General Information

1. How may copies of medical records and billing statements be requested?

Patients or authorized representatives requesting copies of medical records and/or an itemized billing statement must submit a completed Authorization For Release of Protected Health Information form, all required supporting documentation, and payment for any fees owed, to the EMS Records Unit via e-mail to LAFD.EMSRecords@lacity.org, via fax to (213) 978-3813, or by mail to LAFD at the address listed on page 3 of the form.  All requested information must be provided along with any required documentation, such as copies of driver licenses, birth certificates, death certificates, Medical Powers of Attorney, Advance Health Care Directives, etc.  Such documentation is required to establish the relationship between a patient and the person requesting the patient's medical records, which authorizes them to receive those records.  There is no charge to patients requesting records for themselves or any request for an itemized statement only.  For all other requests the following fees apply for each record: $13 for Patient Care Report(s) & Itemized Statement; $10 for a 9-1-1 Audio Recording.  Any questions may be directed to EMS Records at LAFD.EMSRecords@lacity.org or at (213) 978-3648.
 

2. How long does it take to process a request for medical records and may a request be expedited?

Requests for records are processed in the order received and may take up to 2-3 weeks.  Records requests cannot be processed the same day or otherwise expedited.  To reduce processing time requestors should ensure that all required forms are completed and supporting documentation and any applicable fees are submitted at the time of the initial request.

3. Is the Authorization For Release of Protected Health Information form available online?

Yes.  Authorization For Release of Protected Health Information

4. Why is a patient authorization required to obtain copies of medical records and billing statements?

An Authorization For Release of Protected Health Information form is required from patients and third-parties requesting medical records.  Medical records are highly confidential and State and Federal laws require that the LAFD ensure that such records are released only to the patient, the patient's authorized representative, or as otherwise allowed by law.  The authorization form is the LAFD's way of verifying that a patient is authorizing the release of their confidential medical information.

5. May records be delivered via e-mail or picked-up in person?

Most e-mail is unencrypted and is not considered a secure form of communication.  Unless otherwise requested, LAFD will mail requested records.  Other arrangements can be made by contacting the EMS Records Unit at (213) 978-3648 or via e-mail at LAFD.EMSRecords@lacity.org.

6. Are there fees associated with a medical records request?

There is no charge to patients requesting medical records for themselves or any request for an itemized statement only.  For all other requests the following fees apply for each record: $13 for a Patient Care Report & Itemized Statement; $10 for a 9-1-1 Audio Recording.

7. How may errors on an ambulance billing statement be corrected?

To correct billing errors, patients should complete a Request For EMS Billing Correction Or Exemption form and submit to LAFD at the address listed on Page 2 of the form, or contact the LAFD's billing contractor, Intermedix, at (888) 772-3203.

8. What are the fees for ambulance transport and why are the charges so high?

The cost of the Emergency Medical Service Program consists of direct and indirect costs including salaries, supplies, and related expenses.  City policy establishes full cost recovery associated with providing ambulance transportation to patients, either from the patient’s insurance provider, the patient directly, or both.  The charges for ambulance transport are established by Los Angeles City ordinance and the current rates are set forth in Los Angeles Administrative Code Section 22.210.2(b).

9. Will an account be sent to Collections if it is not paid?  Will there be any additional fees?

If an ambulance bill has not been paid, the account may be referred to Collections in accordance with City policy.  If an ambulance bill is paid after an account has already been referred to Collections, additional fees apply.  Patients experiencing financial difficulties may be eligible for low-income assistance by contacting the LAFD billing agent, Intermedix, at (888) 772-3203.

10. Is there a bill if a patient didn't call 9-1-1 or was not transported to a hospital?

The Los Angeles Fire Department bills for ambulance transport only.  Patients may refuse transport, in which case no charges are incurred.  In the event of an ambulance transport, the LAFD is mandated by law to recover the full cost of providing ambulance transportation to patients, either from the patient’s insurance provider, the patient directly, or both.  The charges for ambulance transport are established by Los Angeles City ordinance and the current rates are set forth in Los Angeles Administrative Code Section 22.210.2(b).

11. Is the LAFD's Notice of Privacy Practices available?

Print out a copy of the Los Angeles Fire Department Notice of Privacy Practices or contact EMS Records at LAFD.EMSRecords@lacity.org  or (213) 978-3648 to request that a copy be faxed or mailed.

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