Medical Records Transfer Fee

New job means new gp dr, as the previous gp was right next to the previous workplace. New gp recommended a medical records transfer, which i signed for. Now i have received a $50 invoice from old gp for this service.

My gripe is, at no stage was i advised there would be a fee to this. The new gp's documentation did not mention it, nor did the previous gp advise me before initiating the transfer, that there would be a cost.

Based on the principle i refuse to pay this. I dont believe it right that a business can just perform a transaction and then send an invoice expecting payment. I have googled this and some medical centers state that they will confirm with the patient the cost before going ahead with the service. I believe that this is a very deceptive and misleading practice of the old medical center.

If i dont pay this medical invoice, what actions can they take. Can they automatically take funds out of my account, or send a debt collector/formal body?

Comments

  • +25

    Send them an invoice back for $100 for having to go through the hassle of payment and processing.

    • +2

      Or your Medicare card number…

    • +1

      I often wonder if you can bill them for the time you spend waiting for GPs in the waiting room?

  • -5

    Apparently they can legally charge you.

    I've transferred from clinic to clinic over the years and have never been charged for a copy of my medical records.

    Tell them it's an excessive amount and offer them $10 and see what they say.

    • +2

      and apparently I can legally say whatever nonsense I want on ozbargain…

      • You can, provided it's within the site guidelines.

  • +3

    Thieves

  • +11

    I thought it was all digital these days?

    • +1

      Depends on how old your records are, there’s likely some time spent reviewing them to make sure all the notes about OP being pedantic are scrubbed before exporting them.

    • +15

      As a GP, I can tell you that My Health Record is completely useless. The only reason GPs upload information to it is that a) software does it almost automatically b) there's a (pretty pathetic) payment for reaching a quota. I've never seen anyone actually access it in general practice or a hospital, and it's rarely accurate information. I reckon you'd struggle to find many doctors who actually knows how to access it properly.

      Most GPs will give you a health summary for free because it takes the better part of a minute. Putting together the rest of the documentation takes work and printing and faxing (very little is done digitally). It's reasonable to charge a fee, but they shouldn't do it without your permission.

      I can't imagine they'll come at you particularly aggressively to get their cash, but who knows.

      • +6

        MHR if its kept up to date is actually really useful.
        take it from a hospital doctor.. (:

        • Good to hear!

        • +1

          so what i'm getting from this is it is GP interests to not keep it up to date.

          1 - saves them time and effort
          2 - locks the patient in to their practice
          3 - can charge $50 exit fees when they do change GP

          take it as you will from a cynic who also hasn't seen a doctor since 2001 for a sore throat (dr said it was the worst he'd ever seen. and the swelling had already gone down some since i woke up) and before that 1994 to get a forklift license checkup.

          • +1

            @Antikythera: GP here. Nope. Op was bang on. It’s a pain in the ass. Not many gps I know care about the transfer fee or about “locking patients in”.

          • @Antikythera: What do you do for medical certificates?

      • +4

        I'm constantly disappointed that despite mhr having sections for all kinds of useful records, no GP seems to think it's remotely useful to have a centralised up to date record of ones medical history for some reason, and mine has never been updated despite numerous requests.

        Will be good once we all move into the future and have this information available to consumers and other health professionals.

      • +11

        I'm a GP, and I have to say that MyHealth is a valuable part of my practice which has helped me to decipher what the patient is telling me, helped me find information about what medications the patient has had dispensed, where they had tests/investigation done, which doctors (specialists, or other GPs) they have seen, and is one way to access the Australian Immunization Record.

        I think MyHealth is particularly useful, not for people who are young/middle-aged GPs, who are, like, super-intelligent and fully understand the limited number of health conditions that they have.

        Instead, MyHealth is for those who have limited understanding of their multiple co-morbidities and have trouble understanding what multiple providers have said to them or, perhaps for cultural reasons, choose not to fully disclose what has happened. Some of these patients may also be elderly.

