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Medical records and insurance

Medical records and insurance

Medical records

To request copies of your own medical records, or to authorize the disclosure of your medical records to another individual or third party, you will need to complete a HIPAA compliant Authorization to Release Protected Health Information form and submit your request in writing to the Health Information Services (HIS) department.

For your convenience and ease of access, you may use the quick link below to access our compliant Medical Records Release form. Please be sure to complete all sections when filling out the form.

Authorization for Disclosure of Health Information form

You may mail, fax, or hand-deliver the completed authorization form using one of the following delivery options. You may contact our office to speak to a friendly HIS representative for further assistance during our office hours: Monday–Friday, 8 a.m. to 4 p.m.

Shriners Hospitals for Children — Boston
51 Blossom Street
6th Floor, Room 675
Boston, MA  02114
Phone: 617-371-4789
Fax: 617-720-3739

A fee may be included with fulfilling your request per Massachusetts statute (Chapter 111, section 70) as amended in 2003; or reasonable cost-based fee allowed for patient right of access purposes outlined under HIPAA 45 CFR 164.524(c)(4).

Massachusetts Immunization Information System (MIIS)

Massachusetts law (M.G.L. c. 111, Section 24M) requires providers to report immunization information to a computerized immunization registry known as the Massachusetts Immunization Information System (MIIS). The MIIS stores immunization records for you and your health care provider and can help prevent outbreaks of disease like measles and the flu. All information in the MIIS is kept secure and confidential. The MIIS allows information to be shared with healthcare providers, school nurses, local boards of health, and state agencies concerned with immunization. 

You have the right to object to the sharing of your immunization information across providers in the MIIS. For more information, please ask your health care provider, visit the MIIS website at www.mass.gov/dph/miis or contact the Massachusetts Immunization Program directly at 617-983-6800 or 888-658-2850.

Insurance questions

At Shriners Hospitals for Children — Boston there are no barriers to care. Doctors determine the course of care and all care is provided regardless of the family’s ability to pay. If the child is covered by private insurance or a state funding plan, the hospital will bill and accept reimbursement for services provided at our hospital. However, insurance coverage is not a criterion for care. Any child under 18 with a medical condition that is within the hospital’s scope of services is eligible.

For insurance related questions, please call 617-371-4747.

   
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