Patient Information & Privacy
Welcome to the Compliance Department at Prairie Cardiovascular Consultants (PCC).
The Compliance staff handles external releases of patient information, develops policies regarding education and privacy compliance with applicable laws, and assists patients with privacy issues or concerns.
Requesting a release of information or records
The Compliance Department processes all requests for release of patient information. To assist patients in accessing their personal healthcare information (hard copies of medical records), patients should thoroughly complete the Prairie Cardiovascular Consultants Authorization to Use and/or Disclose Protected Information form.
All completed, signed and dated Authorization forms may be returned to:
Attn: Compliance Department
619 E. Mason Street
Springfield, IL 62701OR E-mail: HIPAA2@prairieheart.com
OR fax directly to the Compliance Department: 217-522-0568
Release of Patient Information Forms
Frequently Asked Questions
What are the fees associated with requesting medical records?
PCC does not bill patients, other health care facilities, providers, or the Department of Veterans Affairs Administration (VAA) for requesting copies of patient medical records.
How do I obtain copies of my medical records?
- An Authorization to Use/Disclose Protected Health Information must be signed by the patient or patient representative.
- To obtain an Authorization to Use/Disclose Protected Health Information form click here.
- Please click here for instructions on how to complete the Authorization to Use/Disclose Protected Health Information.
- If you are unable to print the form, please contact us via the contact information.
- Once the completed, signed and dated authorization has been received by the Compliance Department, the requested information will be sent to the recipient.
When does the authorization expire?
Where do I mail my completed authorization?
Attention: Compliance Department
619 E. Mason Street
Springfield, IL 62701
What is the fax number to send my completed authorization?
Can I e-mail my completed authorization?
What do I need to receive medical records on a deceased patient?
What if there is no agent for the deceased?
How long will it take to receive my medical records?
- For a medical record release, it can take up to 30 days to receive your records. We process requests in the order they are received. However, upcoming appointments, procedures, and emergencies are processed as a STAT request.
- We may be able to process a request same-day, given staffing and information is complete and available. You may contact the Compliance Department to check on the status of your request.