Disclosure Process and Fee Explanation Letter
Dear Patient,
As a patient, you have a right to copies of your medical information. In addition, medical records are legal documents that must be maintained by West Texas Medical Associates. To assure we are doing everything we can to comply with HIPAA rules and protect the privacy of our patients, we have partnered with Chart Request, a national Release of Information provider, to assist us with this process.
Under federal and state law, Chart Request and West Texas Medical Associates can recover certain costs related to making copies of your medical records available to you. The fee we charge is cost-based to include labor, materials, and postage as defined by HIPAA and highlighted by the Omnibus Final Rule. How the records are sorted and delivered are variable factors affecting the fee.
To minimize this fee, we encourage you to limit your request to just the records that you truly need. For many patients, this option is sufficient for their purposes and keeps their bill lower than it otherwise would be.
To request medical records, please visit: http://app.chartrequest.com/28201
- Click "Sign up"
- Choose "Sign up as a Patient''
- Enter your demographics as directed, then click "Create my account"
- Enter your address information
- Enter your telephone information then select how you want to verify your account
- Click "Send Verification Code''
- Enter Verification Code that was sent using the method you previously selected
- Check both boxes to agree to Terms of Service and Authorization for Medical Record Release
- Click "Confirm & Login"
- To begin the request, click "Make a New Request for Records" and follow the prompts
Under federal and state law, Chart Request and West Texas Medical Associates has 7 business days to deliver your medical records. An invoice will be sent to the email address you provided for your account. The fee can be remitted by Check or Credit/Debit Card.
You will be able to view your medical records upon payment. For questions, please contact Chart Request at (888) 895-8366 or email support@chartrequest.com
Thank you for your confidence in West Texas Medical Associates!
Records release form to obtain a copy of YOUR medical records.
Records release form for a FAMILY MEMBER to obtain a copy of your medical records.
Records release form for PSYCHIATRIC records.
Records release form for PSYCHOLOGY records.
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