Ciox Health / Datavant Medical Record Retrieval, Invoice Audit & Escalation Guide
Independent guide to requesting medical records, auditing third-party per-page invoices under Ciox Health, LLC v. Azar (2020), and resolving delayed Release of Information (ROI) requests handled by Datavant (formerly Ciox Health).
Datavant (Formerly Ciox Health) Operational & Billing Facts
- Corporate Status
- Ciox Health merged with Datavant in 2021 and rebranded its hospital Release of Information (ROI) division under the unified Datavant brand.
- Footprint
- Processes Release of Information (ROI) for thousands of U.S. hospitals, health systems, and clinics nationwide.
- Landmark Legal Ruling
- Plaintiff in Ciox Health, LLC v. Azar, 435 F. Supp. 3d 30 (D.D.C. Jan. 23, 2020), which vacated the 2016 HHS rule applying the $6.50 HIPAA Patient Rate to third-party law firm directives.
- Department Split
- Datavant/Ciox typically processes clinical HIM medical charts ONLY—itemized UB-04 hospital billing and raw DICOM radiology disks usually require separate requests to the hospital's billing and film library desks.
How Datavant (Formerly Ciox Health) Invoices Compare Under Federal & State Law
| Request Pathway | Applicable Fee Rule | Billing & Radiology Included? |
|---|---|---|
| Patient Direct Request (45 CFR § 164.524) | Federal “Patient Rate” (cost-based labor only when delivered directly to patient; $0 search fee) | Clinical chart only unless PFS Billing & PACS Film Library are requested separately |
| Third-Party Attorney Request (Post-Ciox v. Azar) | State Statutory Per-Page Fee Schedule + Clerical Search Fee Cap | Requires parallel UB-04/CMS-1500 & DICOM PACS packets |
| USMedicalRecords.com Managed Retrieval | Line-item statutory audit of every vendor invoice before payment | Simultaneous 3-department dispatch (HIM + PFS Billing + Radiology PACS) |
How Datavant (Ciox Health) Processes Patient vs. Law Firm Record Requests Post-Ciox v. Azar
Datavant (formerly Ciox Health) is the largest Release of Information (ROI) contractor in the United States. When you submit a medical record request to a hospital contracted with Ciox/Datavant, the hospital's Health Information Management (HIM) staff forwards or scans the request into Datavant's HealthSource workflow. Because Ciox Health was the actual plaintiff in Ciox Health, LLC v. Azar (2020), their billing system strictly separates requests into two fee tiers: (1) Direct Patient Requests under 45 CFR § 164.524(a) (where records are delivered directly to the patient and billed at the federal cost-based Patient Rate, often $0 to $6.50 for electronic delivery), and (2) Third-Party Requests (such as law firm HIPAA authorizations under 45 CFR § 164.508 or subpoenas, which Ciox bills at the maximum State Statutory Per-Page Fee Schedule plus applicable state search/clerical fees).
Why Ciox / Datavant Requests Get Stuck in 'Pending Facility Review' and How We Escalate
Law firms and patients frequently experience 30-to-60-day delays when a Ciox/Datavant request sits in 'Pending Facility Approval' or 'Awaiting Prepayment.' Common triggers include missing state-specific sensitive-record initials (mental health, HIV, genetic, or substance abuse checkboxes), requesting dates of service that are still being coded by the hospital, or sending itemized billing requests to the Ciox HIM fax line when the hospital's Central Business Office handles UB-04 billing separately. Our retrieval team tracks every Ciox/Datavant request ID on a 48-hour follow-up cycle, audits prepayment invoices against state statutory per-page caps, and dispatches parallel billing/radiology requests directly to the facility.