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MrsMoneyBags

Nurse told me I’m in collections. Is that a violation?

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So my ob office just called me back because I had a health question. The nurse told me I was due for an ultrasound but that they can’t schedule it because I’m in collections for $234. First, I had no idea we were past due but I’m not happy my nurse and probably my ob have access to my financial info. I feel like this could impact my care. I get being deactivated and not being able to schedule because of being past due. But the billing office should be the only one who has that info. If I called in, the receptionist should be the one to say they can’t schedule me until I talk to billing. It feels like a violation of privacy for the nurse to know bc it could impact how they see me and thus, how they care for me. Are drs and nurses allowed to know the billing info? 

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You signed a HIPAA release when you first obtained medical services from your Dr. This allows ANY of their employees or business associates to have access to your personal medical account records. I suggest you start by making sure your reports haven't been "dinged"

https://whychat.me/GUIDEBOOK.html

 

Paying your Dr AFTER it has been turned over for collections risks the account(even if it isn't now reporting) report as a "paid" collection.

If you are going to pay the bill, pay it with a bankcheck or money order with an endorsement on the back "for deposit only to the account of (name of Dr.) or if you have a debit card or charge card and they will accept that as payment make sure the Dr's name is the payee. If they won't accept direct payment then use this;

https://whychat.me/hipltr.html

insert "a"

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3 hours ago, MrsMoneyBags said:

I feel like this could impact my care.

If you mean they will pass judgment in taking care of you: no.

3 hours ago, MrsMoneyBags said:

Are drs and nurses allowed to know the billing info? 

Yes.  There are 2 possible scenarios and the answer changes slightly depending on whether or not the ultrasound was scheduled in the OB's office or at another facility he does not own any interest in financially like the hospital.

 

If the ultrasound was part of your care in the OB's office then he has every right to know that it cannot be scheduled because of a financial issue and it has NOTHING to do with credit or HIPAA.  Informing the ordering physician that a test was not done yet gives three options:  offer the patient an alternative that may be lower cost, delay the test until the financial issue is resolved, or if the test is medically urgent/emergency to the fetus/mother he can over ride any financial restriction as the owner of the business.  ALL employees in his office on his payroll have the right and ability to access a patient's records without violating HIPAA if they have an actual business need to do so.  Since most physicians do not personally return calls to patients and delegate it to their primary nurse he/she would have that need to know as well.  

 

Most practices if not all have the office policy that if a patient is in collections they will restrict or stop providing care until the balance is resolved.  There is always an asterisk with that though which is that both the Billing Manager (if large enough practice to need one) or Practice Manager can over ride the denial to schedule when presented with the information and need.  The tech cannot simply say "Mrs. Moneybags needs her ultrasound" and expect approval.  They have to communicate the medical need to the powers that be to get the approval.  The physician ALWAYS can over ride all of them and approve care regardless of finances.

 

The other reason for the physician to be made aware of a patient with financial issues is that a balance of a couple hundred bucks is not enough to trigger a discharge but a patient with thousands in outstanding bills can legally be discharged from care of the practice. However, to do so the physician must comply with state laws and regulations to do so.  Typically that is notice that there is an outstanding balance that must be dealt with before more care can be received.  If the balance remains and the physician wishes to sever the relationship they must send a letter 30 days in advance notifying the patient and include a 30 day maintenance supply of any medication that doctor was providing to the patient.  Once that 30 days expires the patient must find another provider.

 

If the test was scheduled at another facility and there are financial issues they must tell the referring physician and/or his/her representative like the nurse that they cannot provide the care and why.  The physician may have the power to negotiate on behalf of their patient to get the care with the hospital (I have seen it done) if there is an urgent medical need.  If they cannot intervene they still need to know why their patient is not getting care especially when there is an unborn baby involved that can be impacted by not receiving care.

 

In the end as busy as most OB offices are it is a blip on the radar and they do not have time to pass judgment on you or anyone else for financial reasons.  It will not become an issue affecting your care until you make ZERO efforts to deal with the balance and maintain a partnership with the practice.

 

 

 

 

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