For Patients - Des Moines

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MercyOne's dedicated team of health care professionals is committed to providing you with the highest quality of care and to make your stay with us as comfortable as possible.

Visiting hours to most hospital units are 7 a.m. and 8 p.m. daily.  Friends and family may call patients at 515-247-3121 and ask to be transferred to the patient's room.  The switchboard will not release private room or phone numbers.  

General questions 515-247-3121

• Patient Portal & Request Medical Records
• Pay My Bill
• Cost Estimator
• Food Options
• Gift Shops
• Inpatient Information
• Social Services
• Pastoral Care
• Area Hotels & Discounts

Popular Forms

Maternity Pre-Admission Schedule Mammogram

Bariatric Surgery Class

Copy of Your Medical Records

To request a copy of your medical records for MercyOne Des Moines, MercyOne West Des Moines or MercyOne Central Iowa Clinics, follow the steps below.

1. Print the form:

• Hospital records form
• Clinic records form

2. Return completed form:

• Hospital form:  Fax to:  515-633-3851, or mail:  Attn: Medical Records, MercyOne Des Moines Medical Center, 1111 6th Avenue, Des Moines, IA 50314
• Clinic form: Fax to:  515-358-6996, or mail: MercyOne Central Iowa Clinics Administration, 405 SW 5th Street, Suite F, Des Moines, IA 50309

Please note -- include the patient’s signature and date of signature, located at the bottom of the form. If the patient is unable to sign, please provide the appropriate legal documentation needed to prevent any delays in retrieving records.  

Have Questions?

• Hospital records questions, please call 515-633-3915 from 8 a.m. to 4:30 p.m.
• Clinic records questions, please call 515-358-6918  from 8 a.m. to 4:30 p.m.

MercyOne Clinic - Adult Forms

Please print and complete prior to your visit.  To protect your personal information please DO NOT fax or email forms.

1. Patient Form  OR  Information Del Paciente Adulto
2. Patient Medical History Form
3. Confidential Alternative Communications Request
4. Patient Financial Consent  OR  Información del paciente – Consentimiento financiero
5. Privacy Notice  OR  Aviso de prácticas de privacidad
6. Acknowledgement of Notice of Privacy Practice

MercyOne Clinic - Pediatric Forms

• Pediatric Patient Information Form
• Foster Child Patient Information Form

Checking In/Admission

If you have been instructed to check in at a specific area or department for your appointment, please do so. For directional assistance, feel free to contact the MercyOne Operator at (515) 247-3121. You may also visit any of our information desks, conveniently located near most main entrances and staffed by volunteers who can provide directions and maps, answer questions, and arrange for wheelchairs and patient escorts.

If you were not directed where to check in, please proceed to Admissions, located inside the hospital’s main entrance. Upon arrival, you will be asked to wait momentarily before meeting with one of our patient representatives, who will record your personal information for admitting and billing purposes. Please have your most recent insurance card and a valid government ID available. Once you have been checked in, you will be directed to the appropriate area for your appointment.

Upon Admission/Registration

Upon arrival, a patient’s first step is to register. Most areas have a dedicated registration process. If you have been instructed to register at a specific area or department, you may go directly there. If you have not received direction or are uncertain, please feel free to visit Admissions, located inside the hospital’s main entrance. Our patient representatives will gladly provide assistance and help direct you to your destination.

Treatment Consent

During the registration process, you will be asked to sign a General Consent for Treatment form that allows MercyOne to treat you as a patient. Please read this form carefully. The registration staff will be happy to answer questions.

In the event you are not with your child when an emergency situation occurs, your child cannot receive treatment without your written consent. To ensure immediate medical attention for your child in your absence, complete an Emergency Treatment Authorization for Minors form and leave it with your child’s caregiver.

• Emergency Authorization Form For Minors
• Autorización de emergencia para menores

Insurance

At the time of registration, you will be asked to provide either a current insurance card or information about your current insurance carrier, as well as any specific forms or original documentation (claim forms, authorizations, referrals, etc.) required by your carrier. Once we have all of the necessary information, MercyOne will file your claim as a courtesy service.  Otherwise, payment of your entire account will be the patient's responsibility...learn more

Payment At Registration

MercyOne requests the patient portion of charges be paid at time of registration. The amount varies depending on your insurance coverage. Most policies require patients to pay a deductible and a percentage of the remaining cost of services (co-payments).

MercyOne will make every attempt to verify your insurance benefits prior to service. If possible, we will inform you of the approximate amount you will owe and arrange for payment. If payment at the time of service is not possible, MercyOne will perform services that are indicated to be medically necessary.

MercyOne accepts checks, cash, Master Card, Visa and Discover.