Wiki HIPPA - Who we can discuss the account with

Create Wiki
J

JAMETH345

Networker
Messages
56
Best answers
0
Hypothetical situation - Our patient is a woman, her husband, who is not our patient, is the subscriber. It's his name on the insurance card. Can we discuss her account with him, or do we have to have specific written authorization from the patient to discuss the account with the husband? We're having a spirited discussion about this in our office, and we would appreciate clarification.

Thank you.



John M.
CPC-A
 
HIPPA guidelines say that you may NOT discuss PHI with the spouse unless the patient has signed an authorization. Imagine the headache if she's coming to your office for contraception (or abortion advice), but the husband wants children. Yowzers!

However, as the subscriber, he will receive a EOB. But that's the payers problem, not yours. ;)

-Stephen
 
My understanding is that you may not discuss treatment/clinical information but you CAN discuss payment information. You must still consider "minimum necessary" and divulge as little as possible, but I think this allows for you to identify someone as a patient of the clinic in the process of collecting payment.

When you say "discuss her account" - I don't think you can "discuss" much but you can reveal a balance in an attempt to collect, or if you need assistance getting insurance to pay (such as when insurance needs the subscriber to update COB info prior to payment.)

Information found at these websites:
http://www.gpo.gov/fdsys/pkg/CFR-2002-title45-vol1/xml/CFR-2002-title45-vol1-sec164-506.xml

http://www.hhs.gov/ocr/privacy/hipaa/faq/disclosures/266.html

- I am not a lawyer and this is not legal advice - but this has been my understanding in practice as well as the explanations in the links above.

Chrissy Fegan
 
I'm in agreement with Chrissy. From what I remember reading from HHS last year, financial info may be discussed if that person is involved with the patient's finances.

Lena
 
You must log in or register to reply here.
Top