        These are all social determinants for poor quality healthcare and poor quality health outcomes.

        Declaration of interest - I work in an area with elderly 'culturally and linguistically diverse' patients. I enjoy using medical data to improve patient care, have written my own software to analyze clinic records (dMeasure) and use data to improve patient care. So maybe I have spent a bit more time in thinking about how even small pieces of data can help improve patient care.

        My elderly non-English speaking patients are understandably terrified with the prospect of presenting to an English-speaking casualty department, and are generally quite keen for me to place summaries of their health information on MyHealth.

        I worked as a locum at an Aboriginal Health service in Northern Territory last year. On the second day of my job, when I could barely write a prescription (Communicare may a curse be on you for a hundred years…), I sent a patient to the hospital with what turned out to be a perinephric abscess. The hospital A+E doctor rang me up and asked "Why haven't you uploaded an event summary to MyHealth?". So at least in some parts of the country, there is a recognition of the benefits of sharing health information, and how GPs can help to do that.

    • Doesn't matter, they'll still charge whatever they can get away with.

      Without you agreeing to the fee in first place, I doubt they can legally enforce anything.

  • use my gov

  • +1

    Of course they can charge you. New gp means new gp knows nothing about you, so hopefully the old gp will shortlist the important stuff. What if there is a diagnosis in your records you arent' aware of? it happens all the time, doctors can be very sloppy.

    • If my doctor had made an "important diagnosis" but not bothered to tell me, I certainly would not be arguing they deserve to be getting a fee for anything at all from me - quite the opposite in fact!

      • Well its better to avoid mistakes like that or discover them sooner rather than later.

  • +14

    The invoice covers the work involved to transfer out your records, and probably create a history notation that this happened, etc. All admin stuff, and unless it is covered by a Medicare code the old GP can charge whatever they like. The cost seems reasonable to me.
    If you don't pay the invoice, the old GP can decide what action to take to recover the debt.

    • Definitely no Medicare item number for it. It's not just admin work - it should be screened by a nurse or doctor before being released.

    • -1

      Realistically it would be as simple as 'Export > Send' and take 5 minutes though..

  • +7

    Transferring the file takes work. Why do you think they should do that work for free?

    If your info is up on MyGov (MyHealth?) then the file transfer is extra and arguably not even essential, meaning they're even more entitled to charge for it.

    • -4

      Maybe the doctors have a better records keeping system to make transfer easier.
      They make enough money from a consult anyway.

      • -3

        Are you going to pay them to set up the better records keeping system?

        • +7

          Already have in my consult fees. It's to be assumed some of that fee is to go to cover business care and maintenance.

          • -3

            @stickyfingers: That's a no then? Consult fee is for the consult. Why do you think you're entitled to freebies with it?

            • +11

              @HighAndDry: Indirectly I am. Based off what you're saying they run the business off non-existent funds if their consult fees aren't used to run the business too?

    • +1

      OP questioned more if the practice is okay if they didn't advise (implied or written) in the first place.
      If they didn't advise it, I wouldn't pay it either.

    • +2

      I've never heard of any doctor charging thousands for transfer of records.

      $50 is entirely reasonable.

    • Spot the doctor…

  • +45

    You are all missing the point. The $50 is irrelevant, the deceiving business practice is the issue here. I totally understand why there is a fee.

    At no point was advised there would be a cost to this. Either verbal or written. At no point, before proceeding, did the previous GP call and say "hi, we have recieved this request, just confirming with you it will be a $XXX fee".

    • +3

      There are a lot of places that do not really state the cost of doing things before doing it (sometimes because it's really hard to determine the cost)…

      Those places inevitably end up with a lot of bad debt that is written off.

      • +1

        My Gp is $1 a page. Which adds up fast

      • Now I see why you got 1 vote and the comment right above got 34 (as of this time).

      • Shouldn't the hospital at least advise that there is a fee even if they don't know how much?

      • +8

        just because they omitted to tell you there would be a cost, doesn't mean there wasnt going to be one.

