Is there a fee for patients to receive their medical records?
There is no fee for patients to receive their medical records.
If patients request that medical records be mailed, there will be no mailing fee.
What are your telephone hours of operation?
We are open Monday through Friday from 8 am to 4:30 pm at 909-865-9142
How can I submit my request for medical records, radiology films, or visit
itemized bills?
You may submit a request for medical records, radiology films, or visit
bills by completing the Authorization for Release of Information via online
request or by printing and completing the Authorization for Release of
Information form.
How long does it take to fulfill my request for medical records?
Requests are processed within 15 business days of receipt.
Will you fax the copies to my home or business?
No, due to confidentiality reasons, we cannot fax to home or business (work)
fax numbers unverified numbers to accept PHI
Can anyone other than me
request or receive copies of my medical records?
Yes, only if the person signing on behalf of the patient has provided legal
documentation (i.e., Advance Directive/Power of Attorney) stating that
the person making the request is authorized to request and receive the
patient’s medical records.
What are all the options for medical record correction/amendment?
Patient Amendment – An amendment changes the content of your medical record by the
author of the note in question.
Patient Addendum – An addendum is an addition to your medical record. It does not
delete or change any of the existing information currently in the record.
Accounting of Disclosures – An accounting of disclosures compiles a listing of how Pomona
Valley Hospital Medical Center (PVHMC) has released your medical information.
PVHMC does not list disclosures made for TPO (treatment, payment, and
operations).
Statement of Disagreement – A statement of disagreement is much like an addendum; it is added
to your medical record to state that you disagree with the outcome of
your amendment request.
What information needs to be included on the amendment request?
Please include the following:
What information needs to be corrected (ex, diagnosis, history, visit information, etc?
Why do you want the information corrected?
How do you feel it should be corrected?
If you need corrections to a visit, what is the date of service?
What is the name of the physician, nurse, or clinician who entered the
information on your record?
If applicable, include supporting documents.
How long will it take for my amendment to finalize?
We cannot give a definitive answer, but a reasonable timeframe is 60 to 90 days.
As stated above, the only person who can change the information in your
medical record is the author of the note; HIM cannot. Therefore, we must
contact the author and request that they make the necessary changes. Unfortunately,
not every author responds promptly, but we do our best to maintain contact
until we receive an answer.
Fax: 909-620-0474
Mailing address: Pomona Valley Hospital Medical Center
Attn: Health Information Management – Data Integrity
1798 N. Garey Ave, Pomona, CA 91767
Make sure to put the form type in the subject line when emailing
What are the outcomes for an amendment request?
There are three possible outcomes that the author can choose:
Approve – The author of the note makes all the changes requested. We will
send you a copy of the amended note once it is finalized.
Partial approval – The author of the note makes some of the changes requested but denies
the others. We will send you a letter explaining the changes made, along
with a copy of the amended note.
Denial – The author of the note does not make the changes that the amendment
request is asking for. We will send you a letter letting you know of the denial.
What should I do if I have a question about a note?
Any questions about the content of a note should be directed to your healthcare
provider who wrote it by sending a secure message via MYHEALTH.
What should I do if I have a question about a note?
Any questions about the content of a note should be directed to your healthcare
provider who wrote it by sending a secure message via MYHEALTH.
Can I view a family member's medical record in MYHEALTH?
Yes, if the family member granted you proxy access in MYHEALTH.
MYHEALTH proxy access allows you to access the medical records of your
family members and others you care for, with their permission. You must
be at least 18 years old to have proxy access to another person’s
medical record.
You might also want to grant a family member or friend access to your medical
records when you need assistance managing your appointments and other
medical needs. To give someone access to your medical record (patient
18 years of age or older), complete and submit the
Patient Portal Proxy Authorization form via Email, fax, or mail.
Fax: 909-469-2141
Mailing address: Pomona Valley Hospital Medical Center
Attn: Health Information Management - ROI
1798 N. Garey Ave, Pomona, CA 91767
Send the proxy invite to your selected family member, friend, or caregiver.
You may provide your spouse, parent, or caregiver with proxy access to
your patient portal account by completing a
Patient Portal Proxy Authorization form in person in one of our clinics/hospital registration areas and requesting
a team member to send a proxy invitation to the authorized representative.
