<p>well, putting two and two together, the classmate was able to figure out I was this person’s chaplain. While she knew he was signed up with our agency, she had no knowledge of who the members of his team were until I opened my mouth. It wasn’t my place to release this information in a setting that excluded the patient or family’s wishes or without their authorization.</p>
<p>I understand that you felt badly about this, but how does someone figuring out that you have joined a “team” violate HIPAA if you did not tell the person any information about the patient, even the patient’s name? Do you mean that revealing that the patient has a chaplain reveals his or her religion? I can see that you felt badly, but I cannot understand why this specifically violates HIPPA?</p>
<p>This is so silly and unkind. Pay the bill! Your daughter will reimburse you when she returns from China.
Redirect your anger toward something that really matters.
Be thankful that your daughter is healthy enough to make the trip and that she has the necessary immunizations (at no charge!) to return healthy. There are a lot of patients in that office who have problems a lot bigger than yours.
No wonder people no longer want to go into medicine…</p>
<p>“Opie, you are so good at twisting things into scenario’s that fit your point. What if the bill had a pregnancy test on it? C’mon…”</p>
<p>twisting? please, when someone disagrees with you and points out some more practical possibilities to the situation, it’s not twisting, it’s pointing out some other possibilities that aren’t so evil… </p>
<p>For most people left to think for themselves with only bits of information, the usual conclusion is something bad or worrisome. I and a few others have tried to point out, maybe the intention was to benefit your D, not harm her privacy. I also pointed out the ripple effect of one decision (not paying a bill) into another unrelated decision (home loan) and a possible favor being done, even if a little embarassment occurs… </p>
<p>I believe this action was done with every bit a “good intention” on your D’s behalf. Somebody was trying to help your family. Yes, it’s a bill and that doesn’t sound like a favor, but it really was.</p>
<p>“What if the bill had a pregnancy test on it? C’mon…”</p>
<p>What? Geeze I guess I would beat her to an inch of her life. Throw her in stocks and veggie toss her? I have no idea if you thought this would induce outrage in me or what… or if it would have more stronger meaning… maybe you should have gone for sex change? 
</p>
<p>My kids have lived a milktoast life compared to mine…shocking dad is a bit hard to do…</p>
<p>Okay, I give up. On my opening post I said, “On the other hand, we do live in a small town and they may have thought they were doing us a favor because it would be bad if this was given over to a collection agency and put on her credit report. But still… Just doesn’t seem right.”</p>
<p>That’s all. I’m not outraged, I’m not screaming out the window. I just thought it was not quite right and I guess made the mistake of coming here and venting. Where’s that Parents sanctuary?</p>
<p>“I guess made the mistake of coming here and venting”</p>
<p>Not really and no body’s really mad at you, but… did you ever consider people in the same profession might post here? I’m not mad or trying to start a flame war, but I also see it as a favor first. I might feel differently if this person had an ax to grind with the family and said something aloud across the room like “mr. kathiep, jenny hasn’t paid us for her shots to cure her stds yet, you want to take care of that?..Oh, I meant overseas travel shots…” That’s a bit much… even I have limits. but this really was pretty innocent… no?</p>
<p>Personally I think the OP is correct. It’s not a huge deal but it IS against the rules. My mother and I go to the same dentist and I’m sure I wouldn’t want them telling her if I forgot to pay. </p>
<p>The person who made the mistake should at least be informed that a mistake was, in fact, made. Who knows what she’d do next? These rules are made for a reason and it’s not up to the receptionist to decide when they can be broken. </p>
<p>What does the fact that people in the same profession might post here have to do with it? Those people should be the first ones to say that the receptioninst was in the wrong. They know the rules, or should. Doesn’t matter if it wasn’t meant to be mean. The fact remains that it broke rules. </p>
<p>I would have a hard time going to a doctor’s office where I know the receptionist either doesn’t know the rules, or chooses to disregard them.</p>
<p>That’s really the problem, most people, including medical service providers, really don’t understand the rules. Either they are undertrained or have been trained to “over apply” the rules because it is better to err on the side of non-disclosure than to inadvertently violate the rules. I see it all the time in my representation of Health and Welfare Funds where I deal with HIPAA application with Fund administrators, participants, trustees, medical service providers, insurance companies and other professional service providers to the Funds. Insurance companies that won’t release PHI to a Fund administrator even though they are both “covered entities” and the disclosure is for a HIPAA permitted purpose, doctors offices that won’t discuss PHI because there is no written release even though the patient is available by phone to give a verbal release, the list seems endless at times! And with regard to the earlier comment about non-disclosure to a parent whose 18 year old is in the hospital, if there are exigent circumstances and it is necessary to the care of the patient to discuss PHI in order to provide critical treatment and the patient is incapable of giving consent, HIPAA permits disclosure to the parent.</p>
