Medical & Behavioral Health Records – Access and Fee Policy

Purpose:
To clarify how medical and behavioral health records are released, requested, and billed in compliance with Oklahoma law (Title 43A §1-109 and Title 76 §19), the HIPAA Privacy Rule (45 CFR 164.524), and 42 CFR Part 2 for Substance Use Disorder (SUD) information.

Because Tulsa Family Psychiatry & Wellness (TFPW) is a psychiatry and behavioral health practice, most of our clinical records are governed by Title 43A §1-109, not by the general medical records statute (Title 76 §19).
The distinctions below explain when each applies.

Governing Laws and Applicability

Behavioral Health Record Access (Title 43A §1-109)

• Behavioral-health records may be released to another treating provider for continuity of care without a separate authorization, when necessary for ongoing treatment.

• Patients may request access to their behavioral-health record; however, release may be limited if, in the provider’s professional judgment, such access would likely cause substantial harm to the patient or others.

• Requests involving SUD information must meet 42 CFR Part 2 consent requirements.

• Psychotherapy notes (provider’s personal process notes, maintained separately from the clinical record) are not subject to patient access under HIPAA.

Requests Received From Other Providers

Typical scenario: another psychiatrist, therapist, or primary-care provider requests your patient’s records for coordination of care.

• Permitted without fee and without a new authorization when for treatment purposes.

• Documentation should note “Continuity of Care Release – per 43A §1-109/HIPAA 164.506.”

• Verify identity of the requesting provider and method of transmission (fax, portal, encrypted email).

• Redact third-party information or notes unrelated to the current episode of care.

Requests Made By TFPW to Other Providers

When TFPW requests patient records from another behavioral-health or medical practice:

• Obtain a signed ROI when required by the other facility’s policy or if records include SUD information.

• Under HIPAA and 43A §1-109, providers may exchange PHI for treatment without a release, but some organizations require written consent as best practice.

• Tag received records as Inbound ROI and note any restrictions (e.g., “Part 2 protected”).

Patient or Third-Party Requests for TFPW Records

When a patient, legal representative, or outside entity (e.g., attorney, insurer) requests copies of records from TFPW, apply the following:

A. Behavioral-Health Records (Most TFPW Records)

• Governed by 43A §1-109 – not subject to the per-page fee schedule in 76 §19.

• TFPW may charge reasonable cost-based fees permitted by HIPAA for copying and delivery.

• Fees must cover only labor, supplies, and postage; no retrieval or review charges.

• Typical internal standard (for reference only):

  • Paper: $0.50 per page (cap $200)

  • Electronic: $0.30 per page (max $200 per request)

  • CD/DVD or USB: $20 per media

  • No fee for fax or secure portal delivery.

B. Requests from Attorneys, Insurers, or Subpoenas

• Require a signed patient authorization or a court order.
  Behavioral-health and SUD records cannot be released under a blanket subpoena.

• Because TFPW records are governed by Title 43A §1-109 and HIPAA,
  no base retrieval or statutory fees (such as the $20 fee under 76 O.S. §19) may be charged.

• Permissible fees are limited to reasonable, cost-based charges for copying and delivery only.
  Example: actual cost of paper, labor for duplication, postage, or encrypted media.

• If a certification or notarized affidavit is specifically requested, a nominal cost-based fee may be charged (to cover the notary or administrative time).

• SUD records: release only with explicit, written 42 CFR Part 2–compliant consent.

C. Deceased Patients

• Release only to:

  • Court-appointed personal representative,

  • If none, spouse, or

  • If none, a responsible family member (parent, adult child, or sibling involved in care).

• Verify relationship and document authority before disclosure.

Summary Table

Quick Decision Guide – Before You Release or Request Records

Step 1 – Identify the Record Type

Step 2 – Who Is Requesting?

Step 3 – Special Protections

• If the record includes SUD info → STOP: must have 42 CFR Part 2 consent.

• If psychotherapy notes → do not release.

• If provider believes release could cause harm → provider may limit or deny access (per 43A §1-109).

• Always log the release reason in the ROI tracker.

Step 4 – When in Doubt

Ask yourself:

• Is this behavioral-health or SUD information?

• Do we have the correct consent or exception?

• If unsure → escalate to the Privacy Officer before sending.

✅ Bottom Line

Behavioral-health and SUD records are not “standard medical records.”
Always confirm whether Title 43A or Part 2 applies before processing any release or request.

Legal References

• • 43A O.S. §1-109 – Disclosure of Mental-Health and Substance-Abuse Records
    Oklahoma law governing confidentiality and release of psychiatric, psychological, and SUD treatment records.

  • 76 O.S. §19 – Medical Records: Patient Access and Fees
    Oklahoma statute defining patient rights and fee limits for general medical record requests.

  • 42 CFR Part 2 – Confidentiality of Substance Use Disorder Patient Records
    Federal rule establishing consent requirements and disclosure limitations for SUD information.

  • 45 CFR §164.524 – Access of Individuals to Protected Health Information
    HIPAA rule detailing the patient’s right of access to PHI and limitations (including psychotherapy notes).

  • 45 CFR §164.506 – Uses and Disclosures for Treatment, Payment, and Health Care Operations
    HIPAA provision allowing provider-to-provider sharing of PHI for treatment without additional authorization.