        I might accept this if it was a negligible amount, but to not mention to the OP that there was a $50 fee for this service is a bit deceptive in my eyes.

        • +1

          $50 is a negligible amount. It probably barely covers the cost of the time to do the work.

          • +10

            @HighAndDry: There is no work! It's just a straight transfer through the system. Basically like attaching it to an email. I'm in the medical field and a lot of doctors can't believe how the patients are being charged for this, sometimes up to $200.

            • -6

              @Whisper Quiet: You're also apparently unaware of the concept of overheads.

            • @Whisper Quiet:

              Basically like attaching it to an email.

              What if the records weren't digital?

              • +1

                @spaceflight: Unless you live in a backcountry swamp it's all digital. That was done years ago where it was mandatory to be uploaded on a server.

                • +3

                  @Whisper Quiet:

                  That was done years ago where it was mandatory to be uploaded on a server.

                  There is no mandate.

                  Paper records are still used and kept.

                  Most new medical records are now digital however there are archives of paper records.

      • +18

        I don't agree. OP should have been advised there is a fee involved.

        It's an issue of consent and being informed properly in making decision. Had OP been told about the cost, he/she could have had the doctor printed the medical records and OP could bring them to the new doctor.

        For that reason, I would agree OP should not have had to pay for that in principle.

        But…. if I were OP, I'll pay for it. Karma will pay you double :-)

        • +2

          he/she could have had the doctor printed the medical records and OP could bring them to the new doctor.

          What makes you think that you have been free? The Doctor is legally allowed to charge for the following:

          Provide an accurate summary of records to the person (schedule 1, item 4)
          The usual consultation fee (if a health service provider)or $42.90 (2.9 fee units) per quarter hour up to $139.20 (9.4 fee units), whichever is more.

          Provide a copy of health records to the person (under schedule 1, item 3)
          20 cents per page for A4 black & white. Reasonable costs otherwise, including for electronic copies.

        • +1

          Exactly “informed consent”. A topic all medical practitioners should be well aware of.

    • +2

      New gp recommended a medical records transfer, which i signed for.

      If your new GP arranged the transfer, check the terms of the document that you signed as it may have mentioned that practitioners can impose fees for retrieval of your records and photocopying expenses.

      Otherwise, you can contact the Health Complaints Commissioner & get their advice.

    • +4

      Why did you assume it would be free?

      • +5

        This. Medical practitioners, services and hospitals (public and private) own their patients’ medical records - not their patients.

        If you ask any of the above for a copy of your records, they invariably charge a fee because the retrieval, including printing or otherwise, is a ‘cost’ for them.

        Ditto when a patient requests a transfer of their records between medical providers, including GPs, although some GPs may do it for free as a gesture of goodwill.

        It’s comforting to know that by law, access to your medical records by a third party be it a GP or any other medical provider cannot be granted without your consent.

        Although I suspect that when your health is seriously at stake and you are unable to give consent, relevant parts of your medical history, such as current medications, may be shared between medical providers.

      • +18

        I never said i assumed anything. I read through the original transfer form, and no where did it state there would be a fee.

        The old gp did not advise there would be a fee either, they simply proceeded with the transaction and then decided to bill me, assuming i would just pay. sorry, doesnt work like that.

        • -2

          I never said i assumed anything. I read through the original transfer form, and no where did it state there would be a fee.

          Why would it?
          Your new doctor wouldn't know what your old doctor would charge.

          The old gp did not advise there would be a fee either, they simply proceeded with the transaction and then decided to bill me

          Why would they advise you?
          You had already authorised them to make the transfer.

          You authorised them to perform a service. They are a business. Businesses charge for services.

          sorry, doesnt work like that

          Yes it does

    • +5

      I agree with you. Receptionist pushes print or turns them all into a pdf and then forwards them to your new GP via email or fax. Sure there could be a cost but I would not be paying more than $20. Ask them to break it down as per how GPs charge as certainly the doctor would not have done this themselves. More to the point, as you outlined, you were not told of a charge and considering you were a previous client, it should be free anyway. Absolutely on the same level of lawyers when it comes to billing.

