.... My wife is not only a medical biller running her own part time co. but she also works for a bunch of surgeons doing their billing. She knows the HIPAA laws quite well. I have her picking their brain at the legal department. Even in the letter to restrict medical information you posted from CCHH there's that damn disclaimer. "CCHC specifically does not warrant the effectiveness of said form in restricting access to or use of personal information by government agencies or private organizations." But here's what I think so far; this issue is so complex that the'res a slim chance the medical provider would know any difference so maybe it'd be worth a try. I for one intent to NAIL this issue. I'll let ya know what I find out.
Good morning, Butch, WHAT you're still sleeping? Mindcrime must still be whacking the snooze alarm ;-) You two crack me up, gave me a good giggle on my way to bed last night, thank you! I didn't mention the Sharon Kay Foundation but I've read about it, I thought they (he) were non-profit do-gooders, they charge 30 bucks for 2 sections of the FCRA? Grrrrrrrrrrrrrrrrr, I really hate that too. It's just not right, that's what my problem is, I've my share of collection accounts that were medical, or did, but the privacy issue is getting to be a wild hair! It reads to me like the HIPAA will provide for consent to run through each step or organization in the medical chain via specific business associate and chain of trust agreements; actually I think likely it will make medical facilities and doctors turn into affiliates with everyone they do business with and then the agreements will be so broad it will only cover their butts, not help with maintaining privacy at all. The privacy thing is a secondary purpose to the law anyway, I think it's a smokescreen to make it tolerable for passing the legislation. Anyway, that's my sassy opinion without a cup of coffee yet. Case in point on the confidentiality issue. From my own reports, if you go to www.google.com and type in "dr ted dietrich" tell me how long it takes you to figure out what kind of health problems I have or have been treated for, AND LOL, I promise you don't have to search through 2,000 entries ;-), won't even take you 5 minutes. I think you could say 5 years ago maybe and 10 years ago certainly, releasing the name of a doctor on a CR really had no practical impact on a persons privacy or confidentiality in medical treatment, unless someone was willing to do a lot of legwork, now, with everything online, just the name alone is enough to make some valid assumptions that can easily be verified by anyone that knows how to turn a computer on. WAVING to you, Mrs. Butch!!!!!!! pick, pick, pick at those legal eagles -- have them check their own reports and if they've a collection just enter it into a search engine, the implications are huge! I noticed that disclosure on the privacy forms too, because there are buried provisions in those 1,500 pages that no matter how you restrict what information and to who it may be released, the doctors or pharmacists or facility itself, I found the last 2 shocking, can do it anyway, using their professional judgment. There's a letter I found on a medical billing message board, not very active but interesting, a draft they were working on to get around being bound by any restrictions on release by saying just that. What I think is scary are the implications beyond medical services being paid for, and that's what I don't think people are stopping to think of. I've a right to privacy by virtue of my citizenship and wrap me in the flag and I'll sing yankee doodle too, medical privacy and confidentiality in that relationship with your doctor has always been sacred. If we've no medical privacy, we've no privacy at all; it goes wayyyyyyyyyyy beyond medicine, did you see that list you have to specifically ask to be restricted and that was just for medicine, there's another for financial and another for your home. I'm with you as far as the medical provider goes, they've bigger issues in order to comply for the moment, they may get themselves covered with front line 3rd party servicers, like billing, but there's no way it can effectively be extended through the chain. I did find this, unresolved problems with the HIPAA regulations: http://www.angelfire.com/pa5/kpama/HIPAA2.HTML It's a table so I can't cut and paste it, but it says the current law uses the wording, collection and credit reporting are "permitted by law," but are not "required by law." HIPAA uses the wording, â??useâ? or â??disclosureâ? of private health information as â??required by lawâ? is allowed, but not as â??permitted by law,â? i.e., credit reporting or collecting from responsible parties. The result is it conflicts with the with the Fair Debt Collection Practices Act, Fair Credit Billing Act, Fair Credit Reporting Act, and state laws. Actually, it would be good for us, all of us, if this conflicting language goes unnoticed -- Don't look Mrs. Butch ;-) And an article from ACA's collector.com on suggested changes that's revealing: http://www.collector.com/content/press/pr/2001/010418.html I'm passing you my hammer, Butch, NAIL NAIL NAIL, I'll look forward to whatever you find out. No more snoozing, mindcrime, can't you smell the coffee ;-) Sassy
Here's the letter I referenced, this tweaks me already, of course you have the right to restrict the release of information, however you'll then be responsible for your bill and we'll blow you off anyway. Sassy To: Emergency Department Patient Subject: Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulation Consent Form. On April 14, 2001, the Privacy Regulation of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 went into effect, requiring the protection of the confidentiality of your health information. We require your consent, in nearly all situations, involving the disclosure of your personal health information (PHI). Please make sure you read all of the information contained on this consent form before you sign it. As your emergency department provider, I do not work for the hospital where you are being treated. The services I am providing to you are separate than that provided by the hospital. I will be billing you separately from the hospital, or, per