Address: 24821 w 135th St, Plainfield IL 60544
How can I obtain my medical records?
Due to COVID-19 we are temporarily not accepting in person requests or pick-up of medical records. If you need to request a copy of your medical record, please send your request via the USPS . A handwritten signature, date and copy of your State ID is required for any record request. FBH will WAIVE FEES for an OFFICIAL FBH SUMMARY LETTER which contains Diagnoses, Medicines and Labs(if needed) to you or your new provider at NO COST. This is only for SUMMARY LETTERS. Please note that FBH is not required to send Psychotherapy or Process Notes per Federal HIPAA Law (45 CFR 164.524(a)(2)). We can however send the diagnoses, medicine history, labs and NON-Psychiatric/Psychotherapy Medical Data. The following people are authorized to sign for the release of medical records:
• The patient or the patient’s legally authorized representative (legal documentation is required)
• The parent of a patient under the age of 18 (Please note that the patient must make their own HIPAA Request for records if they are no longer a minor and now are age 18 years or older.
• A legally-appointed executor or administrator of an estate if the patient is deceased (legal documentation, court order or small estate affidavit, and a death certificate are required)
RECORD REQUEST FEES:
Can I be charged a fee for records? Yes.
45 CFR 164.524(c)(4) HIPAA Privacy Rule permits a covered entity to charge a reasonable, cost-based fee for individuals (or their personal representatives) to receive (or direct to a third party) a copy of the individuals’ PHI. In addition to being reasonable, the fee may include only certain labor, supply, and postage costs that may apply in providing the individual with the copy in the form and format and manner requested or agreed to by the individual. FBH will WAIVE FEES for an OFFICIAL FBH SUMMARY LETTER which contains Diagnoses, Medicines and Labs(if needed) to you or your new provider at NO COST. This is only for SUMMARY LETTERS.
Please submit your request in writing.
• Attention: FBH Medical Records Department
• 24821 W 135th St
• Plainfield, IL 60544
Please note per HIPAA 45 CFR 164.524(b)(2): FBH has after receiving the patient’s written request, the covered entity has 30 days (up to 60 days if an extension is applicable) to send the PHI to the designated recipient as directed by the individual. FBH does not operate on most Federal Holidays and we are closed on Fridays and most weekends. We can only process record requests during clinic operating hours. FBH phone line hours of operation are Monday through Thursday from 10 a.m. to 4 p.m. Messages will be returned at the next appropriate business day.