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Shriners Hospitals for Children — St. Louis

4400 Clayton Ave. St. Louis, MO 63110

St. Louis, MO

314-432-3600

Call today

314-432-3600

Medical Records and Insurance

Medical record information

To request copies of your medical record please contact our health information services staff at 314-872-8342, ext. 1338.

You will be asked to complete an Authorization for Disclosure of Health Information form or we can send it to you by fax, email or mail.

Request for records usually take less than two weeks to complete, but sometimes, depending on the size of the records, it could take as long as 30 days to complete the request. If you are requesting the records for parents/guardian, patients or legal action, there will be a charge of $23.94 (processing fee) plus $.55 per page.

Insurance

At Shriners Hospitals for Children — St. Louis, we provide medical services without barriers. Our practitioners determine the plan of care for all families regardless of their ability to pay. We accept all insurance types and companies, and offer options for financial assistance to those who need help, or are uninsured.

Shriners Hospitals for Children — St. Louis has a patient financial services department that is available from 7 a.m. – 3:30 p.m., Monday – Friday. The staff can provide assistance with questions about insurance, costs and coverage.

Patient financial services
314-692-6435 (Monday – Friday)

Insurance referral coordinator
314-872-8319
314-692-6428 (fax)

Registration and scheduling department

If your name, address, telephone number or insurance coverage has changed, please call the registration and scheduling department at 314-872-7820.

Billing and payment inquiries

For any billing and payment inquiries, please contact our billing office from 7 a.m. – 7 p.m., Monday – Friday at 800-276-5133.

Authorizations

Our patient financial services staff handles authorizations regarding services ordered by the St. Louis Shriners Hospital physicians before your appointment.

Insurance referrals

If you have an insurance plan that requires you to obtain a referral to seek care from a specialist, please talk to your primary care physician prior to your appointment at the St. Louis Shriners Hospital. Insurance referrals are typically required for patients covered by Tricare Prime, Medicaid and other managed care organizations (MCO). Insurance referrals can be faxed to patient financial services at 612-335-5379.

If you do not know if an insurance referral is required to seek care at the St. Louis Shriners Hospital, please contact our insurance referral coordinator for assistance or contact your insurance provider’s customer service department by calling the number on the back of your ID card.

Inpatient notifications

For each inpatient hospitalization, the St. Louis Shriners Hospital is required to contact your insurance provider to notify them prior to the admission date. Our patient financial services staff handles the notification process.

Services performed outside of Shriners Hospitals for Children — St. Louis

Occasionally, a patient will need services performed that cannot be completed at the St. Louis Shriners Hospital. This includes, but is not limited to MRIs, CT scans, gait labs, genetics counseling and testing, and some surgeries. It is your responsibility to ensure that the location or physician providing services to your child is part of your insurance provider’s network. Generally, any remaining financial balances for these outside services will be your responsibility.

Shriners Hospitals for Children — St. Louis' financial assistance cannot cover services performed by other hospitals and professionals. Please contact the patient financial services staff at the location of your service(s) if you have questions or concerns regarding your ability to pay. The patient financial services staff can assist you with contact information if you need it.

Please note that the St. Louis Shriners Hospital cannot assist you with payment on your prescriptions, select medical equipment and any rehabilitation therapies you receive from other locations.

Frequently asked questions about medical records, insurance and billing:

Do I have any out-of-pocket costs at the St. Louis Shriners Hospital?

Shriners Hospitals for Children — St. Louis will send you a bill for the remaining balance after your insurance company has processed the claim. You will not be held responsible for any services that have been denied by your insurance company.

Please note that the St. Louis Shriners Hospital cannot accept payment at the time of service. Once you receive your bill from us, you may mail in your payment as directed, or arrange a payment plan that fits your budget. If you feel that the amount due will cause a hardship to you and your family, please contact the hospital and ask to speak to a patient financial services representative.

Does the St. Louis Shriners Hospital accept my insurance?

Shriners Hospitals for Children — St. Louis accepts all insurance providers, including Medicare and Medicaid. You may contact your insurance provider to see if we are considered an in-network or out-of-network provider. You may also contact patient financial services or the registration and scheduling staff to determine our network status with your insurance payer.

What if my child does not have health insurance?

At Shriners Hospitals for Children — St. Louis, we do not turn away patients who do not have health insurance. We see all patients regardless of their families' ability to pay. We have many ways to assist with difficult financial concerns. Our patient financial services staff will assist you in finding medical coverage or financial assistance. We offer charity care and/or Shrine assistance for those individuals who do not qualify for private or state funded health benefits.

Contact our patient financial services staff before your appointment to discuss your options. If you do not call prior to your appointment, you will be required to speak with a financial counselor before you leave the hospital, which will lengthen your visit.

What if my child is being seen at the St. Louis Shriners Hospital due to an injury?

We do not turn away patients who do not have health insurance. We see all patients who can benefit from our specialized services regardless of their families' ability to pay. We have many ways to assist with difficult financial concerns. Our patient financial services staff will assist you in finding available medical coverage or financial assistance. We offer charity care and/or Shrine assistance for those individuals who do not qualify for private or state funded health benefits.

Contact our patient financial services staff before your appointment to discuss your options. If you do not call prior to your appointment, you will be required to speak with a financial counselor during your appointment, which will lengthen your visit.

Can you tell me more about the insurance referral process?

An insurance referral is a form of authorization, either paper or electronic, that comes from your primary care physician (PCP) or a physician within your insurance network, showing their recommendation that you seek evaluation and possible treatment with a specialist. The insurance referral must be pre-approved by your insurance provider prior to your appointment date.

Many insurance plans require their policyholders and beneficiaries to obtain insurance referrals and will not cover care provided outside of the primary care clinic unless an insurance referral is issued. Always check with your insurance provider to see if an insurance referral is needed.

If your doctor recommends that your child seeks care from a specialist, ask that an insurance referral be sent to your insurance company. If you are covered with a Medicaid policy that requires an insurance referral, please have the physician, or the physician’s care team, fax the insurance referral card to 314-692-6248. It is a good idea to ask for a copy of the insurance referral for your records.

The insurance referral provides the specialist with the number of visits that will be approved within a specific time frame. Insurance referrals usually last three months unless otherwise noted by the referring physician. The insurance referral specifies what types of services are to be performed, i.e., clinical services, labs, x-rays, blood tests, surgery, etc. If your insurance referral expires or you use up the number of allowed visits, you will need to ask the referring physician for a new insurance referral.

What happens if I do not have an insurance referral?

You may be asked to speak with one of our financial counselors. We will try to contact your primary physician to obtain the insurance referral for you. If we are unsuccessful we will not be able to bill your insurance benefits for the cost of your care.