Attorney Requests

We understand that patients may turn to the courts after an accident, and Mediserv LTD has assembled a team to assist law firms and record retrieval companies in securing the documents needed to further a legal claim. We are a billing company and, as such, can provide copies of patient statements as well as execute affidavits and depositions related to ER physician billing. However, we do not store and cannot provide copies of medical records. Any request for medical records, films, etc. should be directed to the hospital at which your client was treated.

 ASSEMBLING THE PAPERWORK

If your firm requires a document from us, please download and fully complete the provided Mediserv medical authorization. You may access and download the document here.

SUBMITTING YOUR REQUEST / RECEIVING DOCUMENTS

Once you have completed the Mediserv medical authorization, please electronically transmit your request to us via ChartSwap. The postal service has become an increasingly unreliable method of delivery and, because of that, Mediserv has partnered with ChartSwap, a web utility that allows us to exchange billing documents, affidavits, etc. via the Internet. You may access an existing account or create a new account at ChartSwap.

ChartSwap

HIPAA Grade Security and Encryption

Have an account?

New to ChartSwap?

PAYING FOR THE DOCUMENTS

Before we work your request, Mediserv will invoice your firm. Our fees vary based on the complexity of the request and individual state law. Upon electronically receiving the invoice, you may pay on the ChartSwap website with your credit card or e-check. Or, you may draft and mail a check to us. Either option is fine, and the instructions and address for mailing a check are printed on the invoice.

To review our fees, please select the state where the patient received care from the list below:

Arkansas

  • $15.50 for billing record requests*

*Fee includes one billing statement. There is a charge (beginning at $0.50 per page) for each additional statement.

  • $15 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Colorado

  • $18.53 for billing record requests*

*Fee includes up to 10 billing statements. There is a charge (beginning at $0.85 per page) for each additional statement.

  • $10 for a certification page (plus the cost of billing records)
  • $10 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Florida

  • $1.00 per page for the first 25 pages of billing records, and $0.25 per page for every page thereafter
  • $10 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Illinois

  • $27.91 for billing record requests, plus $1.05 per page for paper copies of records and $0.52 per page for electronically delivered records.
  • $10 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Iowa

  • $20 for billing record requests*

*Fee includes up to 20 billing statements. There is a charge (beginning at $1.00 per page) for each additional statement.

  • $10 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Kansas

  • $20.97 for billing record requests*

*Fee includes one billing statement. There is a charge (beginning at $0.67 per page) for each additional statement.

  • $10 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

Louisiana

  • $26 for billing record requests*

*Fee includes one billing statement. There is a charge (beginning at $1.00 per page) for each additional statement.

  • $15 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Missouri

  • $26.10 for billing record requests*

 *Fee includes one billing statement. There is a charge (beginning at $0.59 per page) for each additional statement.

  • $10 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records) There is a charge (beginning at $0.59 per page) for each page of billing.

Nevada

  • $0.60 per page of ER physician billing
  • $10 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Oklahoma

  • $10.30 for billing record requests*

*Fee includes one billing statement. There is a charge (beginning at $0.30 per page for electronic records and $.50 per page for paper records) for each additional statement.

  • $15 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Tennessee

  • $20 for billing record requests*

*Fee includes up to five billing statements. There is a charge (beginning at $0.50 per page) for each additional statement.

  • $20 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)

 

Texas

  • $25 for billing record requests*

*Fee includes up to 20 billing statements. There is a charge (beginning at $0.50 per page) for each additional statement.

  • $15 for a notarized affidavit (plus the cost of billing records)
  • $35 for deposition or cross questions (plus the cost of billing records)