7 Mistakes to Avoid When Releasing Medical Records

The Road to Compliant Release of Information is Treacherous

There’s a universal truth every HIM professional knows: even the simplest medical record requests are more complex than they appear at first.

Releasing medical records is a high-risk process. It’s almost never as easy as just pulling the information and releasing it to the requestor; instead, you’re navigating a minefield of regulations, rules and requirements, all while doing your best to protect confidential health information.

It’s a difficult balance to strike, and if you’re not careful, it’s easy to overlook a required verification, release more or less information than requested or miss a deadline altogether. And when this happens, that “simple” request quickly escalates into administrative headaches.

Do you need help safely navigating the release of information minefield? You’ve come to the right place! In this blog, we’ll examine the seven biggest mistakes to avoid when releasing medical records.

Mistake #1: The Identity and Authorization Mismatch

It goes without saying that releasing medical records to someone who is not authorized to receive them is a major issue for HIPAA. In fact, it’s probably the first issue that comes to your mind. So how does that happen in the first place? It often starts with authorizations.

Not confirming the identity of the requestor and their authorization to receive the requested records is a common compliance mistake. In a rush to meet deadlines and save time, it can be easy to overlook a mandatory authorization or let an incomplete request sneak by. If medical records are released to a requestor without a valid authorization, you can end up in hot water with the Office for Civil Rights (OCR) – and nobody wants that!

Best Practice: Establishing Compliance Guardrails

To avoid this mistake, implement compliance safeguards, including:

• An identity verification procedure
• Valid authorization checks
• Quality assurance checkpoints throughout the process

Mistake #2: Violating the “Minimum Necessary” Rule

The minimum necessary rule exists for a reason: to limit how much patient information is disclosed to only what’s required. Problems arise when that guardrail is ignored, such as sending a full medical record when a third-party like a lawyer or insurer is only authorized to view a limited set of patient data.

These issues aren’t always as obvious as releasing records to the wrong person, but they are issues all the same. And like any privacy breach or incident, they must be addressed accordingly.

Best Practice: Precision is Paramount

Staying compliant with the minimum necessary rule comes down to precision. That means:

• Reviewing the request or authorization closely and isolating only the required data, dates and encounters
• Following clear protocols to redact or exclude any unnecessary PHI

When disclosures are tightly aligned to the request, risk stays low—and compliance stays intact.

Mistake #3: Unintentionally Information Blocking

Following the minimum necessary rule is so important, but being overly restrictive can lead to another mistake entirely: information blocking.

Information blocking occurs when access to PHI is improperly delayed, restricted or denied. This could look like withholding portions of a designated record set that are required for continuity of care or delaying access to a patient’s medical records while debating whether certain elements of the release are “truly necessary.”

Even well-intentioned workflows can trigger information blocking concerns if they consistently result in delays or incomplete disclosures.

Best Practice: Balance Compliance with Access

Avoiding information blocking requires a thoughtful balance between privacy protection and lawful access. That means:

• Understanding when the minimum necessary standard applies and when it doesn’t (such as many treatment-related disclosures)
• Ensuring policies align with information blocking exceptions under the 21st Century Cures Act
• Designing workflows that support timely, complete disclosures without unnecessary friction

Striking the right balance between prioritizing privacy and access keeps compliance strong on both fronts.

Mistake #4: Mishandling Highly Sensitive Records

Not all PHI is treated equally. Some records are considered highly sensitive and come with protections that go beyond a standard HIPAA authorization. The biggest risk comes in treating these records like any other request.

Common examples of highly sensitive records include PHI related to:

• Substance use disorder (SUD) treatment, which is protected under federal law (42 CFR Part 2)
• Reproductive health information, which is often governed by strict state confidentiality laws
• Behavioral health or psychotherapy notes, which have additional HIPAA safeguards

For these types of records, a standard HIPAA consent usually isn’t enough. Extra care, and usually a separate authorization altogether, is required to stay compliant.

