The Health Information Management (HIM) Department is responsible for managing your information. Medical records contain protected health information. All medical records are protected by federal, state, and hospital privacy laws.
Listed below are some Frequently Asked Questions. Should you require additional information, please contact our Release of Information Office within Health Information Management.
|Monday - Friday
||8:00 am - 4:30 pm
|Mishawaka Medical Center
|Plymouth Medical Center
How can I obtain a copy of my medical records?
An authorization form must be completed in order to obtain a copy of your medical record. It must to be completed, signed, and dated by the patient or the patient’s guardian/legal representative. The authorization, Request for Release of Protected Health Information, can be downloaded and printed here. All sections of the form must be completed. Forms can be submitted by mail or by fax. Campus addresses and fax numbers are located at the top of the authorization form.
How long does it take to process a request to release medical records?
Typically you can expect a 7-10 day turn around time for your request to be completed after the request has been received in the Health Information Management Department. If your circumstances require a more rapid turn around time, please contact the Health Information Management Department to discuss your request. On occasion, extenuating circumstances applicable to certain requests may delay the turn around time.
Am I able to obtain a copy of a family member’s medical record?
Only the patient may release his/her records. If, however, you have a Healthcare Power of Attorney (POA) or are the executor of the patient’s estate, you are able to request and obtain records. An authorization form must be completed, signed, and dated. In addition, POA documentation must be provided; a copy will be retained for hospital records.
I have an upcoming appointment with another healthcare provider and would like my medical records sent to that physician. What do I need to do?
Copies of your medical record can be faxed to healthcare providers for continuity of care. Patients can contact the Health Information Management Department and request that copies be sent to the physician. A physicians name, fax number, and phone number will need to be provided. An authorization is not required, but can be completed. There is no charge for copies provided for continuity of care.
How long are medical records retained?
Medical records are retained in accordance with Indiana State Law and Trinity Health Guidelines. You will be contacted if you have submitted a request for records that cannot be fulfilled because the retention period has expired.
Am I able to obtain a copy of my birth certificate?
The hospital does not possess birth certificates. You will need to contact the Health Department for this document.
Is there a cost for obtaining copies of my medical record?
We have partnered with HealthPort Technologies, LLC, the nation’s largest provider of release of medical information services, to process and fulfill your request for a copy of your medical record. Due to the strict procedural and highly regulated steps involved in this process, known as the release of information process, there are costs associated and, therefore, a fee for all patient requests for medical records, based on state and federal law.
| 1 - 10 Pages
|| $1.00 per page
| 11 - 50 Pages
|| $0.50 per page
| 51 & More Pages
|| $0.25 per page
Plus tax and shipping. Cost will be capped at $50.00 plus tax and shipping. The fee should be remitted to HealthPort Technologies, as directed on the HealthPort invoice you receive. Click here to pay your invoice online.
Payment can be accepted in the following forms:
Please note: There is no fee for medical record requests sent directly to a physician or healthcare facility for continuing care purposes.