7.2 Retention, Copying Charges, Timely Release & Confidentiality

Retention, Copies and Confidentiality

Retention — s. 466.018(5) and Rule 64B5-17.002(4)

"All patient records kept in accordance with this section shall be maintained for a period of 4 years from the date of the patient's last appointment."

Rule 64B5-17.002(4) repeats the four-year floor and clarifies two points: the period is calculated from the date the patient was last examined or treated by the dentist, and upon the death of the dentist, the retention provisions of Rule 64B5-17.001 are controlling (see section 7.3).

Note the authority. Retention is set by statute (s. 466.018(5)) and by Rule 64B5-17.002(4) — both in the Dental Practice and Principles chapter. Rule Chapter 64B5-15 is the Fee Schedule; it contains no records rules at all, so any citation of "64B5-15.005" for retention or "64B5-15.004" for practice-closure notice is misattributed.

Separately, Rule 64B5-17.002(5) imposes a parallel four-year retention on appointment book entries, and Rule 64B5-17.006(2) requires copies of dental laboratory prescriptions to be kept in the prescribing dentist's office for four years following issuance, with the laboratory retaining the original for four years.

Copying charges — Rule 64B5-17.009(2)

This is the provision most often misquoted in commercial review material.

"A dentist may charge a fee for copying reports or records not to exceed the cost per page charged by the Clerk of the County Court where the dentist practices. The fee for copies of x-rays shall not exceed actual cost of duplication. Payment of copying fees may be required upon delivery of the copies."

There is no fixed statutory per-page figure in the dental rule. The cap is a moving reference to the local Clerk of the County Court's rate, which varies by county and changes over time. A "$1.00 per page for the first 25 pages and $0.25 per page thereafter" formulation is drawn from a different regulatory scheme and is not the Board of Dentistry's rule.

Records may not be held hostage — Rule 64B5-17.009(1)

"A dentist who makes an examination of, or administers treatment to any person, shall upon the request of such person or his legal representative furnish copies of all reports or records made of such examination or treatment, including x-rays. The furnishing of copies shall not be conditioned upon payment of an unpaid or disputed fee for services rendered."

The rule is unconditional. An outstanding balance, a disputed insurance adjustment, or a fee arbitration in progress does not justify withholding records. Withholding is separately actionable under s. 466.028, F.S.

Timely release — Rule 64B5-17.009(3)

"A dentist shall comply with a patient's written request for copies of records and reports in a timely manner, with due regard for the patient's health needs. In the absence of circumstances beyond the control of the licensee, timely shall mean less than 30 days."

Two elements: an outer limit of less than 30 days in the ordinary case, and an overriding obligation to move faster where the patient's health needs require it.

Confidentiality — Rule 64B5-17.001(1) and s. 456.057, F.S.

"Patient records are confidential and may not be released unless authorized by the patient in writing. This confidentiality prohibits review of the records by a dentist other than the dentist of record or by other health care providers unless they are actually involved in care or treatment of the patient. Maintenance of patient records by a deceased dentist's estate, authorized agent of the estate, or by a successor-owner dentist of a practice does not authorize review of patient records. However, limited review for the purpose of obtaining a patient's name, address and last date of treatment in order to comply with this rule is permitted."

The custody/review distinction is the examinable point. A successor-owner dentist who buys a practice acquires custody of the records and the duty to make them available — but not a right to read them, except to the limited extent of extracting name, address and last treatment date so as to send the notices the rule requires.

Section 456.057, F.S., supplies the cross-profession framework, including the patient's right of access, the exceptions permitting disclosure without written authorization (such as to the Department in a disciplinary investigation, or in response to a subpoena issued as the statute prescribes), and the obligations that attach to records custodians. Because Chapter 456 is on the FDLR reference list but is not reproduced in the Board's 07/2023 booklet, read s. 456.057 directly at flsenate.gov.

The federal overlay

The Health Insurance Portability and Accountability Act applies to dental practices that are covered entities. Where HIPAA and Florida law both apply, the more protective standard governs the disclosure. HIPAA does not displace the Florida-specific rules on copying-fee caps, the 30-day timeliness standard, or the prohibition on conditioning release upon payment.

Retention timeline