19 Oct 2012

Privacy concerns for health plan dependents

19 Oct 2012

Now that children are allowed to stay on their parents’ insurance plans until they turn 26, parents will have more oversight into their adult children’s lives, and we may start seeing a steep increase in privacy-related issues.

The privacy rule of the Health Insurance Portability and Accountability Act (HIPAA) generally prohibits the unauthorized disclosure of an individual’s medical records and other health information. But there’s a catch. Health-care providers and insurers can generally use such information when trying to secure payment for treatment or other services.

Michelle Andrews writing in the Washington Post recounts the story of Elizabeth Nash,  a 21 year old college student who was just finishing her junior year at the College of William & Mary when she had a miscarriage. She planned to tell her parents about it in person, but her insurer beat her to it when, as a matter of routine, it mailed them a form that described the medical treatment she’d received. Nash says the experience “caused a rift that took a while to repair.”

 Healthcare providers submit bills to insurers, who then process them and send Explanation of Benefits (EOB) forms to the policyholder. But many times the EOB does not go to the person who was treated. Some insurers have made strides in addressing confidentiality issues. Cigna, for example, redesigned its EOB forms to strip out specifics about the treatment or services provided. The form only names the facility and the provider. Let’s hope other insurers will follow suit.
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