A patient is moving out of state and requests that her dental records be sent to a new dentist. She has an outstanding balance. What should you do?

Correct answer: B. Obtain her signed written authorisation and release copies of the records

• A. Making the patient come in to collect records, particularly when she is relocating, is an obstruction of her right of access and does not address the request as made.
• B. CORRECT. The record belongs to the patient in terms of the INFORMATION it contains, and under HIPAA she has a right of access. Payment status is a SEPARATE matter and cannot be used to hold records hostage — doing so is unethical, breaches the ADA Code, and in most jurisdictions is unlawful. Obtain a signed release authorising transfer, send copies (retaining the originals), and pursue the balance through normal collection channels.
• C. The new dentist's request does not substitute for the PATIENT'S authorisation. It is the patient who must authorise release.
• D. Withholding records over an unpaid balance is the classic wrong answer here and can jeopardise the patient's continuity of care.

Note: You may charge a reasonable, cost-based fee for copying and postage where state law allows, and you keep the originals. What you cannot do is condition release on payment of a treatment balance.