Physician's Practice - November 2008 - (Page 51)

A I think I’d start by calling the patient back and just explaining why you need the record back (liability, etc.). I’d also sure apologize for keeping her waiting so long that she decided not only to leave, but apparently to leave the practice. Having her doctor make the call might make sense. If she understood more fully, she might simply comply. Make it clear that this is isn’t about forcing her to continue as your patient, although you sure hope she will. It’s about liability, continuity of care, and so on. If she doesn’t reply to this, I’m not sure a letter will work either. I’d A Alas, you ask about a gray area. The HIPAA privacy rules allow physicians to share health information for treatment purposes without patient authorization, but they don’t say anything about what to do if the patient actively prohibits the information sharing, according to Abner Weintraub, who’s with The HIPAA Group. Under HIPAA “A covered entity must permit an individual to request that the covered entity restrict uses or disclosures of protected health information about the individual to carry out treatment, payment, or health care operations; and disclosures permitted under § 164.510(b).” Ah, the dreaded modifier -25, the bane of many an office. SO COMMON, SO FEARED think your next step is to call the risk management department of your liability carrier to ask what they suggest you do to protect yourself. They’d have to defend you should it come to that, so they should be the ones guiding you. GOOD DOCUMENTATION PAYS Q I read with interest your tools on physician documentation tips. Is giving these to physicians considered leading them to be able to up-code? A Not to my knowledge. If they performed a service, they should document it — and be paid for it. Good documentation is never a problem. Lack of documentation or documenting things not done is. HIPAA AND PATIENT OBJECTIONS Q What is my legal position in the state of California if the patient says she doesn’t want me to send her records to a psychiatrist? What if the psychiatrist calls me to ask questions? Are we required to comply with the patient’s request? WWW.PHYSICIANSPRACTICE.COM However, while you have to allow individuals to request restrictions, you don’t actually have to agree with the request. The HIPAA regulation continues: “A covered entity is not required to agree to a restriction.” State laws in California also seem to vet this issue insufﬁciently. Here is a summary of state rules: www.health privacy.org/usr_doc/CA2002.pdf. But you’re in a real quandary, aren’t you? Clearly, you are not taking good care of the patient if you do not share the info. But sharing it without the patient’s consent may not be the best choice either, whatever the legalities. I suggest you call the risk department at your malpractice insurer and ask their opinion. They’ll need to defend you should something go wrong with either decision you might make, so their guidance is necessary. PRACTICE COLLECTION RATES Q I need to find the average percentage that doctors collect of their patient responsibility. For example, hospitals, NOVEMBER 2008 | PHYSICIANS PRACTICE | 51 http://www.healthprivacy.org/usr_doc/CA2002.pdf http://www.healthprivacy.org/usr_doc/CA2002.pdf http://merage.uci.edu/go/HCEMBA http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physician's Practice - November 2008

Physician's Practice - November 2008 Contents Death of Solo Practice Just a Myth Letters HSAy What? Noteworthy Finding Lost Revenue: The Search for Billing and Coding Gold Getting More: Our Annual Physician Compensation Survey ’Tis the Season to be Neutral Ask the Experts Evaluating Paperless Labs HR in a Box? The Guide Coding Third-Party Audits on the Rise Branding the Cash-Only Practice Intra-Office Tug-of-Wars Stickin‘ Up For Yourself Classifieds Advertiser Index

Physician's Practice - November 2008

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