The Records Request and the Unpaid Balance
A patient treated by Dr. S. for eight visits for low back pain owes $640. The patient sends a written request for a complete copy of the chiropractic records to take to a new provider. The front desk tells the patient the clinic will send only a one-page summary and will charge $250, and that the full file will be released only after the balance is paid. The patient signed a financial policy at intake stating 'records remain the property of the clinic and may be withheld for nonpayment.' The patient files a complaint with the New Mexico Board. Dr. S. asks whether the financial policy is enforceable and whether he must send the full record, including his handwritten notes and the billing ledger, or only the treatment summary.
1. Does the patient have a right to the chiropractic records? Can the clinic withhold them for an unpaid balance?
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Yes, the patient has a right to a copy of the chiropractic records. The Board's recordkeeping rules and general health-privacy principles give patients access to their treatment records so they can continue care, obtain second opinions, or pursue legal rights. A financial policy that says records are clinic property and may be withheld for nonpayment does not override that access right. The clinic may charge a reasonable, cost-based copying fee, but it may not condition release on payment of the outstanding treatment balance. Withholding records to collect a debt is likely to be treated as unprofessional conduct and may violate privacy law. Dr. S. should release the records promptly after receiving a proper written request and should not retaliate against the patient for filing a Board complaint.
2. May Dr. S. send only a summary or charge $250? What should the response include?
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A one-page summary is not a complete response to a request for the full record. The response should include the clinical record, handwritten notes, imaging reports if any, correspondence, and billing records that are part of the patient's file, unless a specific legal exception applies. Dr. S. may redact information about a third party if necessary and may charge a reasonable fee, but a $250 flat fee may be hard to justify if it is not tied to actual copying costs. He should itemize the fee, explain any redactions, and provide the records in a timely manner. If the patient requested only a summary, a summary might suffice, but this patient requested a complete copy. Dr. S. should also correct the front-desk policy and train staff so future requests are handled consistently.
3. How should Dr. S. respond to the Board complaint?
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Dr. S. should cooperate fully and promptly. He should acknowledge the complaint, preserve the original records, provide copies to the Board as requested, and explain the clinic's policy without arguing that the patient's debt justifies withholding records. He should avoid contacting the patient in an intimidating way or retaliating because of the complaint. If the clinic made an error, he should correct it, release the records, refund any improper fee, and document the corrective action. The Board will likely consider whether the violation was a single staff mistake or a written policy that encouraged withholding records. A candid response, corrective action, and staff retraining may mitigate discipline. The Board may still impose a reprimand, fine, or recordkeeping requirements.