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Thread: Release of billing records to law firm for work comp case

  1. #1

    Default Release of billing records to law firm for work comp case

    AAPC: Back to School
    A law firm called me today asking me to fax a paitents billing records. I stated that I needed a supena or a release signed by the patient. She in turn said that since it is a work comp case, I don't need a release from the patient or a supena...

    Can someone more savy with HIPPA clear this up for me.

    Thank you

  2. #2
    Join Date
    Apr 2007
    Salt Lake City


    That does not sound right to me at all, who is the attorney representing Workers comp or the patient? Either way I would think you need a release from the patient or the subpeona.
    Jenifer McPolin CPC, CPMA, RCC

  3. #3
    Join Date
    Apr 2007
    Carmel, New York

    Default Not true - authorization is required

    I have heard this trick before where a lawyer's office will say that "workers comp records are not covered under HIPAA" so that an authorization or subpeona is not required. This is not the case for MEDICAL records. Because you are a Covered Entity (CE) under HIPAA you are obligated to follow the requirements. The information you have in the patient's record is certainly Protected Health Information (PHI) as as such, you have to treat it as such under HIPAA. The information being released to the attorney does not fall under treatment, payment (because the requestor is not the one who will reimburse you for the treatment) or operations. As such, then the information can only be released to them with a signed authorization by the patient or a subpeona. Another trick they do - if the subpoeana is not signed by a judge (some are only signed by attorneys) and is not accompanied by a signed authorization by the patient, it is not valid for release of PHI.

    Where "workers comp is not covered under HIPAA" DOES apply are records kept by state Workers Compensation boards, as they are not CE's and therefore HIPAA does not apply. There could be PHI in those records, so it is imperfect, but in your case, you are a CE and you are storing PHI, therefore you do need the authorization and/or subpeona.

    Hope this helps.


    2016 Secretary
    Ellenville, NY Local Chapter

  4. #4


    Amen! Lance is correct and gave awesome info that I plan to reference myself! Those Attorney's can be tricky!


  5. #5


    I do the medical records in my office, and we always, no matter what case it is with an attorney, request a medical release form for authorization from the patient to release records...and we don't fax medical records, because you never know who is on the other end.

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