<p>A question was posed earlier about the genesis of the privacy regulations. Remember that HIPAA started out as a set of rules concerning access to and portability of health care i.e. limitations on debarment due to pre-existing conditions, the ability to move from one health care plan to another and to obtain health care in an increasingly mobile society. With that came the need to transfer and share health care information and also protect against the misuse or abusive disclosure of such information. Part of this also involved the standardization of how healthcare information is recorded and organized so that all healthcare providers would be using standardized data sets. Add to it the increasing use of electronic data storage and transmission, well, you get the picture, the nuances of the privacy issues became very complex. Add to it the misuse of improper disclosures that had been rampant in segments unrelated to the providing of medical services, such as improper access by employers or prospective employers and the lobbying by patients advocacy groups and the result was a set of broad reaching rules.</p>
<p>Please carefully consider the consequences vs. the spirit that the comment was made. It sounds like the receptionist was just trying to do a favor. She did not read the families medical charts on her lunch hour, and then broadcast the news at the church sewing circle. However, any complaint about a breach of privacy will probably cost her job, and will be noted on any attempts for re-employment in another medical office when they call for references. Is the trip to China secret from the entire community? I think not.</p>
<p>
3bm- As MichaelNKat has so eloquently pointed out, the rules and regulations are so cumbersome, confusing and unclear that no one can really “know” the rules. I do agree that the receptionist/front office staff represent the Drs office, and are the first entry into the practice. How they interact with the patients can make or break a Drs. practice. I hear a lot of patients complain about the difficulty they have with some other Drs. office staff. That said, in this situation, I don’t think the receptionist meant to do anything wrong-- she was probably trying to be helpful. Perhaps if the OP’s H had said “my d is over 18 and has her own insu. I don’t think we are supposed to be talking about her account” (or something lke that), the receptionist might have apologized for the boo boo. I repeat, I think, over the course of this discussion, some things have taken on a bigger issue than was the initial intent. It didn’t sound to me like the receptionist was purposely choosing to disregard the rules. And to fire her , have to replace her, go through the whole hiring and training process is a challenge. Yes, she should be formally reminded of the HIPAA privacy guidelines, and even perhaps have a note placed in her employee file. But I don’t think she did anything so egregious that warrants termination. She sounds like a good, caring employee. They are hard to find.</p>
<p>I doubt if the receptionist would lose her job over that. However, I do think that she needs to hear from her boss about the privacy breech so she doesn’t do it again. If she just hears about it from the OP, she may think the OP is overreacting.</p>
<p>I am among the several people here who think that what the receptionist did was a mistake. I wouldn’t have been happy about it if I were the D or the mother, and I would wonder about the possibility of other privacy violations. Sure, the receptionist was trying to be helpful, but what she did still was wrong. What other privacy breeches is she making in her efforts to be helpful?</p>
<p>In addition, if I – a layperson – knows HIPP well enough to know that confidentiality was breeched, the receptionist certainly should know the same.</p>
<p>With all due respect, NSM, in your earlier posts (especially # 18 and #22) you sounded like you would be hopping mad (“I would no longer want to see that doctor”…“If they violated my privacy there, I fear more would be violated (paraphrasing a bit)” and that the breach was “inexcusable”.) Honestly, I don’t think this receptionist needs to be tarred and feathered for what she did. Personally for all we know, the staff may be instructed to try to collect outstanding balances from people when they are in the office (normal business practice) and the receptionist may have tried to apply that too generally. That would be reason to remind the staff person that they cant do that with adult children. Personally, I think some people are overreacting to this situation, but thats just me. And for the record everyone, its HIPAA not HIPPA.</p>
<p>I think the receptionist was very very wrong- I wouldn’t go to that doctor again either, if the receptionist is so open with information, who knows what else she tells people</p>
<p>And the billing matter is irrelevant- we are talking about adults here, who happen to have the same mailing address- different insurance, etc, so the doctor’s office should absolutely be told about the breach</p>
<p>She owes the D an apology, as well for sharing her personal information with others, no matter the relationship</p>
<p>What if it had been for an STD or the like? And for the receptionist to assume the family knew about ANY medical work done is just wrong</p>
<p>The receptionist should ONLY have asked if it was correct to continue sending correspondence to their address, period, and there was no need to even discuss what the correspondence was</p>
<p>I agree with NSM wholeheartedly</p>
<p>Who wants to bet the receptionist isn’t very discreet in general…bet those that say what she did wasn’t that bad wouldn’t want her talking about them</p>
<p>We just see one example of sharing private information here, wonder what ELSE she shares</p>
<p>As for going to China, no way should that information leave the doctor’s office via ANY of its employees and if the employees are in the presence of others talking about the girls trip, out of respect for the patient, any information they have that they got from working in that office they should not share</p>
<p>
I am not sure this is true. The daughter is in China and may or may not have lived at home beforehand. I repeat-- I think some people are overreacting to this particular example. Not saying it was ok, but it was a mistake. Sheesh. I have unfortunately heard far more egregious breaches that would cause me to consider whether a certain drs office is run to my comfort zone. If you think this particular situation warrants stomping out and changing doctors, well that seems excessive to me- but again, thats just me.</p>
