I pose a hypothetical question to the experts: PRE-4/14/03 events: 1. Consumer asks CA for validation 2. CA replies with partial validation, but it contains medical codes, diagnosis, other very intimate/personal info 3. HIPAA letter sent to HCP Post 4/14/03: 1. Should the consumer pursue 'complete' validation? Would it jeopardize the validity of the HIPAA letter sent above? 2. If the HCP provided the sensitive info prior to 4/14/03, where is the HIPAA violation? 3. I have read about the 'minimum necessary', and am still not clear on it. What is required for an HCP to be in compliance with it and when did it become effective? 4. Please detail the difference between CA accounts that were paid pre-4/14/03 and illegitimate CA accounts. More questions to come, I promise :O)
Edit of initial post My 15 minutes were up before I could edit. I pose a hypothetical question to the experts about medical collections either paid pre-4/14/03 or is illegitimate: PRE-4/14/03 events: 1. Consumer asks CA for validation 2. CA replies with partial validation, but it contains medical codes, diagnosis, other very intimate/personal info 3. HIPAA letter sent to HCP Post 4/14/03: 1. Should the consumer pursue 'complete' validation? Would it jeopardize the validity of the HIPAA letter sent above? 2. If the HCP provided the sensitive info prior to 4/14/03, where is the HIPAA violation? 3. If the CA, at this point sends the same doc/info that contain HIPAA-violating information to a consumer after 4/14/03 BUT the information was obviously received by the CA prior to 4/17/03, would that still constitute a HIPAA violation? 3. I have read about the 'minimum necessary', and am still not clear on it. What is required for an HCP to be in compliance with it and when did it become effective?
Edit of initial post Officially HIPAA compliance went into effective 4-14-03. New to those boards as far as glossary goes, however think I have the hang of the most important words. Unfortunately I have to deal w/ HIPAA compliance 40 hours a week. I you asked a CA for validation pre 4-14-03 and the info received included personal medical info no violation. If you asked for validation after 4-14-03, violation. This is provided the HP and CA have a business associate contract ( a HP would be insane NOT to ) that gives the HP the right to share a patients info w/ the CA. I keep meaning to bring home my manual and post verbatim what the manual states. The manual goes something like this (don't quote me exactly) the only info a HP can share w/ a CRA is demographics ONLY, name, address, ss#, date of birth, account activity and balance. To a CA as long as there is a contract then any info necessary to retrieve legitimate funds due. Technically speaking if the medical info was pertinent to the collection of funds due and the contract has been signed by both parties(HP-CA) then no violation. However, at no time can I ever see the need to sent a CA medical info. So, that clause is ridiculous. The only info I ever send to a CA ( and I can't stress enough, I HATE TO DO IT) is name, address, ss#, dob, account #, and balance. I never felt the need to be lazy and just print the info of the computer. Which would give the CA personal info. Most patients if they had questions after being sent to collections (and receiving my notices b4 that) have called the office, I explained what it was for, how much they owed, and given them the option to pay me directly (I have to pay the CA whether they get paid or I do ) and I would have it removed from CA and then I have the CA send both me and the patient a letter stating the account was updated and the CRA would be notified. Even though I have to work w/ a CA doesn't mean I have to trust them
Edit of initial post Also, FYI next time you guys visit your HP they'll give a HIPAA form to read and sign. This is a "short" version. That form does not included the specifics. If you have a long wait ask for the complete manual, it has to be on file in the office and available for anyone to review upon request . In the section headed Patients Billing Rights (dont quote, but close) is the info on who a HP can share what with.
Edit of initial post Most of the medical collections the people are dealing with are accounts that were sent to collection agencies more than a year ago, and many of those collection agencies are not now,nor could they ever be, in compliance with the HIPAA requirements. I designed the "Letter to HC providers" on my website to take advantage of the "catch 22" that occurs between the requirements of the FCRA and FDCPA for validation, and the lack of any "qualified business relationship" between the reporting CA and the OC health care provider. As a bonus, since I object to CA's in general, and I believe that if a debt can be paid, it should be paid to the ORIGINAL CREDITOR (especially a health care provider) the form I designed allows for the OC health provder to be paid, when the account is valid,and gives the payor the tax benefit as well.
Edit of initial post Ok, but HIPAA also reguires a HP to if at all possible to up date and correct any info that might have been given to a CA prior to 4-14-03, and or the CAs to remove any inproper or unnecessary info from a persons file. ( OK that might never happen) but as of 4-14-03 they (CAs) are supposed to (it's in the contract my office has) to contact us first to confirm the info they have b4 disclosing it to any other parties. If they don't and medical info is given out unnecessarily, then nail them by all means. Remember the HP has to have a contract to give out that info and it has to be pertinent to getting payment. If no contract then -violation. Also, a HP doesn't need the patients "permission" to disclose info for payment.
Re: Edit of initial post You HIT THE NAIL ON THE HEAD!!! The OC Health Care provider is REQUIRED to "fix" errors in data to ANY CA,even those they do not have an ongoing relationship and contract with. If someone pays the OC, then there is no longer any collection account,if a valid dispute has been ongoing for years with a CA (lots of THOSE)and is unresolved, the OC has an obligation to FIX IT.
Re: Edit of initial post It seems silly to me sometimes that people get so worked up about credit while missing the truth. Even if it's kicking you in the teeth. http://www.sierratimes.com/03/04/15/health.htm H
