FORMS FEES. a. Medical record copies β Medical record copy requests made by the patient for their personal use, for an insurance company, an attorney, etc., will incur a copying fee, as directed by the state statute and are as follows, following the completion of a release of medical records form: $25.00 for the first 20 pages $.15 per page for additional pages over 20 $25.00 for Billing Records There is no charge for records being released to another physician.
Appears in 4 contracts
Samples: Patient Financial Agreement, Patient Financial Agreement, Patient Financial Agreement