Health Information Management

HIPAA Q&A: You’ve got questions. We’ve got answers!

HIM-HIPAA Insider, March 16, 2015

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Submit your HIPAA questions to Editor Jaclyn Fitzgerald at jfitzgerald@hcpro.com and we will work with our experts to provide you with the information you need.

Q: How should an organization handle patient requests to withhold PHI from the patient's insurance company?
 
A: Patients have a right to ask that their insurance companies not be billed for specific encounters. Most healthcare providers require that patients pay for these services themselves before agreeing to provide the services and not bill the patient's insurance company. Your organization should have a policy/procedure in place to handle such requests. You'll probably want the patient to make the request in writing. You'll need to ensure that the information about the encounter is secured in the patient's medical record, so it isn't released with any future requests from the insurance company. You'll also need a mechanism to bill the patient directly and prevent a bill for the services from being sent to the insurance company.
 
Editor’s note: Mary D. Brandt, MBA, RHIA, CHE, CHPS, vice president of health information, Central Texas Division, Baylor Scott & White Health in Temple, Texas, answered this question for HCPro’s Briefings on HIPAA newsletter. This information does not constitute legal advice. Consult legal counsel for answers to specific privacy and security questions.



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