How to Get Medical Records from Hospitals in Maryland (PI Law Firm's Guide)

Obtaining complete medical records is the foundation of every successful personal injury case in Maryland. Under the Maryland Confidentiality of Medical Records Act, healthcare providers must respond to record requests within 21 business days—but knowing how to leverage this requirement separates efficient firms from those buried in administrative delays. The process involves specific authorization forms, fee structures capped by state law, and department-specific routing that varies by hospital system. Platforms like Codes Health streamline this entire workflow by automating retrieval, catching authorization errors before submission, and delivering complete records in 10-12 days.

For Maryland PI attorneys, medical record retrieval represents both a critical case-building function and a significant operational burden. Requests that should take weeks often stretch into months when authorization forms contain errors, providers remain unresponsive, or billing invoices get lost in firm workflows. Understanding Maryland-specific requirements—and knowing when to leverage specialized retrieval services—directly impacts case velocity and settlement outcomes.

This guide covers the legal framework governing medical record access in Maryland, step-by-step retrieval processes, and strategies for handling delays and denials that frequently derail case timelines.

Key Takeaways

• Maryland law mandates 21 business days for providers to fulfill medical record requests, with specific fee caps of $0.76/page for paper and $0.57/page for electronic records
• Incomplete authorizations are the #1 cause of denied requests—missing signatures, unclear expiration dates, or unchecked boxes restart your timeline
• Hospital requests often require separate submissions to ER, radiology, billing, and inpatient departments
• The July 2025 Hollabaugh v. MRO ruling prohibits providers from charging preparation fees for unsuccessful record searches
• Codes Health uses AI to flag authorization errors before submission and delivers complete records in 10-12 days with flat-fee pricing

Understanding Your Rights to Medical Records in Maryland

Maryland personal injury attorneys operate under a dual regulatory framework: federal HIPAA requirements and the Maryland Confidentiality of Medical Records Act (Health-Gen. §§ 4-301 – 4-310). State law often provides stronger protections and more specific timelines than federal regulations alone.

Key Maryland Laws Governing Medical Record Requests

The Maryland Medical Records Act establishes clear obligations for healthcare providers responding to attorney requests. Under Health-Gen. § 4-309, providers must furnish records within 21 business days of receiving a valid authorization. Failure to comply can result in penalties, giving attorneys leverage when following up on delayed requests.

Fee structures are explicitly capped by state law:

• Paper records: $22.88 preparation fee plus $0.76 per page
• Electronic records: $22.88 preparation fee plus $0.57 per page, capped at $80
• Certified copies: Additional $15-50 per provider when required for expert review

Maryland law also mandates 7-year record retention for adult patients. For minors, records must be retained until the patient reaches age 25 (18 years plus 7 additional years).

Who Can Request Medical Records?

Under HIPAA and Maryland law, valid requesters include:

• The patient directly
• Authorized legal representatives with proper documentation
• Attorneys with client-signed HIPAA release forms
• Guardians or parents for minor patients
• Personal representatives of deceased patients

Authorization forms must include the patient's full name, date of birth, dates of service, specific records requested, and a signature dated within one year of submission. Missing any element gives providers grounds for rejection.

Step-by-Step Guide: Requesting Records Directly from Maryland Hospitals

Direct provider contact gives firms maximum control over the retrieval process but requires significant staff time and attention to detail. A typical car accident case involving 5+ provider locations can generate 8 or more separate record requests when accounting for hospital department structures.

Identifying the Correct Department

Maryland hospitals typically maintain separate record systems across departments. A single hospital visit may require requests to:

• Health Information Management (HIM): Primary department for inpatient and general records
• Emergency Department: Separate record system in many facilities
• Radiology: Imaging records often stored independently
• Billing Department: Financial records and itemized bills
• Laboratory: Test results and pathology reports

Johns Hopkins, University of Maryland Medical System, and other major Maryland hospital networks each have specific internal routing. Contacting the HIM department first to confirm proper routing prevents wasted time and duplicate requests.

Completing Authorization Forms Accurately

Incomplete authorizations are the #1 cause of denied requests. Missing patient signatures, unclear expiration dates, or unchecked boxes for sensitive records will restart your clock. Codes Health's AI review catches these errors before submission—their system automatically flags misspellings, missing dates of service, and signature issues that would otherwise cause provider rejections.

Common rejection triggers include:

• Missing or illegible patient signatures
• Expiration dates beyond one year from signing
• Unchecked boxes for sensitive records (mental health, HIV, substance abuse)
• Incorrect provider names or addresses
• Missing dates of service

Every rejection restarts the compliance clock. For high-volume firms, this compounds into weeks or months of cumulative delays across active cases.

