Phase 5 – Medical Record and Billing E-Letter Gfile User: The Medical Record & Billing E-Letter app function is designed to be a centralized way to send a properly drafted HIPAA request from the Platform. The E-Letter collaterally creates a record in the source file and email which is properly formatted, printed and sent via U.S. Mail. The Medical Record & Billing E-Letter is hard copied to the file, thus ensuring a digital copy on the Platform, an email to your user email address and a hard copy in the file. Be focused when completing the form to ensure the specific information is inputted and utilize the Upload feature to ensure HIPAA compliance by attaching a properly completed Release of Information. Gfile User Email: Gfile User Name: Email of Recipient: Address of Recipient (GPS Block Format): Regarding: Individual Whose Records and or Bills are Requested Social Security Number: Date of Birth: Date Range Records are Requested: Upload any applicable media (documents, images, etc.): Body of E-Letter Medical Request and Billing E-Letter: Please allow this letter to serve as notice that our firm represents the above-individual and we are in need of his/her records as referenced above. We are willing to pay the statutory costs for production of the same. For email version of this request, the HIPAA Compliant Medical Authorization is sent by separate emails. For the U.S. Mail version, a signed HIPAA Compliant Medical Authorization is attached. If you have any questions, please feel welcome to contact our office. Otherwise we do request the records be mailed to: Gfile.Legal, 2024 Third Avenue North, Birmingham, Alabama 35203 or emailed to the email address above. Warm regard be with you.