Understanding the Problem

If your North Carolina personal injury case depends on proving what physical therapy was provided, can the law office require the clinic to send the actual treatment records (not just bills) when the clinic says records must be requested through its third-party vendor portal?

Apply the Law

In North Carolina, physical therapy treatment notes are medical records, and clinics generally release them either (1) with the patient’s valid written authorization (commonly a HIPAA-compliant authorization) or (2) in response to a lawful subpoena issued in a civil case. Many clinics outsource copying and delivery to a records vendor; that does not eliminate the clinic’s obligation to respond to a proper authorization or a properly served subpoena, but it often changes the practical “how” of submitting the request and paying any permitted copy fees.

If a lawsuit is already filed, North Carolina’s subpoena process is commonly used to compel production of records from a non-party provider. If a lawsuit is not filed yet, you typically must rely on a compliant authorization and the provider’s release process (including any vendor portal steps) unless another legal process applies.

Key Requirements

• Valid patient authorization: The request should include a signed, HIPAA-compliant authorization that clearly identifies the clinic, the type of records requested (e.g., “full chart,” “PT evaluation,” “daily treatment notes,” “progress notes,” “discharge summary”), the date range, and where to send them.
• Clear scope (records vs. bills): Ask for “treatment records” or “clinical records,” not “billing,” and list the specific components you need so the vendor does not treat it as a billing-only request.
• Use the clinic’s designated process: If the clinic routes requests through a vendor portal, submitting through that channel (and keeping confirmation screenshots/emails) often prevents delays caused by “we never received it” or “wrong department.”
• Proof of authority and identity: The clinic/vendor may require verification that the requestor is the patient or the patient’s attorney (for example, a letter of representation plus the signed authorization).
• Subpoena power once a case is filed: If voluntary production stalls, a subpoena for records can require the custodian/vendor to produce records under North Carolina civil procedure rules.
• Plan for admissibility needs: If you will use the records in court, you may need the records produced through the subpoena process in a way that supports later use at hearing or trial (for example, production by the custodian as contemplated by the subpoena rule).

What the Statutes Say

• N.C. Gen. Stat. Chapter 1A, Article 26 (Rule 45) (Subpoenas) - Provides the procedure to subpoena documents (including medical records) from non-parties and the method for production/objections.
• N.C. Gen. Stat. § 8-44.1 (Hospital medical records) - Addresses how hospital medical records may be received as evidence when produced by the custodian in accordance with Rule 45(c) or authenticated by testimony.
• N.C. Gen. Stat. § 8-58.1 (Injured party as witness when medical charges at issue) - Allows an injured person to testify about medical charges with supporting charge records and creates certain presumptions about reasonableness/necessity of services.
• N.C. Gen. Stat. § 44-50.1 (Accounting of disbursements; attorney's fees to enforce lien rights) - In lien/disbursement contexts, emphasizes that nothing requires action contrary to HIPAA, which is a practical reminder that record release must still follow privacy rules.

Analysis

Apply the Rule to the Facts: Here, the law office asked the clinic for “bills and medical records” and received only billing statements. That usually means the request was processed as a billing request, or the records portion was not routed correctly through the clinic’s records-release workflow. Because the clinic says records are handled by a third-party vendor, the fastest path is typically (1) a fresh, tightly written request for “full treatment records” with a valid authorization, submitted through the vendor portal, and (2) if the case is in litigation and the vendor still does not produce, a subpoena under Rule 45 directed to the custodian/vendor for the complete chart.

Process & Timing

1. Who files: The patient (or the patient’s attorney with a signed authorization). Where: With the clinic’s medical records department or its designated third-party records vendor. What: A HIPAA-compliant authorization plus a written request that specifically demands “full treatment records/complete chart,” including PT evaluation, daily treatment notes/flowsheets, progress notes, plan of care, re-evaluations, discharge summary, and any imaging/referrals the clinic has. When: As soon as possible; do not wait until settlement deadlines or discovery cutoffs are close.
2. Escalate if incomplete: If you receive only billing again, send a written deficiency notice the same day identifying what is missing (e.g., “no treatment notes provided”) and attach the prior confirmation/receipt from the portal submission. Ask for a written production log stating what was searched and what was produced.
3. Use a subpoena if needed (litigation): If a lawsuit is pending and voluntary production fails, issue and serve a subpoena for records under North Carolina Rule 45 on the records custodian/vendor (and any other required recipients under the rule). The subpoena should request production of the complete chart and specify the production method (secure upload, certified mail, or production to the issuing attorney) consistent with Rule 45 practice.

Exceptions & Pitfalls

• Authorization problems: Missing signatures, unclear date ranges, or vague descriptions like “any and all records” can trigger vendor rejection or partial production. A precise list of PT record components reduces “billing-only” responses.
• Wrong recipient: Sending requests to the clinic’s front desk or billing department often yields only statements. Direct the request to “Medical Records/Release of Information” or the vendor portal the clinic designates.
• Not matching the patient identity: Name variations, wrong date of birth, or missing patient account numbers can cause “no records found.” Include identifiers the clinic uses (without oversharing).
• Subpoena missteps: A subpoena that is not issued/served correctly, is overbroad, or fails to allow proper time for objections can delay production and create motion practice.
• Confusing bills with clinical proof: Billing statements help prove charges, but they usually do not show objective findings, functional limits, or therapy progress. In a personal injury claim, treatment notes often matter for causation and necessity, not just the amount billed.

Conclusion

In North Carolina, getting full physical therapy treatment records usually requires a clear written request with a valid HIPAA authorization that specifically asks for the complete clinical chart, submitted through the clinic’s designated records process even if a third-party vendor handles release. If voluntary production still fails and a lawsuit is pending, the next step is typically to issue a Rule 45 subpoena to the records custodian/vendor and request the complete chart. Act early so you can serve the subpoena before discovery deadlines.

Talk to a Personal Injury Attorney

If you're dealing with a physical therapy clinic that will only send billing statements and not the full treatment records, our firm has experienced attorneys who can help you use the right authorization language, follow the vendor process, and (when appropriate) use North Carolina subpoenas to obtain the records on a workable timeline. Call (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.