Anticipating Costs and Timelines

Budget for $175-500 per set depending on page volume. Electronic format requests cap at $80 for copying fees but still incur the $22.88 preparation fee.

Invoice management presents its own challenge. Maryland hospitals contract with various record retrieval companies—Healthport, MRO, IOD, Chartswap, Verisma—each sending separate invoices that must be tracked and paid promptly. Records are typically held pending payment, adding 5-7 days when invoices get lost in firm workflows.

Handling Delayed or Denied Requests

Provider non-compliance is common despite Maryland's 21-day mandate. Complex regulations and providers rank among the top challenges law firms face when acquiring medical records.

Common Reasons for Delays or Denials

Requests fail for predictable reasons that proactive review can prevent:

• Incomplete authorizations: Missing signatures, dates, or required checkboxes
• Wrong department routing: Hospital records split across multiple systems
• Outstanding patient balances: Some providers delay records pending patient account resolution
• Privacy officer review: Sensitive records require additional internal approval
• System limitations: Smaller practices without electronic records face longer processing times

Steps for Unresponsive Hospitals

When providers miss the 21-day deadline, escalation options include:

1. Send a follow-up letter citing Health-Gen. § 4-309 with specific penalty language
2. Contact the facility's compliance officer directly rather than the HIM department
3. File a complaint with the Maryland Board of Physicians for documented non-compliance
4. Document all communication for potential HIPAA complaints to the Office for Civil Rights

The July 2025 Hollabaugh v. MRO decision adds new leverage: providers cannot charge fees for searches that yield no records. Dispute any such charges immediately.

Leveraging Medical Record Retrieval Services

Professional retrieval services address the administrative burden that in-house processes create. For firms handling more than 10-15 active cases monthly, the staff time required for direct provider contact often exceeds the cost of specialized services.

Benefits for Personal Injury Firms

Retrieval services deliver measurable efficiency gains:

• Faster turnaround: 16-day average compared to 21+ days for direct requests
• Higher completion rates: 98% completion with managed services versus approximately 75% with direct methods
• Reduced staff burden: Significantly reduces paralegal time spent on follow-up calls and administrative tasks
• Automatic follow-up: Daily provider contact until records arrive
• Certified copies: Available automatically when needed for expert review

The true cost comparison favors retrieval services at scale. While direct costs for retrieval services may appear similar to in-house methods, outsourcing can lead to significant savings when accounting for the reduction in staff hours and administrative overhead.

Choosing a Reputable Retrieval Partner

Evaluate potential partners on:

• Turnaround guarantees: Look for specific SLAs, not vague promises
• HIPAA compliance: Verify Business Associate Agreement availability
• Portal capabilities: Real-time status tracking reduces follow-up burden
• Error prevention: AI-powered review of authorizations before submission
• Integration options: CRM and case management system connections

Competitors offering same-day retrieval typically deliver incomplete records that require client involvement and generate additional requests—which can lead to churn. Complete retrieval in 10-12 days outperforms fast but fragmented alternatives.

AI-Powered Insights Beyond Basic Retrieval

Record retrieval represents only the first step. Organizing, summarizing, and extracting case-relevant insights from thousands of pages requires additional processing that AI platforms now automate.

How AI Transforms Case Preparation

General AI platforms like ChatGPT cannot accurately analyze medical records due to training limitations and HIPAA concerns. Purpose-built medical record AI delivers high-precision analysis with:

• Chronological organization: All encounters organized by date with visit summaries
• Diagnosis extraction: Every diagnosis, treatment, and procedure identified and categorized
• Gap identification: Missing records flagged within the timeline before trial preparation
• Pre-existing condition alerts: Historical conditions that opposing counsel might exploit
• Future expense projection: Documented treatment recommendations supporting damages calculations

Strategic Advantages for Litigation

AI-generated case chronologies reduce attorney review time from hours to minutes. Rather than reading through 2,000 pages of records, attorneys receive indexed summaries linking to source documents for verification.

For personal injury cases, AI specifically flags:

• Missed appointments that could suggest malingering
• Treatment gaps requiring explanation
• Inconsistencies between provider notes
• Breaches in standard of care supporting malpractice claims
• Documentation supporting or contradicting claimed injuries

Ensuring Record Completeness Before Trial

Incomplete records create case vulnerabilities that opposing counsel will exploit. Maryland PI attorneys must verify completeness before settlement negotiations or trial preparation begins.