    • +1

      What would you have said if you had received that email/phone call? "No, thanks." ?

      Ps: They probably would have charged you for that phone call too. Instead of $50, it would have been $60+ then 😂 You're no longer a patient of theirs, why should they work for free for you?

    • +1

      Why would the old GP call you? You are leaving for a competitor. You can't expect tax payer subsidised health care to provide white glove service. And you really don't want healthcare to take up car sales retention practices.

      The only dodgy party here is the new GP, for soliciting work from you that is going to incur cost owed by you from another company without warning you first. Pay the fee. Tell the new GP about the fee, and if they aren't overly apologetic about their mistake, find another new, better staffed GP (or go back to your old one).

      • +1

        Maybe that GP doesn't charge to provide a copy of medical records, so didn't see it as an issue.

        For the new GP to apologise is unrealistic and petty.

        • -1

          By GP I meant GP's office. The actual doctor should have no idea of this issue unless it is their practice. I have never heard of a medicare doctor calling a client outside of a very small town.

          The new GP's office would be apologetic for not informing OP about potential charge. It is how you behave in business when you screw up and you want to keep a customer.

          If the new GP's office dose not apologise, it means their receptionists either aren't the smartest tools in the shed, they lack compassion or the clinic deflects responsibility. This is a red flag to me for a health care company.

          Yes, you don't ask for the apology. Yes, that would be petty. It is a sanity check to make sure you are not entrusting your health to an unhealthy company.

    • Maybe you should have asked?

    • If they have to do some prep work to prepare your files/medical records for transfer to the new Doctor, I guess $50 isn't too bad.

      It's not like your files are universally accessible to all Doctors and/or Hospitals.

      Surely you can cancel the transfer, hence not pay for the fee. Just start fresh with the new doctor. LoL

      • Imagine if you'd asked a lawyer to provide some documents instead!

    • why is this even relevant anymore with that digital My Health Record?

  • I dont believe it right that a business can just perform a transaction and then send an invoice expecting payment.

    Why not? You have requested them to undertake an activity. In this respect it's no different from you actually going to the doctor or engaging any other profession or trade.

    The apparent fact that you think the amount they have charged is "unfair" is a separate matter.

    • +14

      I don’t think you’ve read a word I’ve written. To recap:

      The $50 amount is irrelevant/insignificant

      They never advised that there would be a cost to this transaction. Not in writing, not verbally.

      • -3

        The $50 amount is irrelevant/insignificant

        Well just pay it then.

      • +5

        I don’t think you’ve read a word I’ve written. To recap:

        You have requested a service. You should expect that a business will charge you for rendering that service. You should have ensured the situation relevant to costs prior to your request as you should do before asking any business to provide you with a service.

        The amount of the charge and whether or not it is "fair" is an entirely separate matter. Would we still be having this conversation if the amount was $10? Would the disclosure of the $50 upfront have actually caused you not to transfer your records?

      • +6

        They never advised that there would be a cost to this transaction.

        You didn't ask if there was a cost before asking for the transfer.

        It's like ordering a dish without asking to see the menu first, then complaining about the price of it after you've finished eating.

        • +1

          that the same problem of going to a restaurant that doesn't have prices on it and expecting food to be free.

      • +1

        that's why "I" ask if there's any fees attached to this?
        if you dont ask, most likely they wont tell you

      • Agree with OP, had it been 50c or $1, prob as high as $5, may be give it a miss if they did not notify. But if they take $50 without notifying, then I think it is an issue.

  • What you could do is ask the old doctor to print all of the medical records they have on you and you can bring these document to the new doctor who would then noted them.

    This has worked for me.

    • +1

      They can charge you for the printing and the appointment for handing over and explaining the information.

  • +2

    New gp recommended a medical records transfer, which i signed for.

    Do you have a copy of this form you signed?

