Health Information Management

HIPAA Q&A: Authorization on insurance

HIM-HIPAA Insider, March 5, 2010

Q. Our physician practice confirms patients’ insurance coverage by contacting their health plans the day before their appointments to verify coverage and patients’ financial responsibility. When patients enroll in a new health plan, do we need their consent or authorization to contact their new health plan?

A.
Patient consent or authorization is not necessary. This is considered part of treatment, payment, and healthcare operations even if the patient changes health plans and is allowed by the HIPAA Privacy Rule. Contact would be for payment purposes.

Editor’s note: Chris Apgar, CISSP, answered this question. This is not legal advice. Consult your attorney regarding legal matters.

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