Short Answer

In North Carolina, you have the right to get your medical and billing records from the provider that created or maintains them. Send a HIPAA-compliant written request or authorization to each potential custodian: the health system’s Health Information Management/Release of Information (HIM/ROI) department and the named urgent care. Providers must respond within 30 days (with one possible written 30-day extension). Ask for the “designated record set” and an itemized bill; North Carolina limits copy fees for paper records.

Understanding the Problem

You’re trying to get North Carolina medical and billing records for a single urgent care visit. The health system could not find the visit and told you a separate urgent care holds the records. The question is: how do you confirm who has custody and get the records and bill for that one date of service?

Apply the Law

Under North Carolina and federal law, a patient (or an attorney with a valid authorization) can access the medical provider’s “designated record set” for a specific encounter. The correct custodian is the legal entity that rendered care or maintains the records, which may be different from the brand on the building. Requests go to the provider’s Health Information Management/Release of Information (HIM/ROI) unit; billing records typically come from Patient Financial Services or a revenue-cycle vendor. Providers generally must fulfill access requests within 30 days; one written 30-day extension is allowed. Copy fees for paper records are limited by North Carolina law; electronic copies should be at a reasonable, cost-based fee.

Key Requirements

• Valid request/authorization: Send a written patient request or HIPAA authorization that clearly identifies the patient, date of service, and location; specify delivery format (electronic if available).
• Identify the true custodian: Confirm the legal entity and location that provided care; if branding differs from ownership, the urgent care itself may hold the chart and bill.
• Scope of records: Ask for the “designated record set” for the visit (clinical notes, orders, labs, imaging reports, and discharge instructions) and an itemized bill; psychotherapy notes are excluded.
• Timing: The provider must respond within 30 days; one additional 30-day extension requires a written explanation and a new date.
• Fees: Paper copy fees are capped under state law; electronic copies should be reasonable and cost-based.

What the Statutes Say

• North Carolina Gen. Stat. § 90-411 (Copying fees for medical records) - Sets limits on fees for copies of medical records, especially paper copies.
• 45 C.F.R. § 164.524 (Access to protected health information) - Establishes the patient’s right of access, scope of the “designated record set,” response timelines, and permissible fees.

Analysis

Apply the Rule to the Facts: Because the health system could not locate the urgent care visit and redirected you, send a HIPAA authorization to both the system’s HIM/ROI and the named urgent care. In each request, identify the patient and exact date of service and ask for the designated record set and an itemized bill. Ask HIM/ROI to confirm in writing the legal entity/location code for that visit; if the urgent care is independent, it will likely be the custodian for both the chart and the bill. Track the 30-day response clock and require any extension in writing.

Process & Timing

1. Who files: The patient or the attorney with a signed HIPAA authorization. Where: The health system’s HIM/ROI and the urgent care’s records department in North Carolina. What: A written HIPAA authorization/request specifying the patient, date of service, facility name/address, “designated record set,” and “itemized billing statement.” When: Send immediately; providers must respond within 30 days (one written 30‑day extension allowed).
2. If the health system cannot find the record, request written confirmation of the legal custodian and the facility’s legal name/tax ID; ask to speak with the Privacy Officer. For billing, also send the request to Patient Financial Services and ask if a third‑party billing vendor holds the itemized statement.
3. If custody remains unclear or responses are incomplete after the deadline, escalate to the Privacy Officer and document the delay. In active litigation, consider a subpoena duces tecum; otherwise, maintain the HIPAA authorization path.

Exceptions & Pitfalls

• Branded but independent clinics: An urgent care may share branding with a health system but keep its own records and billing. Confirm the legal entity that rendered care.
• Incomplete authorizations: Missing signatures, wrong facility names, or absent date ranges cause denials. Use precise names and the exact date of service.
• Scope confusion: Ask for the “designated record set” for the visit and an “itemized billing statement.” Imaging films may be held by a radiology group; request reports and images separately if needed.
• Sensitive records: Substance use disorder records may require specific consent language under federal rules; psychotherapy notes are generally excluded from access requests.
• Fee traps: Paper copies can trigger per‑page fees. Request electronic delivery to reduce costs under reasonable, cost‑based fee rules.
• Missed timelines: Track the 30‑day deadline and insist on written extensions; escalate to the provider’s Privacy Officer if the clock runs.

Talk to a Personal Injury Attorney

If you're dealing with back‑and‑forth over who holds your urgent care records and bills, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.