    Now i have received a $50 invoice from old gp for this service.

    Pretty sure the conscent form you signed above, agreed to any charges.

    Anyhow the old gp has to do work, who pays for this? Do you do work for 'free'? No didn't think so.

  • +2

    Nothing precluded the OP from continuing to see the same Doctor next to
    the old workplace.

  • +6

    https://www.oaic.gov.au/privacy/health-information/access-yo…

    Is there a charge?

    A health service provider may charge a fee for giving you access, but this charge can’t be excessive.

    The charge may include the cost of:

    staff searching for, locating and retrieving the requested information, and deciding which health information is relevant to the request
    staff reproducing and sending the health information
    the postage or materials involved in giving access
    using an intermediary, if necessary
    

    A health service provider can’t use this charge to discourage you from requesting access to your health information. If possible, they should tell you the likely amount of the charge.

    They should also discuss with you options for changing your request to minimise the charge. For example, by changing the way they give it to you — by email rather than paper copy.

    [I assume this would apply to a transfer as well]

  • +1

    the amount seems reasonable, did the OP sign off on the $50 cost to transfer initially? what did you sign off on?

    • I signed a records transfer form. It did not state any potential costs.

      • Why would it?

        You new doctor doesn't know if your old doctor will charge a fee.

  • Let me make two points:
    1. Depending on the form you signed you might have:
    a) agreed to the transfer of the rcords (for privacy reasons) AND the associated costs, or
    b) agreed to the transfer of the records (for privacy reasons) only.
    If b) then the transfer is being done at the request of the new clinic and for their benefit. They should pay or it
    2. When I have a client leave my firm following a termination of retainer, so long as their bills are paid up I am not entitled to charge them for making their records available to them to collect and take wherever they want. The client has already paid for the records, I can hardly charge them twice. We might charge them the courier costs to send it somewhere, but won't charge at all for merely making their own records available to them. Why should a medical office charge for the records the client has already paid for?

    • +2

      agreed to the transfer of the records (for privacy reasons) only.

      You don't transfer your records to another practice for privacy reasons. You have a legal right to access them but the medical records belong to the practice. If you want a copy, they are well within their rights to charge you, any other legally authorised person or authority requesting the information, the reasonable cost for the transfer.

      Here's the fee schedule for Victoria

      • +2

        You missed the point entirely.
        No person who holds your private information is allowed to transfer or release it to a third party without your authorisation.
        In this case your current medical centre cannot release your personal medical information to a new medical centre without your permission.
        This is sometimes called a Privacy Notification and Consent Form.

        If OP signed such a form it would authorise the current medical practice to release the information to the new practice. It would not (necessarily) constitute agreement to pay for the service.

        • My comment was in reference to your second point. HPP 11 gives patients the legal right to require that information be made available to another health service provider and regulation 7 (schedule 2) allows a fee to be charged when information is made available in response to such a request.

          The transfer forms I've seen have always included the following statements:

          I acknowledge that there may be an administrative charge involved in processing my request and providing access to the requested information.

          or , like someone mentionned below, :

          patient consents to any fees/charges associated with transfer

          If the one that OP signed didn't , then the invoice should be sent to the new GP, who will find one way or another, to pass it on to OP.

  • +2

    OP yes they should have told you beforehand of any cost. If it was intentional or not is less certain.

    In the grand scheme of things, $50 is a relatively small amount to transfer your medical records given the time involved. You appear to have also assumed that there was no cost and if they were truly deceptive (and wanted to make money off you) they could have easily sent you a bill for $500-1,000. I think the latter is very unlikely as GP can earn quite a bit so $50 is like nothing for them. I suspect the practice is just covering their costs.

  • +2

    The new clinic usually absorbs this cost in state operated bulk billing clinics, which some of us might be very used to. A private clinic I would have thought would absorb this cost as a cost of business, and increase the hourly charge the doctors charge patients to make up for it. So a lot of us would never be aware of this fee. But no clinic is obliged to do things like this. And the clinic would lose money if they paid this cost for a patient that only checks in once a year before moving to a new job, yet you still benefit from having the clinic ready to treat you with your correct records just in case anything happens to you over the course of your employment. Also I bet they will just waive it if you ask, but do you really want to be known as a "difficult" person by the very people you're trusting your life with?