<p>And it doesn’t matter if the trip to China was a community celebration or private matter and clandestine, the receptionist in a doctors office has no place taking ANY information she got from her job and sharing with ANYONE </p>
<p>My sister-in-law works in a pediatricians office and we often run into some of the offices patients- she NEVER mentions where she knows them from, UNLESS the patient themselves says, Oh Mary, nice to see you, this is my doctor’s receptionist</p>
<p>As well, when my Ds went to their doctor, they often had private conversations with their doctor about who knows what- I didn’t ask, and unless there was some real medical crisis, I didn’t need to know</p>
<p>I was invited to go into the room, but I never did once they were over 12- I may have stepped in at the end of the exame to touch base, etc, but I felt very strongly that my Ds needed to be able to talk to their Doctor</p>
<p>If I was the OP, I would send a polite note to the office manager saying that you wanted to clarify the relationship the doctor has with the family- that the D is in her majority and SHE is libeble for all bills, etc, and that you are not to be privy to HER information.</p>
<p>And that you will be sure to pass along her mail as you are the current billing address but that you would prefer that the staff deal directly with your lovely daughter.</p>
<p>This may be a “small” incident, but that doesn’t matter one iota, and if the receptionist was trying to be helpful, maybe she is “helpful” in other ways that cross the line as well.</p>
<p>
I believe this example, and the example of a pregnancy test, were already used earlier inthis thread. The prro receptionist did NOT disclose any medical information, and did not broadcast across the waiting room, to my knowledge, any additional information about the daughter’s whereabouts. And where’d the notion that this happened came from?
. If you are giving this as an example of what “could” happen, it is a big leap from what the OP said. Gosh- this stuff gets so embellished.
and as for this
another generalization with no data to support it. Should we assume that just because someone comes across as negative or harsh here that this describes how they are everywhere?? Good grief.</p>
<p>"With all due respect, NSM, in your earlier posts (especially # 18 and #22) you sounded like you would be hopping mad (“I would no longer want to see that doctor”…“If they violated my privacy there, I fear more would be violated (paraphrasing a bit)” and that the breach was “inexcusable”.) Honestly, I don’t think this receptionist needs to be tarred and feathered for what she did. Personally for all we know, the staff may be instructed to try to collect outstanding balances from people when they are in the office (normal business practice) and the receptionist may have tried to apply that too generally. That would be reason to remind the staff person that they cant do that with adult children. "</p>
<p>They shouldn’t have to be reminded about that: Privacy is a fundamental issue and right when it comes to doctors’ offices. This was true way before HIPPA. </p>
<p>One reason that I’m taking a tough line on this is that I have had personal experience indicating that if a person is thoughtless about privacy as was the receptionist, it’s not likely that they’ll only be thoughtless once.</p>
<p>I wonder what other information the receptionist is spilling in her efforts to be “helpful.”</p>
<p>jym, so, its okay if the receptionist shares your billing information with your brother or mother? that you haven’t paid a bill is okay to share with anyone of your relatives</p>
<p>Just the FACT that the Adult D WENT to the doctor , no matter WHAT the reason is, is something that should not be shared with anyone!!!</p>
<p>Just mentioning an outstanding bill crosses the line.</p>
<p>If I went to the doctor privately for whatever reason, that receptionist should not say to my H, oh, it was good to see your wife last week. Its not her place to do that, no matter how small or big the town is.</p>
<p>My mother and I share a dentist, and not ONCE has anyone in that office even brought up my mothers name to me or me to her, under any circumstances, not even to verify an appointment.</p>
<p>My mother has TOLD her other doctors that it is okay to call our house and share her appointment information when they call to remind her about appointments.</p>
<p>Once they called, asked for her, she wasn’t home and they just left an inoccous message with no information whatsoever, as it should be</p>
<p>
Sounds like you and cgm think alike. I’d prefer to take a positive view, not a negative view, and not automatically think the worst about someone. But, again… thats just me.</p>
<p>You can talk amongst yourselves-- I have to get back to work.</p>
<p>there once was a story about a gossip who just shared ONE little story, and it was like letting a feather lose, it was just a feather, but it flitted around all over the place, and it was impossible to take it back</p>
<p>When it comes to medical issues, there is no “taking” back what a person says</p>
<p>And if you can’t trust the frontline of an office to not share private information, even the fact that the person even had an appointment, for any reason, is enough for me to at a minimum let the boss know</p>
<p>What if it HAD been for something else, and if the receptionist didn’t mention the WHY of the appointment it was still none of dad’s business that the adult D was even at the Doctor’s office at all- even if it was for a hangnail- the idea of even sharing any information- no matter what it was, was bad</p>
<p>And to even make a further point, the receptionist shouldn’t even comment on the clothes a patient was wearing, as innocent as that may be…once you are in those offices, that staff has to be the model of decorum, and privacy, and a patient should not have to have any worry about that staff sharing anything at all about any patient in any way…period</p>