST, VERIFY THE PATIENT'S INFORMATION, ENTER THE REQUEST INFORMATION INTO A TRACKING SYSTEM FOR HIPAA REGULATIONS, STATUS PHONE CALLS, EMAILS, CORRESPONDENCE, SEARCHING AND COLLECTION OF DIGITAL INFORMATION, SEARCHING AND COLLECTION OF PAPER INFORMATION FROM ARCHIVED FILES, IF ANY, PROCESSING ONE OR MORE FORMATS OF DOCUMENTS, CHARTS, RECORDS, DOCUMENTS COMPILATION AGAINST SPECIFIC DATES OF SERVICE REQUESTED, RECORDS REVIEW AND CERTIFICATION, RECORDS UPLOAD AND DISTRIBUTION, CD PREPARATION, PRODUCTION OF PAGES IN HARD COPIES, SHIPPING, AND HANDLING, ETC...
RETURNED CHECK FEE. A thirty-six $36 service charge will be levied on all checks returned. The returned check will not be re-deposited. The requester must cover the returned check with a money order or certified check, including our service charge of $36.