The Pitfalls of Incomplete Records in Litigation

Missing records undermine case value in multiple ways:

• Causation gaps: Inability to establish continuous treatment timeline
• Damages questions: Missing billing records reduce documented economic losses
• Credibility attacks: Unexplained treatment gaps suggest symptom exaggeration
• Expert limitations: Incomplete records constrain expert opinion scope

Strategies for Identifying Gaps

Cross-reference received records against:

• Client-reported treatment history from intake interviews
• Insurance explanation of benefits documents
• Pharmacy records showing prescribed medications
• Prior records referencing other providers

AI-powered platforms automatically identify timeline gaps and flag missing provider records based on references within received documents. This proactive approach prevents discovery-phase surprises.

Compliance and Security for PHI in Maryland

Handling protected health information requires strict compliance protocols. Maryland attorneys must maintain HIPAA compliance throughout the retrieval, storage, and case management process.

Key Compliance Requirements

Maryland PI firms must implement:

• Secure transmission: Encrypted email and secure portals for record transfer
• Access controls: Role-based permissions limiting record access to assigned staff
• Retention policies: Documented procedures for record storage and destruction
• Breach notification: 60-day notification requirement if records are compromised
• Business Associate Agreements: Required with any third-party handling PHI

Note that Maryland's CRISP Health Information Exchange connects 48 hospitals statewide but remains provider-only. Attorneys cannot access CRISP directly and must use traditional retrieval methods.

Why Codes Health Delivers Results for Maryland PI Firms

Codes Health addresses the specific challenges Maryland personal injury attorneys face when obtaining and analyzing medical records. The platform combines AI-powered retrieval with human verification to deliver complete, organized records ready for case evaluation.

Proactive Error Prevention

Incomplete authorizations are the #1 cause of denied requests. Codes Health's AI review automatically flags misspellings, missing dates of service, and signature issues before submission—preventing the rejections that restart your 21-day clock. This pre-submission verification eliminates the most common delay triggers.

Complete Records in 10-12 Days

Unlike competitors promising same-day retrieval that delivers incomplete records requiring client involvement, Codes Health prioritizes completeness. The platform gathers records from all provider sources—hospitals, specialists, imaging centers, billing departments—through HIE integrations, TEFCA network access, and traditional retrieval methods. Average turnaround of 10-12 days beats manual processes while ensuring nothing is missed.

AI-Powered Case Analysis

Codes Health's purpose-built AI organizes records chronologically, extracts diagnoses and treatments, identifies missing records, and flags case-critical information like pre-existing conditions and treatment gaps. The platform combines the capabilities of a nurse, paralegal, and assistant—verified by human experts for accuracy.

Continuous Platform Evolution

Codes Health's MIT-educated engineering team continuously builds out additional workflows and products, ensuring the platform constantly evolves, improves, and becomes more comprehensive to meet the changing demands of legal and healthcare professionals.

Flat-Fee Pricing and Custom Integrations

Codes Health offers flat-fee pricing that eliminates cost uncertainty. For high-volume firms, custom integrations with CRM platforms and case management systems streamline workflows further. Real-time status updates provide complete visibility into every request without manual follow-up calls.

Frequently Asked Questions

How long does it typically take to get medical records from a hospital in Maryland?

Maryland law requires providers to respond within 21 business days of receiving a valid authorization. However, actual turnaround often extends to 30+ days due to department routing, invoice processing, and follow-up delays. Professional retrieval services average 16 days, while AI-powered platforms like Codes Health deliver complete records in 10-12 days.

What information do I need to provide when requesting medical records?

Valid HIPAA authorization forms require the patient's full legal name, date of birth, Social Security number, specific dates of service, description of records requested, the requesting party's information, patient signature, and signature date within one year. Missing any element provides grounds for rejection.

Are there fees for obtaining medical records in Maryland, and how much are they?

Maryland caps fees at $22.88 preparation plus $0.76 per page for paper records or $0.57 per page for electronic records (capped at $80 for copying). Following the July 2025 Hollabaugh ruling, providers cannot charge fees when searches find no records.

What are the most common reasons a hospital might deny a medical record request?

Denials typically result from incomplete authorizations—missing signatures, expired dates, unchecked boxes for sensitive records, or incorrect provider information. Other causes include outstanding patient balances, wrong department routing, and privacy officer holds on sensitive records. AI-powered review of authorizations before submission prevents most rejections.

How can a personal injury law firm ensure they receive all necessary medical records for a case?

Cross-reference received records against client intake interviews, insurance EOB documents, and pharmacy records. Hospital requests often require separate submissions to ER, radiology, billing, and inpatient departments. AI platforms that automatically identify timeline gaps and flag missing provider references based on received documents provide the most reliable completeness verification.