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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 form and submit your request in writing to the Health Information Services (HIS) department. Note: Please be sure to complete all sections when filling out the form.

Patients, legal guardians and personal representatives with legal authority to make health care decisions on behalf of the individual may obtain medical record copies by one of two methods:

  1. Completing a Patient Request for Information form: (English) (Español), or
  2. Submitting a request to release the medical record through the Shriners Hospitals for Children Patient Portal. (Note: This process does not require completion of the form listed above.)
    • If you already have access to the Shriners Hospitals for Children Patient Portal, see instructions here.
    • If you do not yet have access to the Shriners Hospitals for Children Patient Portal, contact the Shriners Hospitals for Children registration staff or care manager at this location to request an invitation.

Third parties may obtain medical record copies by submitting an Authorization for Disclosure of Health Information form that is completed and signed by the patient and/or legal guardian: (English) (Español).

For personal assistance with your medical record request, you may contact health information services at 814-875-8797.

You will be asked to complete the Authorization for Disclosure of Health Information form, which can be downloaded from the above links, or can be sent to you by fax or email. If you prefer, you may pick up a form in person by stopping by the front reception desk during our regular business hours: 8 a.m. – 4:30 p.m., Monday – Friday.

Requests for copies take up to 14 business days to process upon receipt of the authorization form. Please fax completed Authorization for Disclosure of Health Information form to 814-875-8779 or email. You may also drop the form off at the front reception desk.

Insurance questions

At Shriners Hospitals for Children — Erie, there are no barriers to care. Doctors determine the course of care and all care is provided regardless of the families' ability to pay. We accept many types of insurance and are a participating provider with Highmark Blue Cross Blue Shield, UPMC, AmeriHealth Caritas, Aetna Better Health, Gateway Health and Pennsylvania Medicaid. However, insurance coverage is not a criterion for care. We work with all families regardless of their insurance or ability to pay. Any child under 18 with a medical condition that is within the medical center’s scope of services is eligible.

For insurance related questions, please call 814-875-8866.