PDA

View Full Version : Hipaa Privacy Act


Mackey Mouse
01-27-2007, 05:09 PM
I do not get, I will never get it. I received a bill the other day from the hospital in Boston....just a date and an amount, I have no clue what it was for and I have insurance. It showed what insurance paid, and what I owed.. Here's the thing, what was it for? So I call the hospital and ask.. oh Dear God, they cannot tell me because that would violate the Hipaa Privacy Act. So I said well why don't you send a detailed bill rather then just this with no explanation... Once again, I was told what if the mail got into someone else's hands, once again the Hipaa Privacy Act was the answer.

I was on the edge, and so I said to this inept person on the other end of the phone.......Who exactly does the Hipaa Privacy Act protect? Is it the patient? Because if it is, why isn't someone protecting my husband's rights when he is having chemo, in front of everyone else, and you come with the chemotherapy and say his name out loud and make him answer with his birth date and then you announce to the world what he is getting for chemotherapy...where is Hipaa then?

There has to be some patient advocacy group somewhere that I can find and get involved in to protect the patient's rights.. I am just not seeing it right now.

lyeag
01-27-2007, 05:21 PM
:grouphug: What can I say, except I am so sorry. I know you do not need the added stress of all that. I can't believe they don't put a reference number or something on there to code for what is being billed. :sad2:

Although it isn't always fair to the person on the recieving end, it does feel great to just let it fly when you get angry sometimes. You just get so frustrated with the runaround. Hang in there and stay in their faces. I firmly believe that is the only way to stay on top and in the loop when it comes to medical issues.

Saphire
01-27-2007, 05:42 PM
Who exactly does the Hipaa Privacy Act protect? Is it the patient? Because if it is, why isn't someone protecting my husband's rights when he is having chemo, in front of everyone else, and you come with the chemotherapy and say his name out loud and make him answer with his birth date and then you announce to the world what he is getting for chemotherapy...where is Hipaa then?



I agree Marsha, the hypocrisy is astounding. At our hospital we have surveyors come in to make sure we are following all guidelines and HIPAA regulations. And yet, the hospital rooms have two beds, where everything is overheard from the next bed. Doctors/nurses come in and discuss treatment plans/options with a patient, and a closed curtain does not provide privacy! They drill into our heads as health care providers not to talk about patients in the elevators, in the hallways, and yet the roomate knows everything about the medical condition/prognosis of their roomate because they are inches away from them! It really is outrageous, all the money that was spent to put this 'program' in place, and then common sense things like the one you mentioned are overlooked. I despise bureaucracy!

Christine
01-27-2007, 05:55 PM
Yes, the hypocrisy is astounding!!

I have never seen so much contradictory stuff going on as with HIPAA.

I work for a company and with have a flexible medical account. You know, we put pre-tax dollars into an account and when we buy certain stuff not covered by insurance, we can get our medical stuff out.

Well, we are required to submit detailed receipts about every prescription we get, and we also submit our explanation of benefits form. This all goes to some "processing" company where someone reads this stuff. They aren't a doctor's office or anything--just an accounting firm.

I sort of don't like sending them my receipts for Xanax, you know what I mean? But, somehow, THAT'S okay.:confused3

apirateslifeforme
01-27-2007, 07:47 PM
I'd almost forgotten about the HIPAA violation that I witnessed last month...

My mother and I had to take my grandmother to the hospital on Christmas Eve. We spent Christmas Day with her, visiting and opening gifts. Mid-afternoon, a very sloppily-dressed man walked into the room. He was the doctor assigned to Gram's roommate (but he was not her regular doctor - she'd never met him before). We continued to visit quietly, but after about 30 seconds, he poked his head around the curtain and said, "Excuse me, ladies...I'm having a hard time doing this with all the noise going on back here, so I'd appreciate it if you'd cease your conversation until I'm done examining my patient. Thank you." Without waiting for a response, he pulled the curtain and went back to the woman. We sat there in stunned silence for thirty minutes, mostly that he had the nerve to waltz in there, on Christmas Day, and tell us that we weren't allowed to speak until he said we could. He went through this woman's entire medical history with us sitting there, including all of the symptoms she was experiencing now. To make a long story short, when he advised us that he was done and we were allowed to speak again, words were exchanged. He literally sat there and yelled at us - he insisted that he was polite, he'd said "excuse me," and WE were rude :sad2: - and he didn't back down until I said, "Do you have any idea how much of a violation of HIPAA regulations that was?" He quickly backed down and hustled out of that room. While my grandmother was there, he never set foot in there again.

I still have his name. I wonder if it's too late to report him.

