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. Our instruction sheet can guide you through the form completion steps. 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 completing a Patient Request for Information form. (English) (Español)
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)
Does Shriners Hospitals for Children accept my insurance?
Shriners Hospitals for Children accepts insurance from all providers, including Medicaid and Medicare. Shriners Hospitals for Children will send a claim to your insurance provider for services performed during your visit. Any remaining balances such as copays, deductibles and coinsurance amounts will be billed to you by the hospital. If you feel that the amount due will cause a hardship to you and your family, please contact the hospital to begin working with our financial counselor. Shriners Hospitals for Children has financial assistance programs available.
What if my child does not have health insurance?
At Shriners Hospitals for Children, we provide specialized care regardless of the families' ability to pay and whether or not they have health insurance. Our financial counselor is here to assist you and your family with financial matters.
Is Shriners Hospitals for Children in my insurance network?
You may contact your insurance provider to see if we are considered an in-network or out-of-network provider. We are in network for most insurance plans and also bill out-of-network.
Do I have any out-of-pocket costs?
After your insurance company has processed the claim, Shriners Hospitals for Children will send you a statement for the remaining balance. You will not be held responsible for any services performed at the hospital that have been denied by your insurance company.
Once you receive your statement from the hospital, please mail in your payment as directed. If you feel that the amount due will cause a hardship to you and your family, please contact the hospital to speak with our financial counselor. We have financial assistance programs available.
Please note that we cannot accept payment at the time of service.
Will I receive any other bills?
If your child has surgery at Shriners Hospitals for Children — Greenville, Greenville Anesthesia Professional Association (GAPA) will bill your insurance company. You will receive a statement from them for any unpaid balance.
If you are referred to Pediatric Orthotic and Prosthetic Services (POPS) – Southeast, LLC, which is located in our building, they will bill your insurance separately. If you feel that any remaining balances due will cause a hardship to you or your family, please contact the hospital to speak with our financial counselor. Shriners Hospitals for Children has financial assistance programs available for POPS. You will receive a statement from them for any unpaid balance.
If your child receives services outside of our hospital (e.g. MRI, intensive care, etc.), that facility will bill your insurance. You will receive a statement from them for any unpaid balance.
Financial counselor
If you have questions, please call 864-240-8184 or email.