Remote access to our EHR and Radiology imaging system is available for our credentialed or referring Providers and their office staff. Credentialed Providers and their office staff also have access to PatientKeeper and HPF. Please read the following detailed instructions on how to successfully complete our electronic form. You will not be able to print the form until all required fields are completed. Failure to fill out the form correctly will result in a delay of account creation. All three (3) pages of the form are required to process your application. Once complete, fax the forms to the number provided at the top of the form. The link to the form can be found at the bottom of this page. Handwritten forms will not be accepted and you will be asked to resubmit.
Required Fields for Printing
Fields marked with an asterisk (*) are highlighted in RED must be fully completed in order to print the form and submit to gain access to Methodist/STRIC applications.
Required Fields for Processing
Listing Physicians, Groups, or Insurances
- List individual physicians that do not belong to a group
- List physician group (practice) if applicable
- List physician group (practice) if applicable
Physician Sponsor Signature and Date
- You must have physician sponsorship to gain access to Medical Records. The physician sponsor must sign and date before faxing. Billing groups must also have a physician sponsor. (Please note, access to Meditech requires that the physician sponsor be a credentialed member of the Methodist Medical Staff)
Confidentiality and Security Agreement (CSA)
- In order to obtain access, the user must print name, sign, and date the bottom of the CSA on page 3. Please note that the user requesting access should sign this section
Why is my Social Security Number and Date of Birth required?
- By law (the HIPAA Security Rule) HCA must have a mechanism to uniquely identify users with access to electronic Protected Health Information (ePHI), and verify their access and activities are necessary and appropriate through periodic reviews, activity monitoring, and audits.
- HCA must have a mechanism to uniquely identify each user on our network for government, law enforcement, and civil/legal discovery requests for logs and evidence of activities.
- HCA also must have a unique identifier to correlate network user access with other key business processes such as background checks, the OIG List of Excluded Individuals/Entities, reports on disclosure of PHI, screening for terminated workforce members, and credentialing.
- Please contact us at 210-575-0090 or send an email if you would like to receive full documentation on this requirement.