Mackey Mouse
01-28-2007, 05:33 AM
Can I say I am so proud of you A Pirates Life for me.???? Good for you that you spoke up...Bravo, where was Hipaa protecting that woman during her exam....and why weren't you allowed to speak to your loved one on Christmas... I would report him.....if I had a name, I would report him. I speak up too but lately with DH not well I am sometimes feel they are holding his life in their hands and try to hold my tongue as I hate for him to get nervous...

Not sure if I said this one somewhere else, but recently my DD spoke up for her Dad, I might have posted this, not sure. DH was having chemo in the same arm, in the same vein where the week before it had hurt and burned....enough for him to say something, he usually never complains. So we were ready for this treatment, before she started I said will you use the saline as you did the last time to prevent the hurt and burning... she said.. well let's see if it is ok this time.. My daughter said wait.. you are not going to do it.. first you have to hurt him first and once it hurts, then you will do the right thing and prevent the burning and hurt....she said, it might not happen.. I think she thought it about for a few minutes after she had hooked him up and said, I will add the saline if you wish........we just looked at her. Too late is what popped into our heads until it started to hurt and burn and she had to stop the chemo and then add the saline... Why....why...

And then keep in mind that everyone is the world sitting in that big room with no tv's working heard this conversation....no privacy for us.

I want to make it clear that I am railing against the system.. not so much the people who work in the system, some are wonderful, but the ones that are not are the ones who come to mind when you are upset.

And I have never heard from his doctor in Boston after writing the email to the secretary requesting that he do a follow up on Tom by phone....for shame.

Pea-n-Me
01-28-2007, 10:02 AM
HIPPA's been a headache for everyone, but it was put in place by Congress to help protect patient's medical information in this day of electronic sophistication. Even the "experts" are confused about some aspects of it, it's very complicated.

HIPPA

http://en.wikipedia.org/wiki/HIPPA

http://www.hipaadvisory.com/REGS/HIPAAprimer.htm

http://www.peachpit.com/articles/article.asp?p=212184&rl=1

Mackey Mouse
01-28-2007, 02:37 PM
It is a bit confusing.. seems like from what I read, it does not protect the patient's condition being talked about out loud.. only transmitted electronically..

I am sorry.. I need to try to understand this whole thing..... and maybe I will ask to speak to the patient coordinator for that chemo treatment center, which is going to send everyone into a tizzy.. I know it.,

Taximom
01-28-2007, 03:50 PM
Just wanted to chime in here with some of my thoughts. First, I am so sorry that you and your DH are going thru this. I know what a difficult time it can be. I am a RN, and this month I started my treatments for Non Hodgkins Lymphoma. I was SO anxious and upset with my first treatment. No matter how much you read, there is still fear of what is going to happen, plus I had little experience in oncology.
I was put in a patient room with 3 other patients....2 lounge chairs on each side of the curtain. All I could think of was pt confidentiality and HIPPA. I knew everyones diagnosis in that room.... I really was floored! I ended up with 2 different reactions...now that is one way to get rid of a roommate....they pulled "Phil" out of his chair and sent hime to another room....
No, it is certainly not an ideal situation. With the 2nd treatment, I was in a room with just one other patient, tho I was there so long, I actually had 3 roommates, and with my last treatment, I had a room by myself.:goodvibes

I am normally a "friendly" person, but when I'm anxious...I am quite quiet. My DH stayed with me, and he chatted with my roommate, and families. They were very nice (well, except the lady who just wanted to watch her soaps...no Dr Phil for me:sad2: ) I guess, we're all there to do what needs to be done. Some of us want to talk, some want to be left alone. I wish there was a better way to do this....

Prayers for you and your DH! Hugs from Pennsylvania!:grouphug:

Mackey Mouse
01-28-2007, 05:25 PM
Susan.. first let me send you a big hug and thanks for chiming in here. I hope you have an easy time of it.....I have you in my prayers.

This is our second go around with this dread disease, but it does not make it any less upsetting. I wish I could understand why we have to be placed in a large room, no privacy, everyone knowing everyone else's diagnosis, you get to watch some people sleep and snore out loud, God Bless them, and the fear....the fear in the eyes of those who are ill. If I do not look at anyone, they will not talk to me, and then I am not really here.

I just wonder....Luciano Pavarotti has the same diagnosis as my husband....same surgery, same treatment afterwards.......of course money makes all the difference so his treatment is probably brought to him at his house, I cannot see him sitting in the same setting my DH or anyone for that matter does.

I guess if maybe the place had a little more privacy, there was a little more kindness by the nurses in the unit, that the people there having treatment could make eye contact or reach out to each other, maybe it would not bother me as much.....

I am tired of hearing about Hipaa and knowing that really that privacy act is a joke for the patient. It is to protect the hospitals and the insurance companies, I am convinced of it.. Sorry, just real cynical tonight and not looking forward to this week's treatment for my sweetie. I know if they come at him again without the saline and the remark wait and see if it hurts, I may lose it.

