Releasing medical records in Wisconsin can be costly for healthcare practices, especially when the requestor wants digital copies. Have you ever wondered why Wisconsin practices can’t charge for electronic health records?
Every healthcare administrator knows budget optimization is the key to achieving a positive revenue cycle. However, Wisconsin laws restrict what your practice can charge for medical record retrieval.
State legislation passed and upheld in 2023 dictates that SMB and enterprise-level healthcare facilities cannot bill patients for the transfer or use of electronic health records (EHR). Consequently, you may struggle to find the most cost-efficient strategy for your health information exchange.
Unlike other states — where charging for EHR is a standard practice — Wisconsin medical professionals might miss out on substantial income from these services.
Start saving on record exchange today. Schedule a Staff Augmentation consultation with ChartRequest.
How Much Can Your Wisconsin Practice Charge for Medical Records?
Wisconsin State Statute 146.83 (3f) outlines the rules and regulations associated with access to patient healthcare records. While you cannot charge a patient for electronic health records, you can still bill for physical transfers.
It’s essential to bill per these laws. A recent class action lawsuit between Hammetter v. Verisma Systems, Inc. ended in a $4.9 million settlement.
Review the following considerations for your practice:
Paper Copies
Your Wisconsin practice may charge up to $1 per page for the first 25 pages of requested medical records. After the first 25 pages, the cap for fees decreases per page:
- 26-50 Pages: 75 cents
- 51-100 Pages: 50 cents
- 101+ Pages: 30 cents
For clarity, if a requestor in Wisconsin wants 150 pages of paper medical records, you could charge a total of $83.75:
- $25 for the first 25
- $18.75 for the next 25
- $25 for the next 50
- and $15 for the final 50
In the modern age of medical record-keeping, most enterprise healthcare organizations distance themselves from paper records. These methods are expensive, prone to damage or loss, and can create unnecessary bottlenecks for staff during care coordination.
Consider how much time and money your staff spends trying to coordinate the release of physical documents. It may be impractical for you to depend on faxing and transferring paper records for bulk requests, as the Wisconsin Statute may prevent your organization from breaking even on medical records release.
Microfilm
Transferring microfiche (or microfilm) copies of medical imaging records may be necessary when coordinating with healthcare specialists in Wisconsin. The Wisconsin law states that your practice may charge at most $1.50 per page for these sensitive documents.
Like paper records, many healthcare facilities began to phase this type of storage media out of their vaults in favor of electronic documents. A decline in microfilm storage may reduce your ability to earn significant profit for these services in the near future.
X-Ray
X-ray technology is expensive to install and operate. Wisconsin legislators recognize the financial impact these services may have on an organization. That is why you have the right to charge $10 per image when releasing x-ray documentation.
This billing standard is higher than in other states like Georgia and Kansas, which can only charge $9.50 and $5, respectively.
Copy Certifications
Wisconsin law permits your practice to charge requestors who are not patients or authorized by patients for certification of medical record copies. You may charge no more than a one-time $8 fee in these cases.
This rule extends to all copies of non-patient requests: $20 per batch.
Other Considerations
Your practice must respect the foundation of Wisconsin State legislation regarding medical records. The law specifies that any physician or administrator responsible for falsifying or withholding medical records is subject to severe penalties.
This clause might encourage healthcare administrators like you to prioritize the switch to EHR to prevent accidental document tampering and information blocking during requests.
Are ROI Vendors Subject to Wisconsin Medical Record Laws?
You may wonder, “If my healthcare organization can’t charge for EHR, can a third-party ROI service — that is not a healthcare provider — bill patients on our behalf?”
The answer is not so cut and dry.
Subtexts in Wisconsin statutes note that any company coordinating medical record exchange on behalf of a healthcare organization is not technically subject to the fee restrictions in sub. (3f) (b).
However, recent court cases shed light on which organizations are transparent about legal compliance and information sharing. Let’s take a look at a few cases for context:
Andrea Townsend v. ChartSwap
In 2018, Andrea Townsend initiated a class action suit against ChartSwap, a prominent medical record exchange provider. She alleged that ChartSwap’s fees for transferring her medical records exceeded statutorily imposed Wisconsin limits dictated in WIS. STAT. § 146.83(3f)(b).
As outlined in her complaint, Townsend authorized her attorneys to obtain health records from Milwaukee Radiologists after a car accident. ChartSwap responded to the records request and provided Townsend with a one-page certified health care bill for $35.87. Townsend’s attorneys paid the fee and obtained Townsend’s records.
In 2021, the Wisconsin Supreme Court published the appeal case of Andrea Townsend against ChartSwap. The court determined that — because ChartSwap is not a healthcare provider and the law applies to healthcare providers — the law does not apply to ChartSwap.
Daphne Smith v. RecordQuest
Like Andrea Townsend, Daphne Smith filed a complaint against RecordQuest in 2019 for charging excess fees during record retrieval.
She proposed to represent a class of similarly situated individuals who also received excessive fees during deliveries. The defendant, RecordQuest, LLC, is not a healthcare provider, but Smith insisted that RecordQuest fulfilled the inquiry she made to her healthcare provider and sent invoices with illegal charges.
The court dismissed the case on grounds similar to Townsend v. ChartSwap.
Beatriz Banuelos v. the University of Wisconsin Hospitals and Clinics Authority
Beatriz Banuelos filed a case in 2022 against the University of Wisconsin Hospitals and Clinics Authority rather than their release of information vendor, Ciox.
In a 4-3 decision (Justice Walsh Bradley, joined by Justices Dallet, Hagedorn, and Karofsky), the court held that “although Wis. Stat. § 146.83(3f) provides for the imposition of fees for copies of medical records in certain formats, it does not permit health care providers to charge fees for patient records in an electronic format.”
Despite the EMR vendor charging the requestor, the University of Wisconsin Hospitals and Clinics Authority was held liable for the fee.
The Takeaway For Medical Records in Wisconsin
The law of agency distinguishes the actions of an EHR vendor as equivalent to those of the healthcare provider. However, Wisconsin law does not hold vendors responsible for the same billing restrictions.
In the first two suits, the requestor filed complaints against the EMR provider, not the healthcare provider. The courts dismissed these cases because the vendor was within their rights to charge a fee. However, the University of Wisconsin Hospitals and Clinics Authority was subject to penalties because the requestor filed suit against them directly, not Ciox.
Partnering with a reputable medical record vendor — like ChartRequest — is the best solution to avoid monetary and civil penalties. Our company will not charge Wisconsin requestors for electronic medical records, keeping your organization out of the legal fray.
Automate Medical Records Release in Wisconsin and Save
Your organization may avoid hiring ROI vendors due to security and privacy fears. However, putting these time-consuming responsibilities on your staff can drive high overhead costs and delay request fulfillment.
At ChartRequest, we help healthcare providers across Wisconsin save up to 33% on their record requests with our latest offering: Staff Augmentation. With streamlined processes, military-grade security and encryption, and a team of compliance experts, we automate the entire process on your behalf.
In addition to gaining access to dedicated FTEs on our payroll at a fraction of in-house staffing costs, you can guarantee turnaround times of 5 days or less.
Schedule a free consultation to learn how Staff Augmentation partnership helps Wisconsin practices stay compliant and automate the release of information at a fraction of traditional costs.
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