Health Information Management

Q&A: Family accounts

HIPAA Weekly Advisor, May 4, 2009

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Q. We operate a clinic that provides emergency and family practice services in a small community, and we know many of our patients personally. They often call or come to our office to pay or discuss their family accounts. Since HIPAA allows disclosure of PHI for payment purposes without the patient’s specific authorization, how much can we disclose to spouses who are responsible for paying the family expenses?

To keep to the minimum necessary standard, we begin by offering only the dates of service and total charges. When the spouse wants to verify what the payment is for, he or she may ask for more information, such as what services were performed. Under HIPAA regulations, can we give this information to spouses without the written consent of the patient?


A. Your approach to limiting information shared with spouses for payment purposes is appropriate. If the spouse asks about the services provided, you can share that information in general terms (e.g., “That is the charge for the MRI”). If the spouse asks for specific information about the patient’s diagnosis or why a test was done, you should obtain the patient’s consent to disclose this information. One way to do this is to involve the patient in the conversation, in person or by telephone.



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