Release Of Information
Our practice does not accept any type of process serving, including, fax, email, and personal service. You must upload your request for records from our secure Records Request Upload Module. If you are unable to upload, please mail your request to our Records Processing Center located at 1142 S. Diamond Bar Blvd #310, Diamond Bar, CA 91765.
Subpoenas for Personal Appearance must be personally served directly to the medical doctor, who you are requesting to appear at trial or hearing. Witness fees per California Government Code Section 68092.5, must also be included and payable to the doctor's name, at the time of service.
Initial Processing Fee
It's our policy to request an Initial Processing Fee of $15 for every request for records (Medical, Billing, X-Rays, Therapy) as each record is retrieved and processed separately. This fee is required in advance to start the retrieval process and is payable to Records Source our Exchange of Health Information service.
ANY INITIAL PROCESSING FEE CHECK NOT PAYABLE TO "RECORDS SOURCE" WILL BE DESTROYED.
The "treating doctor's name" and the "treating location address" must be specified in your request for records. Your Subpoena or HIPAA Authorization request must be directed to "Pacifica Orthopedics" —Records Source is not a medical provider or treating facility.
The Initial Processing Fee is only to process your request for records, and it's not for the cost of the records reproduction. The Initial Processing Fee is a non-refundable fee to cover the clerical costs incurred for the following:
- HIPAA Disclosure: HIPAA requires that all Covered Entities must have a system in place to track the release of our patients Protected Health Information (PHI).
- Records Request Process: It takes valuable clerical time to process, search, verify and data entry patient's record requests. Without this fee, your request for records might not be processed.
- NO Records Found/ Declaration of No Records: If after a complete search of (digital, paper, storage), no records are found, your request will be closed with a Certificate of No Records and your Initial Processing Fee will cover the cost of all the clerical time spent in complying with your request.
Records Found/ Production Cost
If records (digital, paper, storage) are found, a Final Invoice for the reproduction cost, the certification process, and the digital distribution of the records, will be billed to your office for approval. This final reproduction cost must be made payable to our medical practice "Pacifica Orthopedics" for our valuable time in making records available.
ANY FINAL PRODUCTION CHECK NOT PAYABLE TO "Pacifica Orthopedics" WILL BE DESTROYED.
PLEASE READ AND FOLLOW THE INSTRUCTIONS ON OUR FINAL PRODUCTION INVOICE.
All records requests are subject to twenty 20 business days turnaround, from the day our processing center received your request. PLEASE do not call us during this period of time, we will keep you posted on any further updates by fax and email.
Records eDelivery/ Five 5 Days Download
Our practice will not fax, email, upload, or mail our patient's Private Health Information (PHI). Requested records information will be electronically delivered through our secure Release Of Information Portal. (High-grade SSL data encryption at transfer and 256-bit AES at rest).
As soon as your request is completed, we will notify you by fax or email. You can download your file as many times as you need for ONLY 5 FIVE DAYS, from the notification date. After this time frame, your file will no longer be available. If for whatever reason we need to re-upload a file, there will be a re-upload fee.
Referring Law Firms
Please DO NOT submit a request for records if you are the referring attorney. Just send us an email, providing your client's demographics and the medical provider's information. Please specify that you are the attorney who referred the patient for treatment, and we'll serve you with copies of any and all medical records, reports available.
IT IS OUR POLICY THAT ANY OUT OF STATE SUBPOENA MUST BE ACCOMPANIED WITH A HIPAA AUTHORIZATION SIGNED BY OUR PATIENT.