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Question about HIPAA and medical confidentiality - and bill collections
Posted: Dec 28, 2010
I have a friend who has a huge medical bill that she can't pay and told me that it was going to be sent to a collection agency. So, I've been trying to do a little research to help her, but I'm kind of stumped.
She tells me that she didn't sign any authorizations for the release of her medical information, so how can the doctor's office release any of her medical information to the collection agency in order for them to collect? I've read that if she sends the collection agency a letter, then the collection agency has stop all collection efforts until they validate the debt by telling her exactly who it is from and exactly what it was for. But how can they legally do that without violating HIPAA and medical confidentiality laws?
Is she also supposed to send the collection agency a letter to authorize them to obtain her medical information from the doctor?
I worked for a large clinic and when they sent bills to collections (sm) - anon
[ In Reply To ..]there was no medical information released to the collection agency. They basically gave the agency the amount of money that needed to be collected and the ways to contact the person, address and phone number. Is she positive that medical information has been released?
If collections agencies need personal info to do their - Anon
[ In Reply To ..]jobs, they should be subject to the same confidentiality restrictions we are. Collections is a big part of the medical industry. I'm pretty sure this wasn't overlooked.
Not sure if it's already been released or not - sm
[ In Reply To ..]From what she's told me, I don't think that the collection agency alreay has her medical information, but she just wants to get them to stop calling her every day. And in order to do that, from what I've read, she needs to send them a letter asking the collection agency to "validate the debt." But, in order to validate the debt, the collection agency will also need to have access to all of the details in her private medical information.
I will call her later tonight to see if I can find out some more information. I know she went in for emergency surgery and told the hospital that she couldn't pay (no insurance, unemployed, husband passed away), so the hospital wrote the bill off. But this bill I think is from one of the hospitalists.
Did an extremely brief but interesting browse - Pragmatist
[ In Reply To ..]Have you spoken with her yet?
On browsing, I copied this from a site:
"HIPPA laws limit the people who can view a patient's medical information. However, when a patient owes a debt, the law does not limit ****who can view the debt information**** and how many times the information is viewed. A debtor does not have to be notified when her information is being disclosed to a collection agency. If the patient has medical debt, this information can be passed on to the collection agency without notice."
Thus, if debt information named the "Sunshine Lung Cancer Institute," someone owed $80K to, and of course it would, the cancer someone was trying to keep private, to avoid being fired preemptively, for instance, would be out there.
I did pick up that, mercifully, a new law governing credit reports requires the names of medical providers NOT be listed on those reports, or be listed in code to protect privacy. As we know, many employers check credit reports as part of the hiring process, and I'm guessing many who wondered in the past why they weren't hired might have had their privacy betrayed by listing of a diabetes clinic, etc.
Interesting. Thanks for asking the question.
I would wonder about this site that discusses HIPAA laws, but - does not spell HIPAA correctly. nm
[ In Reply To ..]x
Thanks for pointing that out. What did you find out in - your research? Pragmatist NM
[ In Reply To ..]x
there are exceptions... - DNH
[ In Reply To ..]There are certain instances in which information can be released. They include certain legal situations, to the insurance companies for payment processing, to govt entities and research agencies (in pre-determined situations) among others. I believe attempt for payment is included in those situations.
Wouldn't they be considered covered entities? - Just like remote MTs.
[ In Reply To ..]xx
my understanding.. - dnh
[ In Reply To ..]They don't actually release any medical info, simply the necessary billing info, and that is allowable.
Disclosure of info allowed for billing and collections - sm
[ In Reply To ..]Health care entities do not need a release for certain things, including treatment and reimbursement. They can, for instance, communicate your information to the lab that processes the specimen they collected during your visit, to a third-party payer, and to certain other entities. That would include a collection agency.
Counting on a HIPAA violation here is not going to be useful. If the bill is very large, though, it might be worth your friend's while to contact a lawyer. A lot of collection agencies buy debts in bulk, but do not have enough proof to make the claim stick in court. And, paying one company does not preclude another company later claiming they are collecting the same debt--errors do happen. A lawyer can assist with that.
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