The medical records are the property of the practice.
It is maintained for the benefit of the patient and medical staff.
It is the Practice’s responsibility to protect the records against loss, defacement, and tampering, as well as authorized use. A signed consent by the patient or legal guardian is required before medical records or x-rays can be released to a physician’s office, attorney, or any other organization.
Complete the Authorization for release of Medical information form in its entirety.
MAIL THE COMPLETED FORM TO: (OR FAX TO 843-793-5402)Lowcountry Orthopaedics a member or Arcis, LLC
Release of Information
2880 Tricom Street
N.Charleston, SC 29406
Signed authorization allows release of records (as stated on the release form) to only the requesting party and is not valid for release of information to any additional parties.
The patient has the right to revoke the signed authorization to release records by submitting a written request.
Processing of the x-ray /films is handled by x-ray personnel. 843-797-5050 (ext 141)
The original signed release form is maintained in the patient’s chart.
- Patient’s name
- Social security number
- Name and address of the party requesting records
- Type of records requested
- Patient’s or legal guardian’s signature
It is the policy of the Practice to routinely charge a fee to cover the duplication expenses involved in the transfer of records outside the system and for the completion of forms requested by outside entities. In accordance with South Carolina Statute 44-115-80, you will be billed for the reproductions of your medical records as outlined below:
FEE SCHEDULE AS OF 6/23/14 FOR COPIES OF PATIENT RECORDS BASED ON FORMAT, PAPER OR ELECTRONIC, AND MAXIMUM FEE’S:
- $.65 per page for pages 1-30
- $.50 per page for all other pages
- Clerical fee not to exceed $25.00
- (*ELECTRONIC Records)- Maximum allowable charges not to exceed $150.00 + actual postage /applicable sales tax
- (*PAPER Records)- Maximum allowable charges not to exceed $200.00 + actual postage /applicable sales tax
Any questions concerning the status of your request should be submitted by logging into the patient portal via our website, www.lowcountryortho.com. Click on quick link quick links/ Patient portal. Log-in and send a message to submit a question.
LCO utilizes a third party company to process, deliver and bill for these requests. You will receive a statement from RecordsQuest, and you should remit your payment directly to them.Payment address: RecordQuest, PO Box 2017, Mt Pleasant, SC 29465-2017
If you have a question about your records statement, you should contact RecordQuest directly (Phone) 888-300-7410 (Email message via website) http://www.recordquest.com/
Medical records will be forward to another physician for transfer of care at no charge.