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Medical Record Requests

Contact

Medical Record Requests

Release of Information Services for both Mercy Health and The Jewish Hospital


Obtaining Copies of your Medical Records

Patient medical records are confidential and shall not be released, nor the information contained therein disclosed, except in accordance with legal requirements and Mercy Health and The Jewish Hospital policy and procedure.


Requests for Medical Records

  • There is a charge for copies of medical records. Please see the copy fees listed below.
  • Fees are waived for copies sent directly to patient caregivers for continued patient care and you do not need to complete an authorization.
  • Your physician can request your medical record by calling the respective facility or by faxing the request on their office letterhead at the numbers listed below.
Release of Information is permitted upon Mercy obtaining a valid ‘Authorization to Use, Disclose or Release Health Information.’ This form is available in the Health Information Management Departments at the facilities listed below. Or, you may download the form(s) below:

Authorization to Use, Disclose or Release Health Information (English Version)
Autorización para el uso, revelación o divulgación de información de salud (Spanish Version)
Authorization for Release of Patient Protected Health Information (The Jewish Hospital)

If you have any questions on how to complete this form, please contact the respective site medical records department.

Public Hours of Operation:

Monday – Friday, 8:30 am – 4:30 pm


Anderson Hospital

Attn: Medical Records ROI
7500 State Road | Cincinnati, Ohio 45255
513-624-4073 (phone)
513-624-4074 (fax)


Clermont Hospital

Attn: Medical Records ROI
3000 Hospital Drive | Batavia, OH 45103
513-732-8388 (phone)
513-732-8288 (fax)


Fairfield Hospital

(includes Mercy Hospital Hamilton requests)
Attn: Medical Records ROI
3000 Mack Road | Fairfield, OH 45014
513-682-7259 (phone)
513-870-7313 (fax)


Mt. Airy Hospital

(includes Harrison Urgent Care prior to 3/2006)
Attn: Medical Records ROI
2446 Kipling Avenue | Cincinnati, Ohio 45239
513-853-5219 (phone)
513-853-7869 (fax)


Western Hills Hospital

(includes Harrison Urgent Care 3/2006)
Attn: Medical Records ROI
3131 Queen City Avenue | Cincinnati, OH 45238
513-389-5130 (phone)
513-389-5875 (fax)

The Jewish Hospital — Mercy Health

Send your request to:
The Jewish Hospital
Attn: Medical Records
4777 E. Galbraith Road
Cincinnati, Ohio 45236
513-686-5029
Hours: 7:30 a.m - 4:30 p.m.

Signed & completed ‘Authorization to Use, Disclose or Release Health Information’ forms should be submitted to the site from which you are requesting copies of medical records from. Authorization forms can be submitted in person or by mail or fax to the respective site. Mailing and fax information for each acute Mercy and The Jewish Hospital facility is listed above.

It is requested that you include a phone number that we can contact you at in case an issue is identified with processing your request.

Copies of the medical record (s) requested may be received by mail or picking up from the respective facility during the public hours of operation. Please note that if you are picking up your records, please contact the respective site’s medical record department prior to your arrival to ensure your request has been completed and is ready for pick up. A photo I.D. is required to be presented at the time of pick up.

Usual turnaround time for a request to be completed is within 10 business days from the date of receipt. Additional time may be necessary to process your request if the requested information is located off site or if the authorization to use, disclose or release health information is not properly filled out.

Requests for copies of Birth Certificates should be made to the Ohio Department of Health Vital Statistics or the county health department that the birth took place.

2013 Medical Record Fee Schedule based on the Ohio Revised Code 3701.742

Patients

Retrieval Fee: None
$2.88/pg (1-10 pgs)
.$60/pg (11-50 pgs)
$.24/pg (51+ copies)
actual postage

Attorney, Insurance & Record Service

Retrieval Fee: $17.70
$1.17/pg (1-10 pgs)
$.60/pg (11-50 pgs)
$.24/pg (51+ pgs)
$1.97 other media copies
actual postage

Other Media: data resulting from x-ray, MRI or CAT scan: on paper or film.

The per page rate for any information reproduced from media other than paper is 1.97 + Retrieval fee

Cancellation Fees for Attorney, Insurance & Record Service

Cancellation Fee: None
Retrieval Fee: $17.70
Shipping Fee: None
Sales Tax: None

Payment

Make out check to the Mercy Health facility or exact change only.
  • Walk-ins: Customer requesting 30 pages or less can be process as on-site delivery.
  • Request for medical records are processed in the order they are received and could take 5-10 days to process.
  • MRO will send out a pre-paid invoice and records will be sent once payment has been received.
  • Authorization form must be completed in it's entirety and a picture I.D. must be presented.
To check the status of your medical records requests, please call: 1-888-252-4146 Ext. 1 or by email at: requestinformation@mrocorp.com.



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Date Last Modified: 4/11/2013 11:34:21 AM