Health Information Compliance Alert
Can Insurance Companies Disclose PHI?
PDF
Read the question below and decide how you would handle it before you compare it to our expert's advice.
Question: Are health insurance companies allowed to disclose protected health information to someone who contacts the organization on behalf of the beneficiary?
Answer:
Yes. According to the U.S. Department of Health and Human Services, a covered entity is permitted to disclose health information to a patient's close friend, family member, or relative, as long as the covered entity is reasonably sure that the person requesting this information is directly involved in the patient's care and/or payment for patient care. The health care provider must also determine that the PHI is relevant to that person's involvement with the patient's health care needs.HHS also says that covered entities may disclose certain PHI to a person who is not a close friend, family member or relative, as long as the representative of the covered entity receives "reasonable assurance" that the patient has identified this person as someone who is involved in his/her care or payment for his/her care.
Finally, when the patient is absent or somehow incapacitated (for example, if she is in a coma or mentally incapacitated), representatives of a covered entity are allowed to use their professional judgment to determine if PHI disclosure is in the best interests of the patient.
Health Information Compliance Alert
- Privacy:
Don't Let HIPAA Breaches Trip Up Your Facility
HHS security guidance targets electronic PHI. HIPAA is on CMS' radar screen right now, so [...] - You Be The Security Expert:
Can Insurance Companies Disclose PHI?
Read the question below and decide how you would handle it before you compare it [...] - Security:
Don't Duplicate HIPAA Violations: Secure Your Digital Copiers Now
Avoid major security risks with these tips. If you're using a digital office copier in [...] - HIPAA Quiz:
Permitted Disclosure Or Privacy Violation -- What's The Difference?
HIPAA Quiz: Permitted Disclosure Or Privacy Violation -- What's The Difference? 5 scenarios help you [...] - Security Compliance:
Identity & Authenticity: A Dynamic Duo You Need To Meet
Use these tools to ensure your security rule compliance. The HIPAA security rule not only [...] - Security:
Are Your Faxes Accidents Waiting To Happen?
Send the right messages with these simple tips. Faxing: You do it every day -- [...] - Reader Questions:
Do We Account For Audit Logs?
Question: We have begun auditing our computer systems. Through an exam of the audit logs, [...] - Reader Questions:
Who Signs Whose BAA?
Question: We have decided to use a clearinghouse for our transactions. The company we've chosen [...] - Security News:
Identity Theft Task Force Implements Protections
Learn what the government is doing to keep your private information safe. A special task [...]