I am glad I can talk about it here.

CarolAnnC
01-29-2007, 12:34 PM
I am so sorry to hear of all the turmoil the poor patients and families are going through here.

Marsha, Tommy is a trouper but a person can only take just so much...Hugs.

This HIPAA is out of control IMHO. Notice when it comes time to send the bill and/or pay the bill, they don't care about it then. We are responsible for DD medical bills as she is still a full time student and you can bet they talk to us when they want their money.

j's m
01-31-2007, 09:19 PM
My best HIPAA story is when I called BC/BS about one of DS's doctor bills. The CM refused to talk to me about it "because of HIPAA" and that she could only talk to the patient. I asked her if she really wanted to talk to a six year old! :rotfl: Believe it or not, she refused to give me any info!

Sorry for all that you are going through with the horrible privacy issues. Something really needs to be done.

Mackey Mouse
02-01-2007, 05:51 AM
More Hipaa horrors....yesterday everyone there knew that my husband's platelets were too low and that he could not have his treatment.. also, that the nurses had called the doctor and we were waiting for him to call back.. They actually had to call twice as the first was a fax and it disappeared into cyberspace, their words not mine. When he did call back, after they waited 1/2 hour to recall, the nurse talked to us out loud from the nurse's station telling us what he said.. of course everyone else heard.. what a joke..

I give up.. I truly give up. The woman beside us had just had a port put in and this was her first treatment for a reoccurrence of breast cancer.....wait????am I suppose to know that???? No I am not.. but I do..

My DH felt that I was cruising for a fight yesterday so I kept my mouth shut tight....but came close to saying something.. I figured why get into it, we are going away to get a bit of rest, maybe I will deal with it when I get home.. I do not know.. truly they wear you down and you give up....you fight for your life, but you let them get away with breaking the rules..

But wait...when you ask for an itemized bill when calling the billing department, oh no, they cannot do that, Hipaa Privacy Act... well can you mail it... we can put in the request, but with the Hipaa Privacy act, we are not sure they will mail it.. so then you say something like I will not pay this bill until I know exactly what it is for, itemized....grrrrrrrrrrr

You have to laugh, the right hand does not know what the left hand is doing....in the middle is the poor patient and their family....so sad. They have to speak to the 6 year old as the previous poster said.....really... what a joke...

iamsorcerermickey
02-01-2007, 09:11 AM
With or Without the Hipaa Privacy Act as far as billing is concerned.

I don't understand what these people don't "get".

We request an itemized bill that will be matched to the EOB (which we check for errors and such)

OR

They don't get paid!!

They either want the money or they don't, but they need to make up their minds.

Towncrier
02-01-2007, 09:41 AM
The most ironic thing of all is how the lawmakers have twisted the original intent of HIPAA which was Health Insurance Portability!!! The whole reason that HIPAA was enacted was to ensure that, once you had health insurance, that you could move it with you when you changed carriers.

The unfortunate (and possibly unforeseen) side effect of this legislation is that, to ensure privacy when information is moved, all sorts of safeguards were put in place. The privacy aspect of the law has overshadowed the good that it was supposed to do. I pity the healthcare workers who have to deal with the added paperwork and hassle of HIPAA on a daily basis.

The last time that I was in the hospital for a minor surgery, the nurse who was with me in the pre-surgery area used a radio to call down to the surgical suite to let them know that I was ready. She made the mistake of using my first name and was reprimanded for not referring to me as "Dr. Silberman's 10AM surgical patient".

I have signed a paper with my doctor to the effect that my wife is entitled to any and all of my medical information. That way, if she calls the doctor to see if I'm in the lobby, they can answer her question. What that has to do with insurance portability is beyond me.

tgmousechick
02-01-2007, 11:48 AM
First of all, I'm so sorry what all of you have experienced!!!!

I have Hippa to blame for my first real anxiety attack...

A few weeks ago, my glucose screen for gestational diabetes came back high, and the lab left a cryptic message on my answering machine at home- "we need to discuss the results of your glucose screen." Of course, you know that means you failed. I don't get this message until I get home from work after picking up DD from daycare, and it's 6pm- way too late to call for details.

I realize that this is not a huge deal, but I've never failed a screen of any sort in my life, and you really can't call me the most emotionally stable person right now! LOL! So, Bam, panic attack.

I finally got in touch with the office the next morning, got my results, and complained to the office that their message triggered an attack. And they immediately ducked behind HIPPA. Hello, that's why I have specifically had it put in my records that test results can be left on my home answering machine- take two minutes to read. I have no secrets from DH, particularly with stuff like this.

(Pair this with why they can't call my work phone or my cell with test results, since that's my DAYTIME contact info- msg was left at 12:30pm).

