HIPAA Vent.

[LMC]

DawnCt1:
If you would care to share your son's dental story, please pm me. I too have a son missing alot of teeth due to genetics. My son is now 10 and I just wonder what is in store for him as a young adult. His pediatric dentist has never seen this condition before and really is flying blind. He's already had one set of braces since his two front teeth got out of place really bad due to not having incisors. He still has spaces for his top incisors and this is the one area of treatment I am really not happy with. The dentist has refused to give DS bridges until the permanent eye-teeth come in to close up the space. He has now been partially toothless for 3 years, going on 4. I commented to the dentist last month how long it has been and if he had only given him the bridges when I asked he would have a normal appearance. If DS is like me, he won't get his eye-teeth for a few more years so I guess the dentist expects him to go toothless for several more years.
We capped the four front bottoms and now one of those is about to come out with the lower eye tooth and the dentist expects the one eye tooth to fill in both spaces. HA, we'll see......
He is still missing one 6yr molar and hasn't gotten the last molars yet, we'll have to see if those show up.

 

[Tigger_Magic]

I never have that issue with the primary dental insurance and this is the first time I have had the issue with this insurance. In fact, I called last week and they hadn't received the claim yet. There is absolutely no medical information I am seeking. I am the policy holder, the check will be cut to me, and all of the EOBs come to me. They put things in writing, with date of service and procedure and send them through the mail but they can't tell me if they have received the claim and if the check is in the mail. There are some areas that are indeed HIPAA exempt. Employee health is one. I can't believe that an inquiry into what funds are due in the mail is covered.

I believe that such an inquiry may be covered under HIPAA. According to our training, protected (or personal) health hnformation (PHI) includes any information that relates to physical or mental health of an individual, the provision of healthcare to an individual, or the payment of healthcare to or for an individual. Such information either explicitly identifies an individual, or can be used to deduce the identity of an individual. HIPAA rules govern the confidentiality, integrity and availability of this information.

 

[DanMedix]

I run into issues with HIPAA rights and the violation of those rights all the time. What can and can't we say? What can and can't we use for training?

The biggest example of this is last April when [CONTENT DELETED DUE TO VIOLATION OF HIPAA PRIVACY PRACTICES][CONTENT DELETED DUE TO VIOLATION OF HIPAA PRIVACY PRACTICES] all over! I couldn't believe it! But when I asked [CONTENT DELETED DUE TO VIOLATION OF HIPAA PRIVACY PRACTICES][CONTENT DELETED DUE TO VIOLATION OF HIPAA PRIVACY PRACTICES] my boots!! It was so ironic because about a month later, we responded to [CONTENT DELETED DUE TO VIOLATION OF HIPAA PRIVACY PRACTICES][CONTENT DELETED DUE TO VIOLATION OF HIPAA PRIVACY PRACTICES], so I considered myself lucky, even to this day!!

...just another reason for us to give our hard-earned money to corrupt lawyers! (..sorry if there's any lawyers here, but hey...)

 

[Microcell]

I work at a private medical practice, and our lawyers came and spoke to us abvout the inevitable complaints patients would have. We have our consent divided into two parts, medical and billing.

Here is what I say EVERY DAY:
"On this form we would like you to mark who we might speak to if someone calls on your behalf, please mark on each line, medical and/ or billing who we are allowed to talk to. If you mark no one, we will not even acknowledge that you are a patient here. If someone calls just asking how much your bill is or when your appointment is scheduled, if they are not marked on the appropriate line, we will not discuss that information."

When we rolled our eyes at the very thought, the lawyer pointed out that if we violated one, just one infraction, the fine would be $10,000. He said "That, ladies and gentlemen is a practice closer." If someone decided to sue, it would be many fines issued most likely, not just one. It is complete CYOA because the fire and brimstone would be hurled at you they way the docs were informed about HIPPA. Scared to death is not even how my docs felt. they are in their 60's and will retire soon, but took this very seriously.

