HIPAA and Making Appointments

  1. I'd like to know how offices apply HIPAA to the process of scheduling appointments. I had a maddening phone conversation this week with a receptionist at a practice where my family has a long relationship and believe she went overboard, but would like your input.

    My daughter has seen the same doctor for years to manage a chronic condition. He acknowledges frustration with some of the office staff and has given us his personal contact information in order to circumvent them, but I don't want to take advantage and have never used it.

    We live in a state where the age of adulthood is 19. My daughter turned 19 recently (since she was last seen in the office.) She had an appointment scheduled next week, but had the opportunity to go out of town on short notice, so I told her I would call and reschedule the appointment. When I called, the receptionist asked me to identify myself. I told her I was Ali's mom. She stopped me immediately and said she would not talk to me, that Ali would HAVE to call herself. I attempted to clarify that I was not seeking any information, just trying to reschedule an appointment that my daughter could not keep. She repeated herself. I let her know that Ali was not available at that time to make a phone call, as she was on a flight. Same response. I finally stated that I would have Ali call at her first opportunity (which would probably be on Monday, since the office would be closed by the time she landed on Friday afternoon), however, I insisted that she note that Ali would not be at her scheduled appointment.

    This office has recently implemented a very strict policy of cancellation 48 hours in advance to avoid charges for a missed appointment. I understand that because their time is precious and appointments should not go unfilled when others are waiting to be seen, however, such a policy requires that the office staff accept cancellations when people try, in good faith, to make them.

    I am the designated health care coordinator of our family. I regularly make appointments for my husband, my elderly parents, my husband's elderly aunt and have never had a problem.

    Ironically, the purpose of this visit is to thank the doctor for his expertise over the years, and let him know that Ali will be transitioning her care to another physician while she is away at school.

    I think I just might call his cell and let him know. Seems a whole lot easier than dealing with the witch on the phone.

    Thoughts?
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  2. 28 Comments

  3. by   meanmaryjean
    You could be anybody on the phone. The mother of a creepy ex-boyfriend trying to stir up trouble. I ran into the same thing when my kids turned of age. People just trying to do their jobs and not get into trouble.
  4. by   caliotter3
    My granddaughter had to start making her own appointments when she turned 18.
  5. by   JKL33
    Quote from Jolie
    When I called, the receptionist asked me to identify myself. I told her I was Ali's mom. She stopped me immediately and said she would not talk to me, that Ali would HAVE to call herself.
    This is p***-poor customer service. I can hear it now; I overhear it every shift. There are ways to explain your policy or position to a caller, and there are ways not to - starting with not interrupting them before they can even finish one sentence. I cringe every single time I witness someone answering the phone this way: "Ivory Tower Hospital ED, this is JKL"...."Ma'am...MA'AM!!!!..I can not give you advice over the phone!" Give me a break. This is our business to know about as representatives of our employer, and let's admit that some of it barely makes sense to us, let alone the people we are serving.

    How about this:

    "Oh, hi Mrs. ____!"......"Well, I appreciate you taking the time to give us a call, but I need to ask you to have Ali call at her earliest convenience to confirm this information."....."I know, I'm sorry but this is our policy for all patients in order to protect everyone's privacy and safety...."

    Nothing difficult about that AT ALL.

    OP, call the physician or send a note. Don't mention any of this, since your intention is to thank him. Instead, if you remain bothered by it, contact the practice manager.
  6. by   JKL33
    Quote from meanmaryjean
    You could be anybody on the phone. The mother of a creepy ex-boyfriend trying to stir up trouble. I ran into the same thing when my kids turned of age. People just trying to do their jobs and not get into trouble.
    mmj, I hear you and I agree with you. The problem with it, though, is that they also can't confirm that "Ali" is Ali. If that's the line we want to take with people, well then we should just hardly ever be using the phone, period. That's the part about all of this that makes people mad; it's nonsensical. It's not like she called and said that "Ali's" dog ate her oxycontin and she needs more immediately...
  7. by   hppygr8ful
    Quote from caliotter3
    My granddaughter had to start making her own appointments when she turned 18.
    My kid has to call and make his own appointments and he's only 15. I am also not allowed in the consult room without his consent. Oh I can still pay the bills for office visits and prescriptions. Only in California!

