Release of Record Information and Optical Prescriptions
Due to the increasing number of requests for release of health record information and optical prescriptions, it becomes a substantial burden on optometrists, staff and practices. Therefore, recovery of reasonable costs is crucial for sustainability. Especially our practice
has been trying to minimise the consultation fees and provide the best eye examinations with competitive product prices. The following details from Optometry Australia which is the federated, national professional association of optometrists in Australia, provides evidence regarding what is fair and reasonable for both patients and optometrists.
The information related to the release of prescription on Medicare website is a simplified version of the guidelines from Medicare. Please find the details as below. Legislation in other states are used as reference if there is neither federal nor Western Australian laws available for the matters.
From the detailed "Guidelines: Prescription of Optical Appliances (June 2016)" from Optometry Board of Australia:
Preceding ocular examination
Before issuing a prescription, optometrists should normally perform an examination of the patient addressing ocular health, the need for any referral or review, and determination of whether it is appropriate to issue a prescription.
Rights of patients to their prescription
Optometrists must provide patients with a copy of their prescription on request, at no additional fee, at the conclusion of the consultation once paid for by the patient or billed to an insurer.
When a patient requests a copy of the prescription a period of time after it was determined, you must respond to the request in a reasonable amount of time. You may charge patients fees proportionate to the costs involved in supplying the copy of the prescription.
Supply of contact lens prescriptions
You must not issue a prescription for contact lenses until you are satisfied that:
• the prescription is correct
• the patient can wear contact lenses, and
• the prescribed lenses will provide the patient with proper vision, comfort and freedom from injury, provided the prescription is filled correctly and the patient follows the recommended lens care and wearing instructions.
Supply of Expired Prescriptions
A prescription supplied to a patient after the expiry date should be clearly marked ‘expired’.
Confidentiality
Optometrists have a legal obligation to protect the privacy of patients. You should seek consent from patients before disclosing information, as required under privacy legislation. Optometrists should refer to the Optometry Code of Conduct (confidentiality and privacy) and not release a patient’s prescription to a third party without the permission of the patient, or their guardian. When you are asked to provide a prescription of a patient to a third party, you must be sure that the patient, or guardian, has authorised the release of the prescription. The authorisation of the patient may be obtained in person, in writing or electronically.
From the detailed "Clinical Guidelines On Release Of Spectacle And Contact Lens Prescriptions By Optometrists (Feburary 2017)" from Optometry Australia:
Expiry date of optical prescriptions
The most common expiry date for spectacle prescriptions is two years after the examination at which the prescription was determined.
The most common expiry date for contact lenses is one year after the completion of the prescribing and fitting process. The optometrist may specify a shorter or longer expiry date for both spectacle and contact lens prescriptions based on the clinical interests of the patient.
Patients are entitled to access expired prescriptions. However, when a patient requests a copy of the prescription after the prescription expiry date, the prescription should be marked ‘expired’.
Respond in a reasonable time
An optometrist should respond to the request in a reasonable time. Federal privacy law does not define what a reasonable time is however in ACT, an optometrist must respond in 14 days; and in both NSW and Victoria, an optometrist must respond within 45 days.
A practice can charge a fee for providing access to health records
For optometrists practising in Queensland, Northern Territory, Western Australia, South Australia and Tasmania, federal privacy laws permit charging for access to health records. Recommended fees are not specified other than costs ought to be reasonable, not excessive and should not prevent patients in financial hardship from exercising their legal right to access information held about them. At the same time, the cost of giving access should not create an unreasonable burden on health service providers. The Privacy Commissioner has provided some advice to Australian Privacy Principle entities which can assist practices set reasonable fees which is set out in Attachment C.
Victorian legislation allows optometrists to seek reimbursement for accessing health records. Fees may only be charged for granting access under the Act where this is permitted by the Act itself or the regulations and there is a maximum fee level set under the Act. More information about the Act can be located at:
Recovery of reasonable costs (Attachment C)
A fee for access, if any, may include:
1. Reasonable costs of resources (such as photocopying or reproducing records in other forms).
2. Reasonable costs for time and labour, including:
-
work performed by clerical staff; and
-
if necessary, professional costs (such as where a health professional needs to review the file before information is released, or provide access by way of an extra consultation).”
"Fees To Access Health Information 2019-20" from Health Complaints Commissioner:
More information about the fees to access record information can be found on the website: https://hcc.vic.gov.au/public/health-records
From Member Support and Policy Advisors in Optometry Australia in June 2020:
The hourly rate in 2020 is approximately $254/hour
Spectacle or contact lens prescription: 10 minutes or more.
Both spectacle and contact lens prescription at the same time: 15 minutes or more.
The actual time depends on the amount of records involved and the time required for the optometrist and/or staff to complete the task.
Example: Prepare copy of patient information and email it.
10 minutes to find information, prepare and email $42.30
Consumables (emailing) $0
Total $42.30
If you have any queries, please contact us, Optometry Australia on (03) 9668 8540 and the above organisations to confirm the information.