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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 409-770-6748.You will be asked to complete an Authorization for Disclosure of Health Information form.

Requests for records usually take less than two weeks to complete, but depending on the size of the records, can take as long as 30 days. If you are requesting the records for parents/guardian, patients or legal action, there will be a charge of $45.74 for up to the first 10 pages; $1.54 per page for up to 60th page; and $0.76 per page for pages 61–400.

Insurance

Insurance questions

At Shriners Hospitals for Children — Galveston, we provide medical services regardless of the families’ 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’s patient financial services are available from 8 a.m.–4:30 p.m., Monday–Friday. The staff can provide assistance with questions about insurance, costs and coverage.

Patient financial services
409-770-6763 (Monday–Friday)

Registration and scheduling department
If your name, address, telephone number or insurance coverage has changed, please call the registration and scheduling department at 409-770-6763.

Authorizations

Authorizations regarding services ordered by Shriners Hospitals for Children’s physicians are handled by our patient financial services staff 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 Galveston 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 409-770-6685.

If you do not know if an insurance referral is required to seek care at the Galveston 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, Shriners Hospitals for Children is required to contact your insurance provider to notify them prior to the admission date. The notification process is handled by our patient financial services staff.

Services performed outside of Shriners Hospitals for Children — Galveston

Occasionally, a patient will need services performed that cannot be completed at the Galveston Shriners Hospital. This includes, but is not limited to MRIs, CT scans, EMGs 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 balance for these outside services will be your responsibility.

Shriners Hospitals for Children — Galveston'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.

Please note that Shriners Hospitals cannot assist you with payment of your prescriptions, select medical equipment and any rehabilitation therapies you receive from other locations.

Insurance referrals guide

Please be sure to find out if you need an insurance referral before visiting the Galveston Shriners Hospital.

Frequently asked questions

Do I have an out-of-pocket cost at Shriners Hospitals for Children?

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

Please note that Shriners Hospitals for Children 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 patient financial services.

Does the Galveston Shriners Hospital accept my insurance?

Shriners Hospitals for Children 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 our patient financial services staff to determine our network status with your insurance payer.

What if my child does not have health insurance?

At the Galveston Shriners Hospital, we do not turn away patients who do not have health insurance. We see all patients 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 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 is an insurance referral?

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.

Why do I need an insurance referral?

Insurance plans that require their policyholders and beneficiaries to obtain insurance referrals 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.

How do I obtain an insurance referral?

If your doctor recommends that your child seeks care from a specialist, ask for an insurance referral to 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 409-770-6685. It is a good idea to ask for a copy of the insurance referral for your records.

What does an insurance referral do?

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, laboratory tests, 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 care 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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