Transfer of Records

Citation:

900.12(c)(4)(ii),(iii): Each facility that performs mammograms:

(ii)  Shall upon request by, or on behalf of, the patient, permanently or temporarily transfer the original mammograms and copies of the patient's reports to a medical institution, or to a physician or health care provider of the patient, or to the patient directly;

(iii)  Any fee charged to the patients for providing the services in paragraph (c)(4)(ii) of this section shall not exceed the documented costs associated with this service.

Questions:

1. What should a facility do if a patient (or someone acting on her behalf) requests permanent or temporary transfer of mammograms and/or reports? Who should pay for it? What recourse does the patient have if the facility overcharges for the transfer or refuses to cooperate?
2. What documentation should I get when a patient, or an individual acting on the behalf of the patient, or the patient's physician requests the release of the patient's records? How long should I keep the documentation?
3. What are appropriate charges for the transfer of mammographic records? Can I include the cost of making copies of the films?
4. With the introduction of Full Field Digital Mammography, what constitutes a mammogram for retention and transfer purposes, the digital data or the hardcopy film?
5. We have an FFDM unit and do not keep hardcopy of our exams (i.e., we retain the images electronically). When patients request the release of their exam, we create a hardcopy for them. May we charge the patient for the cost of creating the hardcopy?
6. Can a facility use lossless compression to transmit images to the patient or other medical institutions for final interpretation?
7. Can a facility use lossy compression to transmit images to the patient or other medical institutions for final interpretation?