    Hppy
  8. by   Wuzzie
    Quote from JKL33
    This is p***-poor customer service. I can hear it now; I overhear it every shift. There are ways to explain your policy or position to a caller, and there are ways not to - starting with not interrupting them before they can even finish one sentence. I cringe every single time I witness someone answering the phone this way: "Ivory Tower Hospital ED, this is JKL"...."Ma'am...MA'AM!!!!..I can not give you advice over the phone!" Give me a break. This is our business to know about as representatives of our employer, and let's admit that some of it barely makes sense to us, let alone the people we are serving.

    How about this:

    "Oh, hi Mrs. ____!"......"Well, I appreciate you taking the time to give us a call, but I need to ask you to have Ali call at her earliest convenience to confirm this information."....."I know, I'm sorry but this is our policy for all patients in order to protect everyone's privacy and safety...."

    Nothing difficult about that AT ALL.
    To be fair we really don't know if the receptionist was actually rude. I can be as polite as possible but when I'm not telling the caller what they want to hear I get called all kinds of things including "witch".

    There's also a really easy solution. We have our patients sign a Release of Information for anybody they have assisting with their care.
  9. by   Wuzzie
    meanmaryjean said...

    "You could be anybody on the phone. The mother of a creepy ex-boyfriend trying to stir up trouble. I ran into the same thing when my kids turned of age. People just trying to do their jobs and not get into trouble."

    It's pretty easy to determine. We ask for DOB and last 4 of SS#.
    Last edit by Wuzzie on Jul 10
  10. by   JKL33
    You think her mother doesn't have that information??
  11. by   Wuzzie
    Quote from JKL33
    You think her mother doesn't have that information??
    Sorry JKL33 I should have quoted MMJ not you. My bad. I'll see if I can fix it.
  12. by   JKL33
    No big deal! And with that information I see what you're saying...when Mom called, they should've just had her verify HER identity by asking for those details that she would have if she's actually the mom. I agree.

    As far as the rudeness, it's true, we don't know how rude she was. And people do get upset at us when they run into a roadblock that we can't control. I just overwhelmingly see staff not handling these situations with care. Nurses tend to be a little better at finessing the situation (not always...). We (many staff) tend to act like we're violating HIPAA if we let someone finish a sentence or "hear" what they have to say! And listening to a dang question or brief concern/reason for calling is just not a HIPAA violation.

    What if the Mom in the OP was calling about an urgent matter?? Well...too bad, because the receptionist stopped her as soon as she said she was the patient's mother. I don't need people to be sickeningly sweet to me, but I just think that's rude.
  13. by   verene
    Seems weird to me. I worked as a caregiver for a while and constantly scheduled and rescheduled appointments on behalf of clients. As long as I knew their identifying information no one gave me a problem.

    While it is true that once your child hits 18 s/he is responsible for their own care and parents no longer have any right to their health information. Calling to cancel/reschedule an appointment (with appropriate identifying information) is typically admitted. Just to be on the safe side if your daughter wants you to be involved in her health care and have her sign a ROI with the clinic.
  14. by   Jolie
    Thanks, everyone. I appreciate your perspectives.

    I did some research and found that it is not a HIPAA violation for someone other than the patient to schedule or confirm appointments as long as no private information is shared, for example, asking for a list of my daughter's medications while I am on the phone confirming the appointment.

    JKL33 summed up my frustration. The receptionist was so quick to shut me down that it felt antagonistic from the get-go. What made it worse (in my mind) was that I was calling as a courtesy to the practice, not because I wanted information. I know how precious appointments are, and I wanted to give them ample notice to offer that time to someone else. If my daughter calls them today, they will have less than 24 hours notice, which violates THEIR policy.

    I'm equally aggravated that people have such poor understanding of HIPAA that they invoke it for virtually any situation, regardless of whether it is a violation or not. I would have more respect if she had simply stated that she didn't wish to speak to me, rather than claim a non-existent HIPAA violation. At least that would make her look honest, not rude and stupid.

    I'll let this go. Just disappointing to end a long (and otherwise productive) relationship with this practice on a sour note.


    ETA: Just to clarify, my husband, my sister and I are all authorized to receive information in Ali's records. The last time she was seen in the office, she was still 18. (In our state, 19 is an adult.) I believe Ali would be asked at her next visit to complete a new HIPAA form. For now, her records still reflect people I identified as authorized to communicate with the office, although that authorization is probably null and void since she is now 19.
    Last edit by Jolie on Jul 10

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