Best Practice: Have an Ultra-Specific Consent Policy

Your EHR should allow your team to flag sensitive records so they’re clearly identified and treated with the proper protections. When these records are requested, they often require a separate, detailed authorization that specifies exactly what information can be released (for example, “I authorize release of my substance use disorder records from [Date] to [Date]”).

It’s important to be as clear and specific as possible – vague wording could lead to an unlawful release down the line.

Mistake #5: Failing to Log Disclosures Properly

From patients and public health authorities to law enforcement and legal subpoenas, PHI can travel between many parties. If one of the biggest HIPAA rules is to release the right records to the right requestor, a close second is to keep a detailed, accurate accounting of every disclosure. This is called an accounting of disclosures, and one of the biggest mistakes you can make is not having one on hand, especially when a patient or third-party requests one.

Best Practice: Automate the PHI Trail

There are many ways to track an accounting of disclosures, but perhaps the easiest way is to leverage a digital platform that tracks every request and can double as an accurate log. Your system should track:

• Who received the information
• What PHI was disclosed
• When the disclosure occurred
• Where it was sent
• Why the disclosure was made (legal purpose or specific authorization)

A digital dashboard that captures every interaction with patient records makes compliance seamless – and keeps your team confident that nothing is slipping through the cracks.

Mistake #6: Using Unsecure or Unencrypted Transmission Methods

It doesn’t matter how airtight your release of information process is if a record request is compromised on its way out the door. A secure release only counts if the transfer itself is secure. One common mistake when releasing medical records is using a channel that is not protected, such as:

• Sending PHI via unencrypted email
• Using general fax machines in unsecured, high-traffic areas
• Mailing physical records without tracking or delivery confirmation

Unsecured releases may lead to an incomplete delivery or potential interception, and either of these scenarios could trigger a mandatory breach report to the OCR. That’s a headache no compliance team wants.

Best Practice: Put Security First

Avoid this risk by standardizing a secure process for every release:

• Digital releases: Always use secure, encrypted delivery portals or authenticated electronic transfer methods, such as secure email or secure file transfer services. Encryption isn’t optional.
• Physical releases: Use secure delivery with tracking and confirmation, like certified mail or secure courier. Standard, untracked mail is never acceptable for PHI.

Mistake #7: Treating all State Laws the Same

HIPAA sets the federal baseline for protecting patient information—but it’s just the starting point. Relying solely on HIPAA and ignoring stricter state laws is a common compliance pitfall.

State laws can be more demanding in areas like:

• Patient access rights: Some states require faster turnaround times than HIPAA’s 30-day window
• Minor consent: State rules often determine when a minor can control their own records
• Authorization requirements: Certain states mandate specific language, witnesses or additional elements that HIPAA doesn’t

HIPAA’s preemption principle is clear: you must follow the law that offers the most protection. That means if your state requires a shorter response time or tighter consent rules, state laws apply independent of federal enforcement.

Best Practice: Jurisdiction-Aware Compliance

Unfortunately, there’s no quick fix here. The best way to minimize risk with complex state laws is to stay informed about the laws that directly impact your operations. If this feels overwhelming (because it is!), you can also partner with experts like us here at HealthMark who understand the legal nuances state by state. A knowledgeable partner can help ensure your team meets both federal and state requirements without the guesswork.

Doing it Alone is Scary – HealthMark Can Help

Ask anyone who works in release of information, and they’ll tell you – getting the right information to the right requestor is rule number one. Sure, it’s simple, but in the complex world of HIM, sticking to the basics is usually the best thing you can do. But we’re only humans, and at some point, making a mistake is inevitable.

It’s our duty as stewards of patient data to keep our mistakes to an absolute minimum and have protections in place to mitigate errors in the first place.

If you need help avoiding everyday compliance pitfalls while keeping your release of information operations efficient, HealthMark can help. Subscribe to the blog to get notified every time we post a new compliance guide or legal breakdown!