Wiki Parents Making Appointments For Their Adult Children

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susanmetzgerjohnson

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I believe that it's a HIPAA violation to allow a parent to make a medical appointment for their adult child (over 18). We are a pediatricians office so this happens regularly - and usually a month or two after the child turns 18. I'm getting pushback and would like to gather other feedback. Please advise.
 
The parent cannot have access to their medical record without a signed HIPAA consent form but they can call and make an appointment for them.
 
HIPAA only governs how healthcare 'covered entities' (i.e. providers and payers) may share and release information - it does not regulate such things as whether or not an individual can make an appointment for someone else. The law gives healthcare providers a reasonable amount of latitude for the limited disclosures that take place in situations like this as long as reasonable safeguards are in place to protect the patient's privacy ("a covered entity may use professional judgment and its experience with common practice to make reasonable inferences of the individual's best interest in allowing a person to act on behalf of the individual to pick up filled prescriptions, medical supplies, X-rays, or other similar forms of protected health information"). As long as your office is not releasing PHI to the parent during the process of making an appointment without a release from the adult patient, I believe it highly unlikely that this would constitute a HIPAA violation. However, your practice should have a policy in place for this so that everyone is clear about what they can and cannot do, and it is also something that should be included in your privacy practices notice that is given to all patients so that they are aware of your practices and have the opportunity to object and limit how their information is used if they so choose.
 
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Helicopter Parent issue....

I can help!
I too am in Pediatrics and this IS a common problem we discussed & researched at length! Here is what we do because it is a HIPAA issue:

When the parent calls, we tell them as their "child" is now 18, and an adult, we are no longer allowed to speak to them regarding their "child's" appointments, and to please have the "child" call back and make their own appointment. We are kind, saying this is part of growing up and good training for their kids to make calls. :)

If that fails, we offer the option to have their "child" come in and sign (or mail/fax to them in college) a "Consent to disclosure of Protected Health Information" form which names whom the "child" will allow us to speak with, and EXACTLY what information we are allowed to speak to them about. It also has wording for DECLINING the practice from speaking to anyone BUT the patient, with a signature, date, and expiration date.

We then educate the parent for future calls they can say, "My "child" has a consent on file, I need to make an appointment."
BUT our staff is also trained to VERIFY FIRST that a VALID consent is on file prior to progressing with the call any further.

Hope this helps with your push back!
 
Thank you

Thank you for all your feedback.

We are going to create a policy/guideline for our front desk/clinical staff (all those who will schedule appts)- allowing parents to make appts for their adult child - however, very clearly specify what staff is/isn't allowed to speak to the parent about. Also communicate the need for the adult child to update their demographic information that includes a space for them to consent to share info with their parents (and whoever else they choose).

We also plan on alerting (email? text? portal? - still working out the details) those children who are turning 18 that they will be responsible for making appts moving forward.

Thank you again!
Susie
 
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