What you have a right to
The HIPAA Privacy Rule's access provision is 45 CFR § 164.524. In plain terms:
| Question | What the rule says |
|---|---|
| How fast? | The provider must act "no later than 30 days after receipt of the request." [1] |
| Can they take longer? | Once, by no more than 30 more days, and only if within the first 30 days they give you a written statement of the reasons for the delay and a date for completion. |
| What format? | The format you ask for if it is "readily producible" in that format; otherwise a readable hard copy or another format you agree on. Electronic records can be provided electronically. |
| What may they charge? | A "reasonable, cost-based fee" [1] for labor for copying, supplies (paper or portable media), postage if you ask for mailing, and a summary or explanation if you agreed to one. |
| What if they say no? | They must give access to whatever they can, send a timely written denial in plain language with the basis, how to ask for review and how to complain, and tell you where to send the request if they do not hold the record. |
These rules apply to the records a provider or health plan keeps about you in what the rule calls a designated record set, with limited exceptions.
Tennessee fee limits
Tennessee regulates what providers may charge for copies of records. The figures in the first four bullets come from Tenn. Code Ann. § 63-2-102 (providers) as published by FindLaw (current as of January 2, 2024; check the official code for later changes), and apply to records not involving workers' compensation:
- Paper copies: a flat $25 for five pages or fewer, then up to 50 cents per page after the first five, plus actual mailing cost.
- Radiology images: up to $20 per printed film; on CD, DVD or USB up to $25 per request; files sent by email or portal up to $15 per request.
- Electronic records for you as the patient: the fee follows the federal HIPAA/HITECH rule and cannot exceed labor, supplies and postage.
- Other requesters (for example, someone other than the patient) have different electronic fee limits.
- Hospital records (§ 68-11-304): a hospital must furnish records within 30 days of the request. Ask the hospital's records office for its current copy fee.
- Free copies: hospitals cannot charge an indigent person for records supporting a Social Security claim or appeal if the request includes a recent application or denial; patients represented by legal aid or pro bono attorneys are presumed indigent.
Fee schedules and statutes get amended. Ask the provider for its written fee schedule and the legal basis for any charge that seems higher than these limits.
Records and bills are different things
| What | What it is | Where to ask |
|---|---|---|
| Medical record | The chart: notes, test results, imaging reports, discharge papers | Provider's medical records or health information management office |
| Imaging | The scans or films themselves | Radiology or imaging records (may be separate from the chart) |
| Itemized bill | Lists each service and charge | Provider's billing office |
| Summary statement | Shows a total owed, often without line detail | Billing office |
| Explanation of benefits (EOB) | Your health plan's statement of what it paid and why | Your health plan or its portal |
| Ambulance record and bill | Often kept by the ambulance service, not the hospital | The ambulance provider |
Crash care often involves several providers, so a single treatment episode can mean several separate requests.
A request checklist
- Make a list of every provider: ambulance, ER, hospital, imaging, specialists, therapy, pharmacy.
- For each, find the records office and billing office (website or the number on the bill).
- Ask in writing (patient portal message, fax, or letter). Include your full name, date of birth, dates of treatment, what you want (records, imaging, itemized bill), the format (paper or electronic), and where to send it.
- Put the date you sent each request on a log. The 30-day clock runs from receipt.
- Ask for the fee schedule if you are quoted a charge.
- When the records come, check them for your name, dates and each visit you remember. Keep your own list of anything missing.
- Keep everything with your crash journal and bills organizer.
Sources
- 45 CFR 164.524, right of access (eCFR, current text) (checked November 9, 2026)Official source“no later than 30 days after receipt of the request”“reasonable, cost-based fee”
- Tenn. Code Ann. 63-2-102 (provider copy fees), FindLaw (checked November 9, 2026)Code text via FindLaw (unofficial copy)
- Tenn. Code Ann. 68-11-304 (hospital records), FindLaw (checked November 9, 2026)Code text via FindLaw (unofficial copy)
Unofficial copies come from a legal publisher, not the state. They can lag the current code, so check the official code before relying on a date or amount.
Page last updated November 9, 2026. Attorney review pending. General information, not legal advice. Fees, hours and rules change; confirm on the official page. How we source.
Questions
How long do they have to give me my medical records?
Under the HIPAA access rule, no later than 30 days after receipt, with one possible 30-day extension if they explain in writing [1].
Can they charge me for my medical records?
A reasonable, cost-based fee limited to labor for copying, supplies, postage if you want them mailed, and a summary if you agreed to one.
What is an itemized medical bill?
A bill that lists each service, code and charge instead of one total. Providers can send one on request; ask the billing office.
Do I need a lawyer to get my records?
You can request your own records directly from the provider.
Who do I complain to if I am refused?
The provider's written denial must tell you how to complain to the provider or to the HHS Secretary.
CrashFirst is not a law firm and does not give legal advice. This checklist is general information. Every situation is different.
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