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Medical records and insurance

Medical records and insurance

Medical records

To request copies of your medical record please contact our health information services staff at 513-872-6260.

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 takes 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

Financial information

At Shriners Hospitals for Children — Cincinnati there are no barriers to care.  Doctors determine the course of care, and all care is provided regardless of the families' ability to pay. When families do have insurance, the hospital will accept payment from insurance providers; however, insurance coverage is not a criteria for care. Any child under 18 with a medical condition that is within the scope of services provided is eligible for care.

Services not covered by insurance

Any service provided at our hospital not covered by a third party payer is covered by Shriners Hospitals for Children — Cincinnati.

Registration and scheduling department

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

Billing and payment inquiries

For any billing and payment inquiries, please contact our billing office at 888-385-5729.

Authorizations

Our patient financial services staff handles authorizations regarding services ordered by the Cincinnati 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 Cincinnati 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 513-873-6025.

If you do not know if an insurance referral is required to seek care at the Cincinnati Shriners Hospital, please contact our insurance referral coordinator at 513-872-6260 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 Cincinnati 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 — Cincinnati

Occasionally, a patient will need services performed that cannot be completed at the Cincinnati 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 — Cincinnati’s 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 Cincinnati 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

Do I have any out-of-pocket costs at the Cincinnati Shriners Hospital?

Shriners Hospitals for Children — Cincinnati 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 Cincinnati 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 Cincinnati Shriners Hospital accept my insurance?

Shriners Hospitals for Children — Cincinnati accepts all insurance, 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 — Cincinnati, we do not turn away patients who do not have health insurance. We provide specialized care to children regardless of the families' ability to pay. We have many ways to assist with difficult financial matters. Our patient financial services staff will assist you in finding medical coverage or financial assistance. We offer charity care and/or other 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 Shriners Hospitals for Children 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 the 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 other 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 513-872-6025. 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.

   
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