At Rochelle Community Hospital, we are sensitive to the private nature of a patient’s medical record. We take steps to assure that your medical records are kept confidential and secure.
We require a patient’s written authorization or valid subpoena to release medical records for insurance purposes or legal reasons. These records are sent by mail and are not available by facsimile. The original records are kept at Rochelle Community Hospital, but you may request copies at any time once you have provided us with written authorization.
Note: A separate authorization is required for each request.
You will need to fill out an Authorization for Disclosure of Medical Record Information form and return it with the appropriate fees to:
Rochelle Community Hospital
Health Information Management Department
900 N. 2nd Street
Rochelle, Illinois 61068
Monday – Friday, from 8:00 a.m. – 4:30 p.m.
Completed authorization forms can also be faxed to 815-561-3124.
For ease of reference, hospitals may be reimbursed for copies of medical records as follows:
- $24.81 process fee
- $0.93 per page for pages 1-25
- $0.62 per page for pages 26-50
- $0.31 per page for pages 51 and up
- $1.55 per page for copies made from microfiche or microfilm
Actual postage will be charged for all copies.
The first set of x-ray films or CDs is free of charge.
*Records being sent to a physician or a healthcare facility are provided at no charge to the patient.
VALID ID MUST BE SHOWN AT TIME RECORDS ARE PICKED UP.
Rochelle Community Hospital has the right to refuse to honor a written authorization if there is reasonable doubt as to the identity of the person presenting the authorization or evidence that the person requesting the information is not the person named in the authorization.
If you are not requesting specific documentation, you will be sent an abstract that typically includes history and physical reports, discharge summary, operative reports, consultations, lab, X-ray, specialized tests and most recent outpatient visits.
If the records are for a deceased patient, you must provide legal documentation showing power of attorney, executor of the estate or a death certificate showing next-of-kin to obtain records. A patient’s spouse, relative or friend will not be able to pick up patient medical records without written signed authorization from the patient, stating that the hospital may release records to the specific person. The person must be named in the authorization and proof of identification is required and the patient’s signature will be checked for authenticity.
- Requirements of this statutory section shall be satisfied within 60 days of the receipt of a request by a patient or attorney.
- Most requests are processed within 10 business days of receipt.
For your information, the statutory reference is 735 ILCS 5/8-2001. The fees will be adjusted yearly.
Please contact our Correspondence Department at 815-562-2181, ext. 2740 for additional assistance.