HIPAA–Something to Hide Behind?

by Joanna Smith on Dec 13, 2010

I have been exasperated the last few weeks with both insurance companies and hospitals.  When I work for my clients, I have them sign HIPAA compliant release forms so I can speak with healthcare providers and insurers on behalf of my client.  It may be something as simple as helping resolve a billing question, or as complex as helping a client understand the chemotherapy she is about to begin.

In the last two months, I have had increasing problems getting access, and the reason cited is “HIPAA Law”.  While I have, and use, an authorization for release of medical information that is “HIPAA Compliant”, increasingly insurers and providers will not accept my form:  they require that their own form, vetted by their own attorneys, be filled out.  This presents a significant problem since these forms are not on-line, the member has to request it directly from the insurer or hospital and the forms may only be sent to the member directly, not to an advocate such as myself to fill out with my client.  In addition, this provider refused to even FAX the form directly to the client, insisting that they could only use the U.S. mail.

In another case, the insurer sent out a form to my client, but the insurer had pre-filled the blanks; my client did not like the limited access they were granting me, so he changed the form, signed it and returned it.  The insurer said the form was invalid because there were changes on it!  But it is the client’s form, the client’s information and the client’s signature!  The insurer said they had to send out a new form, and that my client could not make any changes on what they set up as the parameters for release of information.  This completely violates HIPAA:  the client controls the information, not the insurer.  And it contributes to delays in access to information.

What can you do about this?

  • Always initially try to resolve the problem with the insurer or provider directly:  ask to speak with a supervisor if the representative is unable to assist you.
  • If you are experiencing a delay in accessing your healthcare information or have other HIPAA-related complaints, you can file a complaint with your state Health and Human Services Agency or the Regional Manager, Department of Health and Human Services.