Déjeme Saber Si Necesita Esta Información En Español
To Whom It May Concern:
(Déjeme saber si necesita esta información en español)
Thank you for contacting Texas Children’s Hospital.My name is Dulce Palomo and I am the IntakeCoordinator of International Services at Texas Children’s Hospital.I received your inquiry, and it is my pleasure to assist you in coordinating your request for medical services.
Please note that all international patients must go through the Texas Children’s Hospital International Patient Services office, and that the following information is necessary to begin our process:
PLEASE SEND ALL THE REQUESTED INFORMATION TOGETHER, PARTIAL INFORMATION WILL NOT BE PROCESSED.
- For Pediatric Patients: A completed New Patient Information Form (attached) / For Pavilion for Women Patients: Pavilion for Women Patient Information Form (attached)
- Medical reports not older than 3 months(with at least a summary in English).
- Images are part of the patient’s medical reports, please do not send copies of the images through emails or the internet – our system restricts all zip copies.
- Please send all images through DHL or FedEx.Copies of CDs are preferred.Images can be sent to the following address:
Dulce Palomo
Texas Children’s Hospital
International Patient Services
6621 Fannin St., A106
Houston, TX 77030
Actual copy of both the front and back of the family’s insurance card, as well as the U.S. contact information for the medical insurance carrier
- Passports & visas of the patient and bothlegal guardian(s)
For Neurological/ Epilepsy Evaluation:
In order to properly determine if your son is a candidate for the Comprehensive Epilepsy Program and the Stereo-tactical MRI Guided Laser Ablation Surgery for treatment of the Hypothalamic Hamartoma, we will require the following:
- Additional supporting Neurological documentation / medical records
- EEG Reports
- Radiology digital images on CD in Dicom format (i.e. MRI Images, CT scans, PET scans, MEG scans etc.) for physician review.
Request Fororgan or bonetransplant
•Patient must be referred and accepted for transplant by our center
•Patient must be financially cleared for pre-transplant services, the transplant and post-transplant services.
•Patient must have a qualified Physician in post-transplant care in their home country and arrangements with such Physician must be made prior to transplant.
With the exception of the images, please send all other information directly to me at:
Once I receive the above requested information, an International Patient Coordinator will be assigned to this patient’s case and the information sent to a physician specialist for review, medical recommendations and/or appointment scheduling.Based upon the physician recommendations, the Financial Office will contact the family’s medical insurance carrier for verification of medical benefits and coverage.If the family does not have medical insurance coverage, an estimate will be provided.For women wishing to deliver at the Pavilion, they must be medically accepted and financially cleared (payment received) and 1st appointment must be prior to their 29th week of pregnancy.
Please note that, due to the high number of requests, this process typically takes 10-15 business days after the information is sent for review.
Please also be advised that incomplete information will be filed for 30 days.After that time, new information will be requested to ensure the most accurate and updated medical reports are provided for medical review.
Should you need translation of documents, we recommend MasterWord Services to our families:
MasterWord Services
Tel: (281) 589-0810
Fax: (281) 589-1104
Email:
Website:
Should you have any questions or concerns, please feel free to contact me; my contact information is provided below.
Thank you,
Dulce
Dulce Palomo
International Patient Intake Coordinator
Texas Children’s Hospital International Patient Services
6621 Fannin, A1105, Houston, TX 77030
T: +1 (832) 824-6343
F: +1 (832) 825-2545