Pricing Review

The ChartRequest platform prices medical records using complex algorithms that comply with state and federal statutes. If you would like to request a review of a medical records fee, please complete the form below.

Your Name(Required)

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Your Email Address(Required)

Your Phone Number(Required)

Request Identification #(Required)

This number can be found on your invoice. A current and accurate request identification # is required to receive a review of your medical records pricing.

Reason for Review of Medical Records Fee(Required)

List the specific reasons you believe a pricing review is required. Please email the exact pricing issue.

Pricing Support Materials(Required)

Please provide a link or reference document to support your proposed medical records fee.

Phone

This field is for validation purposes and should be left unchanged.

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