your request, I will be sending a claim to your insurance carrier for the medical debt you are incurring today. Please understand that even though you have health insurance, you are legally responsible for ensuring this debt is paid. In order to provide you with the care and treatment you have requested, I do not do the medical billing myself. I contract with a third-party medical billing company that also has access to your personal health information. They use this information so they can medically code your visit. This information is placed on a claim form so they can send the claim to your insurance carrier, or, if you have no insurance, they will send you a bill. The billing company sends the claim to your insurance carrier by paper or by modem to an electronic clearinghouse. The clearinghouse then sends the claim to your insurance carrier. This is accomplished electronically via secure means. The third party medical billing company may also receive requests for your personal health information from other outside sources such as your insurance carrier or an attorney that you may have hired. Failure to allow this information to be released may result in a denial of your medical claim, which will cause you to pay for the medical bill yourself. If your medical debt becomes delinquent, the billing company may send your account to a professional collection agency in order to collect the debt that is owed. The collection agency will also have access to your personal health information based on the data contained in your billing record. The billing company, collection agency, and the clearinghouse, have all signed confidentiality agreements stating your personal health information will not be discussed or released without a signed consent form, from you, allowing them to release this information. Every employee of the billing company, clearinghouse, and collection agency, has signed a similar document. Requests for personal health information that come from your insurance carrier or attorney will not be processed without a written request from them and your written consent. At NO time, will your personal health information, or billing information, be discussed over the telephone or via the internet through websites or e-mail. This includes telephone calls allegedly from you. We will not discuss your private health information with spouses, relatives or parents of children over the age of 18 years old without written consent and then we will only respond in writing. If you refuse the billing company access to your personal health information, this will cause your medical claim to go unprocessed and you will be responsible for paying your medical debt yourself. Even if you refuse to allow the billing company access to your personal health information, we have the right to deny your request. You are entitled to other certain rights, which will be addressed on this consent form. Even though you can make certain requests regarding the access of your health information, these requests may be denied at any time. Your consent is required in nearly all situations involving the disclosure of your personal health information. This consent includes marketing, fund-raising, and underwriting. Your consent is not required for research, law enforcement purposes, judicial proceedings, and public health activities. You have the right to request restrictions as to whom your personal health information is released to. For example, you may ask me not to disclose any of your personal health information to your sister, but, as stated earlier, we do not have to grant your request. You do have the right to your own personal health information and access to any disclosures of your personal health information. All you have to do is submit this request, in writing, to my office. The fee for this is $15 per request. Within 30 days of receipt of your written request and payment, the information will be sent to you. Any other requests for your personal health information will be placed on file and recorded in your medical billing records. - - - - - - - - - - - - - - - - - - - - - - - - - - - Signed Authorization I and or my guarantor _______________________________________, have read this document and I have been informed of my rights to the privacy of my personal health information under the HIPAA Privacy Regulation, by Emergency Medicine Specialists. I or my guarantor, do hereby authorize Emergency Medicine Specialists, itâ??s representative billing company(s), health claims clearinghouse, and collection agency, full access of my personal health information for the purposes of medical coding and billing and debt collecting. I fully understand that this medical debt is my or my guarantorâ??s responsibility and I or my guarantor will do everything to ensure payment of my medical debt to the provider. My or my guarantorâ??s signature allows the release of my personal health information to my attorney or health insurance carrier only upon written receipt of a request for this information and this request also has provisions to protect my personal health information. My signature also allows the provider or his/her representative to file a complaint with the Insurance Commissioner, on my behalf, against my insurance carrier, in the event my medical claim is not paid within the time frame allowed under Florida Law. I understand that all requests for my personal health information will be documented. I understand that even though I may request restrictions on disclosures to others of my personal health information, my request may be denied. I understand that I have a right to a copy of my personal health information, and an accounting of all disclosures of my personal health information and I must make this request in writing. A copy will be sent to me within 30 days of receipt of my request. I also understand there is a $15 fee for copying, postage, and processing of the personal health information and this fee must be paid in advance. _____________________________________________ Patient Signature Date _____________________________________________ Guarantor Signature Date _____________________________________________ Witness Signature Date _____________________________________________ Witness Signature Date
