Health Information Management

Q&A: Billing department

HIM-HIPAA Insider, June 8, 2009

Q. I am fighting a battle with our billing department regarding patient family members contacting billing staff members to help pay the family’s bills. I understand from what I have read that payment and treatment are not covered by HIPAA. If a family member is not obtaining diagnostic information but has significant information about the patient and is just trying to help with his or her bills, can we talk to this family member?

A.
The HIPAA privacy rule addresses disclosure of PHI for treatment and payment purposes and permits the disclosure of this information without the patient’s consent or authorization.

You may disclose limited information to family members who are involved in the patient’s care or paying the patient’s healthcare bills. You are permitted to talk with a family member who is trying to help a patient with his or her bills. Many healthcare organizations verify the family member’s involvement by asking for specific information, such as the patient’s account number, before talking with the family member.

If you have questions about how much information to share with the family member, you should involve the patient in the discussion, in person or by telephone, so you know the patient is comfortable with you sharing the information.

If family members ask for detailed information outside the scope of the billing discussion, such as the patient’s diagnosis or prognosis, the billing staff should ask them to contact the patient’s provider for more information.

You can obtain more information from Office for Civil Rights (OCR) on its HIPAA privacy Web site. The site has several FAQs, including ones about sharing information with family members. To review the questions and answers, go to www.hhs.gov/ocr/privacy/hipaa/faq or enter the keywords “OCR HIPAA privacy” in your Web browser to access the site.

Editor’s note: Mary Brandt, MBA, RHIA, CHE, CHPS, president of Bellaire, TX-based Brandt & Associates, LLC, answered this question. This is not legal advice. Consult your attorney for legal matters.

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