Can you tell I'm a little bitter? :)

HIPPA seems to be employed when it's conveinient to avoid discussion, rather than protecting anyone's best interest. I work at a Children's Hospital (in research, thank goodness, no contact with patient care) and we all have HIPPA crammed down our throats. Nice idea, bad execution.

Kim

Mackey Mouse
02-01-2007, 06:36 PM
TC....glad to know what it was originally intended for.....now if we can just explain that to the health care industry, doctors, nurses, secretaries, billing departments, life would be good..

I am his health care proxy.....they have permission to leave messages on our cell phone, but I really resent them openly discussing his condition in front of other patients.....and even more, I do not feel it is my place to know what is wrong with the person who is sitting beside DH in chemo....it is bad enough that I know they have to have chemo.....because I am staring at them in the face as they have no privacy either..

And to the previous poster.. I hear ya on being annoyed.. I am more than annoyed myself..

Someone needs to get a hold of the health care system and straighten this Hipaa Privacy Act out before someone dies as a result of their giving or not giving the correct information..

Lots of deep breathing going on here and heading to see Mickey.. hugs all around.

mickeymedic
02-24-2007, 05:33 PM
Part of the problem with HIPAA is that those "hiding behind it" don't truly understand it. I work for an ambulance service. When HIPAA first came into effect, we ran into all kinds of misguided healthcare workers. For example, I can't tell you how many times we responded to a nursing home for an ill patient only to be greated by staff members who refused to tell us what was wrong with the patient, medical history, allergies, etc due to fear of violating HIPAA!!!! They would then hand us a sealed envelope to deliver to the hospital staff and tell us that we were not allowed to open it. I guess they thought that we were just glorified taxi drivers. Fortunately most staff are better educated now.

But here's a few things that I don't know if the general public is aware of. HIPAA laws don't forbid all personal health information from being disclosed. Instead, there is the "minimum necessary" clause. Basically healthcare workers are supposed to limit personal health information disclosures to the minimum necessary to provide whatever service they are providing. However there are instances where the minimum necessary clause does NOT apply. "Minimum necessary" does not apply to disclosures made for the purpose of treatment, payment and healthcare operations. So, that might be why you have overheard healthcare professionals talking to patients infront of other patients (and their families.) Now, a well-trained healthcare professional will try to speak in a quiet tone of voice to help protect the privacy of the patient, but the healthcare worker is not technically violating HIPAA by speaking to a patient in front of others. I know this offers no comfort to those of you who have posted on this thread. I'm sorry.

One last thought on the hypocracy of HIPAA...the HIPAA laws only apply to entities that receive money from the health insurance industry. So, as an employee of a commercial ambulance company, I am bound by the HIPAA laws. However, the city firefighter who responds to the same scene as me is NOT bound by HIPAA laws since the city fire department does not bill the insurance company. So, while I am bound by law to not talk about a patient encounter, the firefighter can talk about that same encounter to whomever he (or she) pleases. Tell me how THAT protects the patient. In another example, the county dispatch center does not receive money from the health insurance industry. So, the dispatcher can say over the air "you're going to 123 Main St, the Adams residence for the 63 year old diabetic having chest pain." So much for patient privacy.

Maleficent13
03-07-2007, 08:28 AM
But here's a few things that I don't know if the general public is aware of. HIPAA laws don't forbid all personal health information from being disclosed. Instead, there is the "minimum necessary" clause. Basically healthcare workers are supposed to limit personal health information disclosures to the minimum necessary to provide whatever service they are providing. However there are instances where the minimum necessary clause does NOT apply. "Minimum necessary" does not apply to disclosures made for the purpose of treatment, payment and healthcare operations. So, that might be why you have overheard healthcare professionals talking to patients infront of other patients (and their families.) Now, a well-trained healthcare professional will try to speak in a quiet tone of voice to help protect the privacy of the patient, but the healthcare worker is not technically violating HIPAA by speaking to a patient in front of others. I know this offers no comfort to those of you who have posted on this thread. I'm sorry.

This bears repeating. The bold is mine. For those of you who are having difficulty with the billing depts, you shouldn't be. They are allowed to disclose information in order to get paid, as long as you are a patient, parent, guardian or proxy. I hate seeing what is already a difficult time for people made worse by stuff like this.

And the crap about how they can't send an itemized billing statement is just that: crap.

JunieJay
03-07-2007, 09:34 AM
I have problems with just routine doctors appointments for me, DH and the kids so I can imagine what you are going through. Its no wonder the doctors and nurses at the practices we go to are overworked and overtired, I can imagine their frustration at dealing with all this red tape. And for people like you, who are dealing with a serious illness, I can just imagine you are ready to go postal on these people.

I'm sorry Marsha. I can only hope you find a group to get involved with, because I think you have the intelligence and drive to be really good at something like that. You'd make a great advocate for patients and their families. :grouphug: