When HIPAA interpretations go too far

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Adult patient goes to ER, is self-pay. Signs all paperwork needed to assign
representative and be aware of personal financial obligation, address, phone
number, etc.



Patient is admitted to OBS for 24 hrs.



At discharge, patient is seen by benefits specialist, bill is not finalized,
but so far $2,400.00. A self-pay discount is given at 60% - "but, call me
in a week for final bill." Verified patient 's representative could call
and discuss bill and payment.



Patient's representative on record calls 7 days later for final bill total
and to make payment by phone. It is now $12,564.00 (!!!!). Benefits
specialist states with 60% discount to pay in full is a little over
$5,000.00.



"Can you send a copy of the bill so we can see what we're paying for?"



"We don't do that."



"WHAT?"



"The patient has to authorize a bill to be sent to them."



(My mouth has dropped at this point...they want the bill paid in full by
phone, but can't produce the bill, and for some reason cannot honor the
patient registration process to be billed for services to the mailing
address.)



"But the patient DID AUTHORIZE the bill to be sent to him when he
registered, why does he have to call to have it mailed to him?"



(I never asked to have the bill sent to me, just to the patient.)





Karen A. Hurley, BS, CMM, CPC, CNA

President, HPMSI

PO Box 409

Parrish, FL 34219-0409

Tel: (941) 776-4822

Fax: (240) 368-0059

Web: www.hpmsi.com



Since 1996, Celebrating 20 years of Service to Physicians



Disclaimer: Advice or comments in this email are specific only to the
recipient and the presented issue. It is not intended to be used as a
global solution for future similar events. Reproduction of the information
requires approval by the author.




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Adult patient goes to ER, is self-pay.  Signs all =
paperwork needed to assign representative and be aware of personal =
financial obligation, address, phone number, etc.

 

Patient is =
admitted to OBS for 24 hrs.

 

At =
discharge, patient is seen by benefits specialist, bill is not =
finalized, but so far $2,400.00.  A self-pay discount is given at =
60% - “but, call me in a week for final bill.”  =
Verified patient ‘s representative could call and discuss bill and =
payment.

 

Patient’s representative on record calls 7 days =
later for final bill total and to make payment by phone.  It is now =
$12,564.00 (!!!!).  Benefits specialist states with 60% discount to =
pay in full is a little over $5,000.00.

 

“Can =
you send a copy of the bill so we can see what we’re paying =
for?”

 

“We don’t do that.”

 

“WHAT?”

 

“The =
patient has to authorize a bill to be sent to =
them.”

 

(My mouth has dropped at this point…….they =
want the bill paid in full by phone, but can’t produce the bill, =
and for some reason cannot honor the patient registration process to be =
billed for services to the mailing address.)

 

“But =
the patient DID AUTHORIZE the bill to be sent to him when he registered, =
why does he have to call to have it mailed to =
him?”

 

(I never asked to have the bill sent to me, just to =
the patient.)

 

 

Karen A. Hurley, BS, CMM, =
CPC, CNA

President, =
HPMSI

PO Box 409

Parrish, FL  34219-0409

Tel: (941) 776-4822

Fax: (240) 368-0059

Web: www.hpmsi.com

 

Since 1996, Celebrating 20 =
years of Service to Physicians

 

Disclaimer:  =
Advice or comments in this =
email are specific only to the recipient and the presented issue.  =
It is not intended to be used as a global solution for future similar =
events.  Reproduction of the information requires approval by the =
author.

 

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