The Health Information Management Department at Jackson-Madison County General Hospital is dedicated to maintaining your medical records and keeping your health information private and secure in accordance with federal and state regulations. Normal business hours are, Monday through Friday, 8:00 a.m. – 4:30 p. m. If you have any further questions, please contact us at 731-541-7800.
Simply follow these steps:
Jackson-Madison County General Hospital will take necessary steps to address all requests to access, inspect, and/or obtain a copy (paper or electronic) of medical records in a timely and professional manner. These steps include verifying the identity of the individual making the request by, for example, requesting photo identification. Verification may also be done orally or in writing and, in many cases, the type of verification may depend on how the individual is requesting and/or receiving access. Note: the verification processes and measures should not create barriers to or unreasonably delay you from obtaining access to your medical record.
Jackson-Madison County General Hospital will provide access in the form and format requested, if readily producible in that form and format, or if not, in a readable hard copy form or other form and format as agreed to by Jackson-Madison County General Hospital and you.
You may direct Jackson-Madison County General Hospital to transmit your medical records directly to another person or entity designated by you. The request must be in writing, signed by you, and clearly identify the designated person and where to send the information.
Jackson-Madison County General Hospital may accept an electronic copy of a signed request (e.g., PDF), as well as an electronically executed request that includes an electronic signature, or a faxed or mailed copy of a signed request.
I need my medical records sent to a healthcare provider: Pertinent medical record information is provided to your physician at no charge for continuum of care. You will need to complete a written or electronic request or Access Request form to have your medical records faxed or mailed to your provider. You will need to include the name, address and/or fax number of the healthcare provider. You may fax your request to 731-541-6768 or e-mail to HIMReleaseofInformation@WTH.org.
I need to have my medical records sent to Social Security: There is a $6.50 flat fee for providing your records to Social Security Administration for disability claims. You will need to complete a written or electronic request or Access Request form and provide the social security disability claims letter from Social Security Administration indication you are applying for benefits. However, if the SSA requests your records, there is no charge.
I need to obtain a copy of my medical records for personal use: Any patient requesting a copy of their record will be charged $6.50. The record can be on paper, CD/DVD, emailed, or on a thumb drive. You will need to complete a written or electronic request or Access Request form.
If requested, Jackson-Madison County General Hospital will arrange for a convenient time and place to inspect or obtain a copy (paper or electronic) of your medical record or for mailing or e-mailing of the medical record. Jackson-Madison County General Hospital will not require that you travel to pick up the copy of your medical records if you have requested that the copy be mailed or e-mailed. If e-mail cannot accommodate the file size of requested images, other access options will be presented to you. However, Jackson-Madison County General Hospital will not tolerate unacceptable levels of risk to the security of our information systems in responding to requests for access.
Your record will only contain the radiology report. The actual radiology images are not part of your medical record. You will need to contact Jackson-Madison County General Hospital Radiology Services at 731-541-7850 for the images.
Your medical records do not contain billing statements. However, upon request we can provide them along with your medical record. If all you need is a copy of your Detail Bill please contact the Business Office at 731-541-6468.
Our quality standard is to process your request for copies with 5 to 15 business days.
The only information the Health Information Management Department released verbally is the patient’s date of admission and/or date of discharge to the patient only.
You will need to request the birth certificate from the State of Tennessee Office of Vital Records. The document you received after the birth of your baby named Verification of Birth Facts is used to send to the Office of Vital Records to complete the official birth certificate. You can reach the Office of Vital Records at 615-741-1763.
You will need to request the death certificate for the Office of Vital Records. The funeral home works in conjunction with the physician to complete the death certificate. The funeral home then submits the death certificate information to the Office of Vital Records. You can reach the Office of Vital Records at 615-741-1763.
Medical records at Jackson-Madison County General Hospital are maintained for 10 years. You will be contacted if your medical record request cannot be fulfilled due to expiration of the retention period.
Yes. There is no charge for you to review your records. To view your medical records:
NONDISCRIMINATION NOTICE STATEMENT
West Tennessee Healthcare (WTH) does not exclude, deny benefits to, or otherwise discriminate against any person on the grounds of race, color, national origin, age, religion, disability, Limited English Proficiency or sex, including discrimination based on gender identity, sexual orientation, sex stereotyping or pregnancy in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, whether carried out by WTH directly or through a contractor or any other entity with which WTH arranges to carry out its programs and activities.