  • Why don't you narrow down the source of your issue, e.g. does the $50 cover the old GP or the new GP or does it cover both and by X and Y?

    E.g. if the cost covers the old GP, the new GP might not be aware of the old GP's costs and the old GP might assume that anyone applying for a transfer would inform their client of the cost because he charges one.

    Also, why don't you try to find out the amount of work involved, especially complying with privacy laws.

    Lastly, the cost to call you and inform you of costs might add another $50+ to the bill, which might be less palatable.

    PS: Even if you end up going to another doctor, inform this one and the last one to include notification that there could be a bill for transfer of medical records, so that they can improve their processes for future patients.

  • Have a look at your previous GP's 'Privacy Policy' for reference to patient record access provisions, including whether they charge a fee to cover reasonable costs for complying with such a request.

  • +3

    It's fairly standard for all request for transfer include the clause, "patient consents to any fees/charges associated with transfer."

    $50 is reasonable. At no point did the GP stipulate that the transfer service is free. It is still a service with demonstrable administrative manpower requirements.

    You are not entitled to free service.

    • -1

      I disagree with this. Transferring records seems like a 15 minute job done by an administrative assistant.

      At $50, the assistant working non-stop would earn $345k a year for themselves or the practice. I've known some fantastic administrative assistants in my life, none have ever been paid $345k or even over $250k.

      To put it in perspective tshow, you're suggesting an assistant at a doctor's office should earn more pro-rata for pressing a couple of buttons than many registered psychologists could ever hope to earn.

      50 * 4 * 7.5 * 5 * 46 = 345000

      Edit Changed to many registered psychologists.

      • -1

        Transferring records seems like a 15 minute job done by an administrative assistant.

        It is not.

        At $50, the assistant working non-stop would earn $345k a year for themselves or the practice.

        A medical practice isn't a charity. It's equivalent of claiming JB HiFi employee is earning 500k per year for pointing you in the right direction.

        The assistant isn't earning as much as a psychologist but the medical practice will.

  • +2

    The fee is 100% being charged by the old practice not the new one. Someone has to be paid for their time in providing the service. Although there are big fines for privacy breaches, do you want to risk your medical records being faxed to Bunnings because someone cbf making the effort to do unpaid work properly?

    If the old practice is part of the e-health PIP they will be paid for uploading your records to MyHealth Record, and if you make an appointment for this purpose it might be cost neutral (to you and them) as it is covered by Medicare. MyHR itself is variable in its utility, for example as a GP I can see the dates you have had a certain blood test processed by Medicare but not the actual results, unless the pathologist has chosen to upload the results. I can see all your prescriptions since 2016 (in some cases 2010) but only if they are PBS medications, unless a pharmacist has chosen to upload dispensing records. It's great for uploaded letters and imaging from public hospital EDs. Private hospitals rarely deign to communicate more than 2 lines of information to the GP ("the patient did not attend theatre" is the best I get).

  • +4

    The maximum fees a practice can charge patients to access their health information under the
    Health Records Act 2001 are capped by the Health Records Regulations 2012. Here's the fee schedule for 1 July 2019 - 30 June 2020.

  • +2

    What sort of complaint is this? OMG

    It takes time to do such work.
    Doctors dont work for free you know and I suggest OP wouldnt either.

    Perhaps OP should have asked about the cost involved before hand.
    No. Let me say definitely. Not perhaps.

    The onus is on to the individual to ask if there is a cost involved in doing such work.
    I mean everyone works for a fee. Including OP.

    And what would OP have done if they knew about the $50 fee before hand?
    Of course they would have had to agree to pay the fee

    So there you go. there is your answer. Just pay the fee and stop complaining.

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