 

[DawnCt1]

Bottom line is, I found out that they received the claim and a check will be cut when they process it. I guess if I need to know anything else I will lower my voice an octave or two.

 

[jfulcer]

Well, when someone gives you erroneous information that holds up your medical treatment and refuses to let you speak to a supervisor, then you can compliment them. Once my doctor called, a supervisor called me back and apologized for the erroneous information that this woman repeatedly gave me during our 45 minute conversation. If she HAD spoken to a supervisor, she would have realized she was wrong.

I'm not saying that you should compliment them. I'm saying you need to understand that when people do their jobs, some people are better than others. This person probably went to their supervisor who it appears thought the same thing. However incorrect they may have been, stooping to calling them names lowers you 10 notches below them on the intelligence scale.

Tigger Magic is right - if you KNOW something is wrong, and can't get it straightened out, go to someone who CAN. In this case, it was your doctor. Don't spend 45 minutes spinning your wheels getting upset.

I know, easier said than done. How would you want to be treated in the same situation?

 

[Stacerita]

Also to remember, those of us who are held by HIPAA rules have our hands tied. Its not that we dont want to make it easy to help you get the info you need, but the rules are the rules and we must follow them or face hefty fines. At my place of employment, if we are found to have knowingly broken HIPAA, we will be let go. Thats just how it is. Bending the rules to help someone out may seem like a simple thing and not a big deal, but not to the person who might lose their job over it. Everyone who is entitled to the information will have access to it as long as the follow the rules and have the correct authorizations in place. We aren't trying to keep the info from you. Just protect it from getting into the wrong hands. We follow the rules for you.

 

[CherCrazy]

Had the same problems with these stupid laws myself. I don't understand why if I am paying for the healthcare insurance of my over 18 year old kids who still live at home that I can't know what is going on with them or their bills. This law is just ridiculous.

This law takes parental control and authority away. It's ludicrious!!

 

[Tigger_Magic]

Had the same problems with these stupid laws myself. I don't understand why if I am paying for the healthcare insurance of my over 18 year old kids who still live at home that I can't know what is going on with them or their bills. This law is just ridiculous.

This law takes parental control and authority away. It's ludicrious!!

If you child is 18 or older, the law considers them an adult and no longer under your control. You may pay the bills, but as far as their healthcare goes, under HIPAA you have no rights unless they explicitly authorize it.

 

[disneysteve]

I don't understand why if I am paying for the healthcare insurance of my over 18 year old kids who still live at home that I can't know what is going on with them or their bills. This law is just ridiculous.

This law takes parental control and authority away. It's ludicrious!!

Like it or not, once your child turns 18, they are legally adults, and that has nothing to do with HIPAA. It has been that way for a long time. You have no more right to get personal information about them than they have to get info about you.

HIPAA has not taken away any parental authority. 18 year olds were already considered adults and entitled to privacy.

 

[Cindyluwho]

I know these laws can be extremely irritating in the circumstances mentioned in this thread but for a moment let's think about the folks it protects. What about a young adult who has recieved "private" treatment on their folks insurance. Maybe a college student that has contracted an STD. What if a woman has an abusive spouse, do you want someone like that to have access? There must be a better way to protect those few who need it. Any ideas?

 

[mom2boys]

So, what if a spouse is in an accident? Or a parent?? How does a family member get information?

They won't tell you anything. DH was hit in the forehead with a piece of plywood. His friend - who had been handling the plywood - took him to the emergency room. When I found out DH was at the ER, I immediately called. They would only confirm he was there because I already knew that. I asked a million questions & they wouldn't tell me anything. It was so frustrating. This has gone too far.

Some of my docs have provided release forms allowing me to name individuals that they can discuss my condition with. I always put DH & I usually add my brothers because if DH & I are in an accident and neither of us is able to make decisions for the other, it will be my brothers who are stuck.

 

[Nancy]

I signed the forms for my kids and myself that information can be released to both parents (in the case of kids) my spouse and my mother and sisters. I don't know if my dh has doen the same for his doctors but I will be checking with him when I get home.

