MEDICAL RECORD COPY FEE SCHEDULE:
"Pursuant to HIPAA, we reserve the right to charge a reasonable cost-based fee for producing and mailing copies of your information. At no time will the cost-based fee exceed Mississippi State Law."
I understand that SBJ has thirty (30) calendar days to respond to this request and that, if someone else holds the PHI or it is off-site, the response time is longer.
I agree to pay any fees for copying, summarizing, or explaining my PHI. I understand that this request does not apply to certain PHI, including: (a) information that is not held in the designated record set; (b) psychotherapy notes; (c) information compiled in reasonable anticipation of, or for use in, a civil, criminal or administrative action or proceeding; and (d) other types of PHI not subject to the right to access PHI under HIPAA.