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Patient Information
General Information
Medical Records/Health Information
Patient Financial Services
Medicine Record Form
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General Information
Central Registration/Switchboard: 218-283-4481
NurseOnline: 1-800-714-4646
Address:
1400 highway 71
Int’l Falls, MN 56649
Urgent Care Hours:
Monday – Friday: 3 – 10 p.m.
Saturday, Sunday and holidays: noon – 8 p.m.
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Medical Records/Health Information
Q. How secure are my medical records?
A. Security of your medical records is top priority at Falls Memorial Hospital. Every effort is made to protect the contents. Information is released after verifying proper authorization. State and Federal laws are very strict regarding inappropriate release of information from your medical record.
Q. What do I need to do to get copies of my medical records?
A. Your medical records are confidential and cannot be released without your authorization. If you would like copies, the release of information clerk will ask you to complete a "Release of Information" form. This form will identify who you are, your date of birth, to whom the records are going, why you need your records, and which records you are asking for. The form must be dated and signed by you. You may be asked to provide identification to ensure we are not releasing records to an imposter.
Q. Do I need to come to the hospital to request records?
A. No, you may send a written or a faxed request to the medical records department. The request must identify who you are, where you would like them sent, what records you are asking for and why you need them. Your signature will be authenticated with signatures we have in your medical record to ensure someone other than yourself does not authorize the release.
Q. Can my spouse or another family member sign for release of my records?
A. No, only you can authorize release of your medical records. State, Federal and Falls Memorial Hospital guidelines prohibit anyone else from authorizing release of your medical records.
Q. Will there be a charge?
A. Depending on your need for information from your record, there may be a charge. Please call the release of information clerk at 283-5413 for an answer.
Q. Can I look at my medical records?
A. Yes, you may call medical records at 283-5413 to set up an appointment to view your records. Personnel will be available to assist you.
For more information, click here to read the full text of our Notice of Privacy Practices.
Patient Financial Services
| Sue DeBenedet, Director of Patient Financial Services | (218) 283-5469 |
| Rebecca Bliss, Claims Representative(Blue Cross Blue Sheild, Bois Forte, First Plan Blue, Ontario Health) | (218) 283-5402 |
| Nicole Haugland, Claims Representative(Medicare and Medical Assistance) | (218) 283-5406 |
| Barbara Hanson, Claims Representative(Commercial Insurances & Workers Compensation) | (218) 283-5411 |
What About Insurance?
Patients or their legal guardians are ultimately responsible for medical costs. Insurance companies require the hospital review your insurance card upon each visit. Expenses that are not covered by insurance providers may include: Elective Procedures, Exclusions from your regularly insured treatment, deductibles and co-payments.
Helpful Phone Numbers:
Blue Cross MN |
1-800-262-0820 (follow prompts for patient customer service) |
Blue Cross Regence (Boise/Office Max, & Law Enforcement) |
1-800-909-6069 |
Medicare |
1-800-MEDICARE |
Medica |
1-800-952-3455 |
United Health Care |
1-877-842-3210 |
Preferred One |
1-800-451-9597 |
Triwest |
1-888-874-9378 |
Tricare |
1-800-941-4501 |
Helpful Websites:
http://www.bluecrossmn.com
http://www.noridianmedicare.com
http://www.webmd.com
http://www.medica.com
http://secure.preferredone.com
http://www.mytricare.com
Payment Options:
Medical Care can be expensive. How do you pay for it? At Falls Memorial Hospital, we’ve created five convenient options to help you meet the cost.
· Cash
· Checks
· Credit cards (Visa, MasterCard, Discover, & American Express)
· Extended Payment Plan
· Community Care Fund Program
Falls Memorial Hospital designed the Extended Payment Plan and Community Care Fund program to help those who are unable to pay in full. If approved for the Extended Payment Plan, you can make monthly payments. The Community Care Fund program is made possible by the hospital’s Board of Directors’ commitment to medical care access for all residents of the community. Eligibility is based on family size and income.
Medicine Record Form
To print out a Medicine Record Form, click on one of the following icons. The form will open in a new window; to return to this page, simply close the new window.
To download the form to your hard drive, right-click on the appropriate icon and choose Save Target As...
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If you would like to print out a Medicine Record Form in Microsoft Word format, click on the following link. |
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If you would like to print out a Medicine Record Form in Adobe Acrobat format, click on the following link.* |
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To view this file, you will need Adobe Acrobat Reader. If you do not have Acrobat Reader, you can download it for free by clicking the following link: Get Adobe Acrobat Reader. |
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