 

[Cindyluwho]

They won't tell you anything. DH was hit in the forehead with a piece of plywood. His friend - who had been handling the plywood - took him to the emergency room. When I found out DH was at the ER, I immediately called. They would only confirm he was there because I already knew that. I asked a million questions & they wouldn't tell me anything. It was so frustrating. This has gone too far. .

As I stated above, there are times when that privacy is truly needed to protect the patient. Certainly with everyone complaining about the policy someone must have some decent ideas on how to deal with the situation before it happens or ideas on how to make it work better.

 

[DisneyDotty]

It is a requirement that it be that complicated. Somewhere, in all their training, there is a special day devoted to "Driving The Patient Crazy Until They No Longer Want Us To Pay".

 

[cdrn1]

Don't think thats its just insurance companies who are doing this. My DS18 was admitted to the hospital with a burst appendix. He was very sick, we almost lost him. The hospital staff did not seem to think my DH and I were entitled to any info about his condition or care. Seems that once you are 18 they won't tell anyone anything without consent even if you are the person carrying the insurance/paying the bill.

I actually asked a nurse what was going on with him and she kinda did a head roll towards DS and told me to ask him. I could not believe what I was hearing. DS was so out of it from his morphine that I'm sure he could not even tell me his name.

I went home typed a letter up giving DH and I permission to be updated on his condition and had to wait until he was able to sign it. Once he did, I took it directly to the nurses station and had them put it in his chart. I got info after that but I have to tell you I was completely ticked off by the whole series of events. I feel like we are the parents, we are carrying the insurance and this is still my child living under my roof, and I deserved some answers. I could understand this if he was 26 living on his own but not when hes still a dependent.

The hospital staff did the right thing, according to the law. Sorry you were ticked off, but the staff faces $10,000 fines for violations. At the hospital where I work, the patient is given the opportunity to tell us who is allowed access to the info, and unless that person is on the list all they get to know is whether of not that person is at the hospital. They also have to know a password of the patient's choosing which is our way of verifying that the person is who they say they are.
In emergent situations we are allowed to give certain info without permission if the information can help us take better care of the patient.
Write your congressman if you don't like it. I know that there are times when the law is beneficial, but it is also taken (and interpreted) to the extreme. When it means $10k of my hard-earned money, I am going to err on the side of caution.

 

[DawnCt1]

HIPAA can also interfere with getting a drug donation to the appropriate patient. When I was working in Occ Health last year one of my employee's sons was diagnosed with a rare childhood cancer. The only drug that relieved his nausea was Kytril and the insurance company was balking at paying for the amount he needed. We have a relative who works in the pharmaceutical industry and was able to donate a 2 month supply. The problem was getting it to him. It had to be dispensed by a physician and the child's physician couldn't accept it from the drug rep due to HIPAA regulations. I had the rep. drop it off at DH's office and DH "dispensed" it. I guess where there is a will there is a way but it shouldn't be so hard to do the "right thing".

 

[Planogirl]

These laws may be stupid but that's no reason to take it out on the call center person.

I did the call center bit for a while for a large auto financier. It was a nightmare! People got so angry with me and called me every name in the book because of my company's rules as if I had anything to say about them. Being nice didn't make any difference to many of them. They also got infuriated with me when my Manager refused to speak with them. I couldn't force my Manager to talk to them and all they could do is leave a message for someone to call. But that wasn't good enough and I again routinely got cussed out.

Needless to say, I fled from that job as soon as I could! And I think that people who blame call center people for their troubles are just plain unfair.

 

[DawnCt1]

These laws may be stupid but that's no reason to take it out on the call center person.

You are right. I try to be firm but polite. What I find interesting is that I called the same insurer a week before to see if the claim came in. They told me what the last claim was but they hadn't recieved the claim I was inquiring about. She suggested that it was probably due to the Christmas holiday and the mail being delayed.