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Does anyone know anything about using HIPPA laws to secure a PFD?

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Senior Contributor

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

Message 11 of 20
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New Contributor

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

DV for medical bills is very simple- either you saw the doctor or you didn't. Dr's are required to keep medical records for seven years for adults and ten years for children, so if it has been within the past seven years they will have the records and can quickly and easily validate. If you saw the Dr., I recommend doing a PFD with the OC, and skip the collection agency. I also wanted to say that your "medical record" and your "billing record" are actually two separate things, so a doctor will never give your "medical record" to a collection agency. All the collection agency gets is the financial info, usually just what doctor you saw and how much you owe.
Message 12 of 20
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Regular Contributor

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

courtesy discount...

my med bill is old (2002) and the CA is threatening lawsuit.
I contacted OC and they own it still...
Think I can try courtesy discount now and what about CA's part in it?
Thanks!
6/30/08 TU 441 EQ 425 EX 513
8/01/08 TU 499 EQ 488 EX 489
8/23/08 EQ 556
9/04/08 EQ 567
11/14/08 TU 531, EQ 582, EX 509
12/29/08 EQ 620 (yea!) EX 546 TU 555
1/17/2009 TU 568 EQ 620 EX 584, 4/15/09 TU 506, EQ 612
5/24/09 TU 558, EQ 646
Message 13 of 20
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Moderator Emeritus

Re: Does anyone know anything about using HIPPA laws to secure a PFD?



rizeninme wrote:
Ok. I am a medical biller and have been doing medical billing for over ten years. When a medical bill is sent to a legitimate collection agency, they only know the name of the doctor or facility that is sending the balance, and how much you owe. So collection agencies do not have any information that is protected under HIPPA law. Additionally, HIPPA protects you as a patient, so if you are calling about your own bill, there is no violation of HIPPA because it's your medical information.
 
 

I have been running a medical practice for nearly nine years. When ANY medical collection is listed on a CR, the OC's name MUST be masked...it's the law. Also, any doctor or hospital who furnishes a "business associate", such as a CA, with diagnosis or procedure codes, they are in violation. The OCs must adhere to the "minimum necessary" when furnishing information to their "business associates."
Message 14 of 20
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Senior Contributor

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

Ours isn't, Fused ... on hubby's CR it plainly states "Bay Radiology & Associates" and "Bay Medical Hospital." Smiley Sad

That's as per the 3-in-1 that we get from TC.

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Hubby's FICOs when we started: high 400s (June 2008)
Hubby's FICO NOW (04/06/09): TU: 679 EQ: 608 EX: ???
My FICOs: TU: 643, EQ: 606
Closed on new home: 1/20/2009 -- If we can do it, YOU can do it!!

Message 15 of 20
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Established Contributor

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

Fused,
 
I dv'd a CA for a medical acct a couple of months ago.
 
They sent me an itemization for the acct.
It shows physician name
diag cd  
proc cd    magnetic I Magnetic image neck spine
diagnosis code
magnetic image neck spine
 
Should they be able to have all this info??  Date of service was 12/2002.  It is under dispute with EQ (only report it is listed on)  because they have the date of 2003 as DOFD which is incorrect.
Any suggestions on how to handle this?  It is past SOL.
 
Thanks!
Message 16 of 20
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Moderator Emeritus

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

Please review the HIPAA Standards for Privacy of Individually Identifiable Health Information (the Privacy Rule) (revised 04/03) sections on:
 
business associates:
[45 CFR 164.502(e), 164.504(e), 164.532(d) and (e)]
 
the minimum necessary:
[45 CFR 164.02(b), 164.514(d)]
 
The minimum necessary clearly states that any OC must only share information which is necessary for their business associate to perform their job (task). So in other words, an OC can share personal health information with a third party billing associate for the purposes of filing claims with insurance companies. In this situation, the billing company would need access to office notes, hospital reports, diagnosis and procedure codes and so forth, otherwise they would have no way to kick out claims.
 
As for CAs, they do not need these codes to help them collect on delinquent accounts. Any OC sharing these types of codes has violated the minimum necessary clause. Additionally, it's very rare for an OC to directly report bad accounts to the CRAs. Once the debt is sent to a CA, they report the bad account along with an entry for the OC. CAs are required to mask the OC's name, so as not to give any indication of someone's health condition or the type of treatment they might have had.
 
So for example, a CA can't send the bad OC account to the CRA and mention the OC is the Mayo Clinic in MN. This is an absolute no-no according to the FCRA §605(a)(6)
 
I work for doctors, but if any one of them or a hospital did any of this stuff to me, I would slam their (blank) with a lawsuit.
Message 17 of 20
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Senior Contributor

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

Fused, I sent a PFD to a CA for a medical debt (before reading the whole HIPAA thing) and got back, essentially, a full scale DV. They included EVERYTHING. Down to the procedures (including a biopsy) given.

Can they do THAT? Even though, in their minds (though NOT in my intent), I DVed them?

I'm confused because I though that we lost our rights under HIPAA if we DVed them (even though it was NOT a DV, per se). Also they DO state their client's name in both situations -- and in both cases, it's two different CAs reporting for two different healthcare providers. Or is that something that only I can see? Its on our CRs at TC.

Yeesh. Now I'm even more confused than I was five minutes ago -- and that's saying a LOT. This HIPAA stuff just melts my brain! Smiley Sad

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Hubby's FICOs when we started: high 400s (June 2008)
Hubby's FICO NOW (04/06/09): TU: 679 EQ: 608 EX: ???
My FICOs: TU: 643, EQ: 606
Closed on new home: 1/20/2009 -- If we can do it, YOU can do it!!

Message 18 of 20
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Moderator Emeritus

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

I don't find it confusing. The CA reporting the OC's name without masking it violates
FCRA §605(a)(6).
 
The OC sharing information with a CA (business associate) that has no bearing on the CAs ability to collect bad debt violates the minimum necessary: [45 CFR 164.02(b), 164.514(d)] . An OC is suppose to be withholding certain information that has no bearing on the CAs ability to do their job...which is to collect money. CAs are not medical people, so an OC handing over a bunch of medical codes that reveal a medical condition or medical procedure is ridiculous. How can a CA say in a court of law, "your honor we need the codes to effectively do our jobs and collect money for our clients." PLEASE!!!!!!!!!
 
You should work this out with the OC and let them know your are aware of their violations. It's not in a doctor or hospital's best interest to pursue a debt smaller than what they might pay if they're sued. It's easier to chop down the an OC than a CA. 
Message 19 of 20
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Senior Contributor

Re: Does anyone know anything about using HIPPA laws to secure a PFD?

I think I get it now!! Thank you SO much, Fused!! As always, you ROCK!!! Smiley Happy

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Hubby's FICOs when we started: high 400s (June 2008)
Hubby's FICO NOW (04/06/09): TU: 679 EQ: 608 EX: ???
My FICOs: TU: 643, EQ: 606
Closed on new home: 1/20/2009 -- If we can do it, YOU can do it!!

Message 20 of 20
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