Medical Collection - HIPPA

[800goal800]

My wife received  a collection notice for a procedure done last year.  The collection agency told me what the procedure was for.  I was shocked that they knew any more than the original creidtor, account etc.  Is there any sort of violation here ?

[Horseshoez]

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@800goal800 wrote:

My wife received  a collection notice for a procedure done last year.  The collection agency told me what the procedure was for.  I was shocked that they knew any more than the original creidtor, account etc.  Is there any sort of violation here ?

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No, sorry.

[800goal800]

So they are legally allowed to know medical history ?  Is there anything you can point to ?

[Cowboys4Life]

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@800goal800 wrote:

So they are legally allowed to know medical history ?  Is there anything you can point to ?

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Yes.  Once the provider establishes a business relationship with the collection agency they are allowed to share any information necessary to collect on the debt and that includes medical history when the patient/guarantor starts the validation process.  You can read it in detail a the HHS website here:  https://www.hhs.gov/hipaa/for-professionals/covered-entities/index.html

Releasing the information to you/your wife isn't a violation because you are entitled to your own information as is the guarantor on the account in order to manage the financial aspect.  The collection agency is a business associate and once the contract for the business relationship is in place they are a covered entity and can request the necessary information to respond to a DV request.  @Horseshoez is correct it is not a violation.  Even if there was a violation there is no civil remedy for it. You could make a complaint to HHS but it won't negate the debt.

[800goal800]

So the healthcare provider sends the medical history to the CA proactively with the amount in question to be collected ? Or the CA gets when a DV is being requested by the consumer ?

[ForwardLooking]

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@800goal800 wrote:

So the healthcare provider sends the medical history to the CA proactively with the amount in question to be collected ? Or the CA gets when a DV is being requested by the consumer ?

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It does not matter and can be any order.  The collection agency is considered a business associate under HIPAA to the original creditor and is entitled to any information that allows them to perform their defined business role -- in this case, collect on the outstanding debt.  This information includes your and your wifes medical information relevant to the debt being colected.  The only obligation the Collection Agency has under HIPAA is to protect that information in their system just the same as a healthcare provider.  I don't think you are going to get them on any technicality or loophole here based on your description of events.

[800goal800]

I'm not alluding to shirking any responsibility nor using this as a technicality to avoid paying.  Rather, I found it quite surprsing that madical information is shared when most likely not necessary..........

[Horseshoez]

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@800goal800 wrote:

I'm not alluding to shirking any responsibility nor using this as a technicality to avoid paying.  Rather, I found it quite surprsing that madical information is shared when most likely not necessary..........

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Well, like it or not, that is standard operating procedure for the entire medical collections industry, and it does not violate any HIPAA rules.

[800goal800]

@Horseshoez Sounds terrific....

[FireMedic1]

From Mod/Mentor @gdale6 . Been posted for yrs. How to rid the collections.

1. Call the OC and see if insurance can be billed, (or-rebilled), collections ultimately paid by insurance get removed per new rules that came from CRAs settlement with 22 state AGs. If not then
2. see if you qualify for Charity Care, if not then
3. ask that they recall the collection in exchange for full payment
4. Send the reporting CA a PFD offer
5. Google the HIPAA Process and contact its creator for help, this process cannot be discussed in any forum of myFico.