One of the main responsibilities of this section is to process requests for external release of information. We are custodians of legal records and are called upon to testify when records are required in court.
There are nine work types of informational releases that the section processes for provider offices:
- Subpoenas for records
- Attorney requests
- Employer workers compensation requests
- Insurance applications (health and life)
- Commercial disability forms (loan claims)
- Department of Rehabilitation Services
- Federal Bureau of Disability Determination Services
- Release to patients and other providers (Authorization to Release Medical Information Form and Revocation of Authorization Form)
- Employer disability forms
To assist patients in assessing their personal healthcare information (requests for hard copies of medical records), patients should thoroughly complete the Springfield Clinic’s Authorization To Release Medical Information form. Completed forms should be mailed to:
Attn: Correspondence Section
1025 South 6th Street
PO Box 19248
Springfield, IL 62794-9248
Authorization forms may also be faxed to Correspondence at fax number 217.527.2887.
Processing fee for record copies: In order to maintain reasonable charges and to cover the cost of processing such requests, patients requesting copies of the medical records for their own personal records will be charged a $17 processing fee (each for one to two patients) and $45 processing fee for three or more patients per account. Checks can be mailed along with the authorization form and should be made payable to Springfield Clinic. Patients requesting record copies amounting to ten pages or less will not be charged.
*There will be no charge for requests for record copies to be released to another caregiver (such as transfer of care, continuity of care purposes, second opinion, etc).