HIPAA and Making Appointments

Nurses HIPAA

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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?

Specializes in Maternal - Child Health.

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.

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.

We run into this all of the time. It is NOT a HIPAA violation to fax a progress note/lab results/imaging results to another physician if the other physician is involved in the patient's care. It does not require an ROI to be signed. I'm happy to fax a cover sheet first so you know I'm legit or have you google the phone number and call me back to make sure but to have to figure out how to get the 86 year old who does not have a computer and lives three hours away to sign a sheet to release freaking lab results is crazy.

The same in the ED. If I have a LOL with decreased LOC and call the pharmacy she has listed in her chart to try to get a list of current medications I shouldn't have to give thinly veiled threats about potential litigation to get you to comply. Google the hopsital number, call it and ask for Wuzzie. I'll be there.

I agree that HIPAA is poorly understood and frequently invoked erroneously. As far as front line staff goes, the direct blame for this goes to the institution/facility for their fear-mongering regarding HIPAA. Everyone who has been to any inservice about it knows exactly what I'm talking about. In a way, I don't blame them (institutions/corporations) for trying to keep it black and white, because they really can't afford to leave HIPAA up to the best judgment of thousands of different employees. On the other hand, they never miss an opportunity to make it overly reductive while also throwing in a few threats and "examples" to scare people.

Specializes in Public health program evaluation.
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...

Exactly. Stupid rules breed contempt. Next time the OP could simply say that she is her daughter.

Specializes in DHSc, PA-C.

Ugh! This is a pet peeve of mine with misunderstanding HIPAA. I had a patient come in with her mother. Patient then decided she didn't want to be seen and walked out. The receptionist refused to let mom rescheduled patient's appointment because it was a "HIPAA violation". I instructed the receptionist to reschedule with mom and she refused and took the matter to the "executive director (doctor's wife)" who agreed with receptionist. So, I cut and pasted multiple examples directly from HIPAA website showing they are wrong.

Specializes in Psych.

I would have waited an hour, called in as Ali, said luckily my plane had a lay over, and rescheduled. But I call places as my mom all the time (with her permission/ asking me to) since my hours allow me to do so.

Specializes in Maternal - Child Health.
Exactly. Stupid rules breed contempt. Next time the OP could simply say that she is her daughter.

This! I would have just called back as Ali, but I have a raging case of bronchitis and wouldn't fool anyone.

Update: I got a call Monday evening on my cell reminding me of my daughter's appointment. I reiterated my conversation from last week (which was with another employee). The woman on the phone acknowledged that she knew all about the first conversation, as she was the supervisor of the previous caller, who "reported" our conversation.

I then pointed out that she already knew that Ali couldn't keep the appointment, so I didn't understand the purpose of this call. I swear I was looking for the Candid Camera by this time. She chewed me out for not having Ali call the office Monday to confirm what I had already told them. I reminded her that Ali was out of town and not available by phone. I would have Ali call at her earliest convenience which will be less than 48 hours prior to her scheduled appointment, and why I had called in the first place.

I asked if she was aware that HIPAA does not prevent someone other than the patient from making appointments. She said she couldn't discuss anything with me about my daughter, including her appointments.

I then asked why she called my cell phone to remind me about something she wouldn't discuss with me, when she has my daughter's contact information?!?! That left her grasping for words.

Ali called and cancelled. They still had her appointment in the schedule and tried to argue with her that she would be held responsible. I was proud of her for standing up for herself.

We're done with the office. I'll contact the doctor on his cell and let him know. ARGH!

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

I think you're right to contact the doctor at this point. His staff are going to kill his practice with their stupidity. He really needs to know what's going on.

Specializes in Complex pedi to LTC/SA & now a manager.
This! I would have just called back as Ali, but I have a raging case of bronchitis and wouldn't fool anyone.

Update: I got a call Monday evening on my cell reminding me of my daughter's appointment. I reiterated my conversation from last week (which was with another employee). The woman on the phone acknowledged that she knew all about the first conversation, as she was the supervisor of the previous caller, who "reported" our conversation.

I then pointed out that she already knew that Ali couldn't keep the appointment, so I didn't understand the purpose of this call. I swear I was looking for the Candid Camera by this time. She chewed me out for not having Ali call the office Monday to confirm what I had already told them. I reminded her that Ali was out of town and not available by phone. I would have Ali call at her earliest convenience which will be less than 48 hours prior to her scheduled appointment, and why I had called in the first place.

I asked if she was aware that HIPAA does not prevent someone other than the patient from making appointments. She said she couldn't discuss anything with me about my daughter, including her appointments.

I then asked why she called my cell phone to remind me about something she wouldn't discuss with me, when she has my daughter's contact information?!?! That left her grasping for words.

Ali called and cancelled. They still had her appointment in the schedule and tried to argue with her that she would be held responsible. I was proud of her for standing up for herself.

We're done with the office. I'll contact the doctor on his cell and let him know. ARGH!

Ok this crossed the line. Definitely call

I asked if she was aware that HIPAA does not prevent someone other than the patient from making appointments. She said she couldn't discuss anything with me about my daughter, including her appointments.

I then asked why she called my cell phone to remind me about something she wouldn't discuss with me, when she has my daughter's contact information?!?! That left her grasping for words.

Excellent. Unbelievable. People don't THINK. Half the time they aren't allowed to anyway!

Mandatory inservice awhile back, we were told that the key to reducing errors was to eliminate the need for critical thinking and human problem-solving as much as possible because that's where things go wrong. They touted the many ways they have been working at reducing our need to think critically. So now you know. That pretty much explains everything, doesn't it!

I think you're right to contact the doctor at this point. His staff are going to kill his practice with their stupidity. He really needs to know what's going on.

Yep. If he is a partner or practice owner, definitely. If he's employed, I'd contact the patient experience/satisfaction people, since under those circumstances he will have zero control over it.

I used to manage the diaper order for a long term care pediatric facility. Everything usually went smoothly except for one time when the rep wouldn't discuss anything with me about a 16 year old patient who cannot communicate at all. Because of hipaa... The girl lives in a facility, with multiple diagnoses, and I'm ordering her diapers...what would make you think she can come to the phone???

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