HIPAA right of access (billing + medical records)

45 CFR 164.524: copy within 30 days (one 30-day extension); billing records are in the designated record set (164.501); reasonable cost-based fee only

2026-11-10

To: [provider name]
Re: account [account number]
From: [Your name]

Under 45 CFR 164.524 I request a copy of my designated record set for the dates of service on this account, including billing records, itemized charges and the medical records supporting each charge. Please send it electronically if possible within 30 days and tell me any cost-based fee in advance.

Please reply in writing.

[Your name]

This is general information and a letter you send yourself, not legal advice. BillAdvocate does not contact anyone for you.

Fill in the [brackets], sign, keep a copy, and send it yourself (certified mail for debt and credit letters).

This is general information and a letter you send yourself, not legal advice. BillAdvocate does not contact anyone for you. BillAdvocate is not a law firm and is not your lawyer: letters are drafted by software (and, only if you ask, reworded by an AI service) from what you enter, and no lawyer has reviewed them. Check every fact, amount and date before you send, and talk to a lawyer or legal aid office if you are being sued or a deadline is close. These letters are not a substitute for the advice of an attorney.