The College of Physiotherapists of Alberta has seen an increase in clients who are struggling to get access to their chart records in a timely manner or are being charged fees that do not align with legislation or the Standards of Practice. The goal of this article is to quickly outline the important aspects of chart access, so physiotherapists fully understand what their responsibilities are.
1.Clients get to access their chart records.
Yep, that’s it. As their physiotherapist, you are custodian of their record, but you do not “own” that information. It is the client’s health information within that record and it belongs to the client. They must be able to access their chart record in its entirety upon request. Access rights include both the right to review the chart and the right to a copy of the record. Health-care organizations inform clients how they can go about making a request for access to their record through their privacy statements.
2.Clients are legislatively entitled to get copies of their chart records.
When the client provides you with notification they would like a copy of their chart record, you must determine the applicable privacy legislation. See the Privacy Guide for Alberta Physiotherapists (2025) for information about when different pieces of privacy legislation apply to health records in your custody and control.
The client’s right to access their own personal health information is established in legislation:
- Health Information Act (HIA) Section 7(1) states that “An individual has a right of access to any record containing health information about the individual that is in the custody or under the control of a custodian.”
- Personal Information Protection Act (PIPA) Section 24(1) states “An individual may, in accordance with section 26, request an organization
(a) to provide the individual with access to personal information about the individual, or
(b) to provide the individual with information about the use of disclosure of personal information about the individual.
- Access to Information Act (AIA) Section 6(1) states “An applicant has a right of access to any record in the custody or under the control of a public body, including a record containing personal information about the applicant.”
Data from the College of Physiotherapists of Alberta is showing that clients can be met with barriers to access copies of their chart records including delays in responding to requests. If the client record is subject to HIA or AIA you must make “every reasonable effort to respond within 30 days after receiving the request.” (HIA, Section 12(1)) . If PIPA applies you “must respond” to the applicant within 45 days from the day you received the request (PIPA, Section 28)1)(a)).
3.Fees
One of the barriers that the College often hears about from members of the public are the fees being charged to access chart copies. You must follow the wording in the privacy legislation and the Standards of Practice – Funding Fees and Billing.
Privacy Legislation
HIA: Fees are set at $25 plus $0.25 for every page over 20 pages. This fee is legislated and the $25 covers the work it takes to complete the request. There is no wiggle room so it is important to recognize when this privacy legislation is applied.
PIPA: Section 32(1) states an organization may charge a reasonable fee. The Cambridge dictionary defines reasonable as “based on or using good judgement and therefore fair and practical.” In the context of discussing fees we should pay close attention to the word “fair”.
AIA: Section 96 states that the head of a public body may charge a fee for services provided in accessing the information requested but that those fees must not exceed the actual costs of the service.
The Standard of Practice – Funding, Fees, and Billing states the following specific expectations around fees for client records to ensure the principles stated above are supported. Establishes fees for access to client records that are:
- Consistent with the requirements of applicable legislation
- Reflect the costs of providing a copy of the client record
- Consistent regardless of the party requesting access
Keeping with focus on the word “fair” in PIPA and the guidance from the HIA and AIA, the College’s expectation that a reasonable fee should reflect the cost of providing the chart record and be applied to any person or party equally. The College has seen multiple issues with fees being charged under PIPA legislation that do not meet the expectations of privacy legislation and the Standard of Practice and which result in a financial barrier to access.
The fee for a chart copy must not depend on who’s asking. Whether it is a law office or someone’s grandparent they should all pay the fee established in your fee schedule. The fee should be justifiable and reflect the actual cost of producing the chart record. This should not be a way to generate profit or be a barrier for your client to access their chart record. Charging a flat fee of $300 for a chart record that takes 15 minutes to print from your EMR does not meet the expectations in the Standards of Practice or adhere to the principles in the Code of Ethical Conduct.
4.You are responsible to explain to your client how this works at your practice site, or to refer your client to the person who is responsible to do so.
The Funding Fees and Billing Standard of Practice states that a physiotherapist:
- Makes a reasonable effort to ensure that clients understand the fees and billing practices of the physiotherapist before they become subject to them.
Physiotherapists are expected to know and relay information to their client so they understand how they can access and be provided with a copy of their record. This is often included in your privacy statement given to each client when they first come to your clinic.
If you work in a larger clinic or multi-clinic organization, you may have a privacy officer that you can direct your clients to if they have questions. Those working in a smaller clinic may be the one responsible to answer any questions or justify any costs.
While in public practice, you should be able to provide your clients with contact information for your medical records departments or other party that handles these requests.
As a physiotherapist you are responsible for any billing under your name so while the administrative staff or privacy officer can handle the details of a chart request, you do need to be aware of the request and what fees are being charged to make sure these are occurring as required in the legislation and Standards of Practice.
5.Fees for chart copies should be transparent and accurate.
The Funding Fees and Billing Standard of Practice states that a physiotherapist:
- Prior to the client being subject to any fee, confirms the client or payor has been provided a comprehensive fee schedule that includes transparent and accurate information about billing policies and all potential charges…”
An estimate of the cost to produce the chart record should be provided to the client when they make their request.
Physiotherapists are responsible when their clients request access to their chart record. You must:
- Stay up-to-date on what legislation applies and what the reasonable and justifiable fees are under all privacy legislation.
- Be aware of your practice site’s policies and procedures when it comes to a client’s access to their chart records.
- Confirm that those policies and procedures align with the legislative requirements and expectations in the Standards of Practice.
- If the policies do not align then you need to address it with those responsible for setting the policies and procedures at the practice site.
