HIPAA question

I'm a first year NS and work at the check in area of a large, successful medical office. Today, all members of the office staff were handed 10 pages each of adult patients who have not been scheduled for a physical in the past 15 months. We were instructed to call and tell the patient the reason we were calling is to "schedule your yearly physical since it has been over a year since you've had one done". I've worked in this office for over 3 years, mostly PRN and part time, and we have never done anything remotely like this. When I asked why we were beginning this "activity" I was told "money". Are you kidding me???? I refused to take part in this; I feel like this amounts to accessing the patient records without valid reason and is a violation of their right to privacy and right to choose whether or not to contact our office for their physical. Not only that, but it feels like I've been asked to telemarket our office. Its obvious that nobody cares that the patient has missed a physical and could be jeopardizing their health, only that we missed out on a few bucks. I am very upset that I seem to be the only one who has an issue with this. When I spoke up to my manager I was told it was not an activity I could choose to participate in, it was an assignment I was given and expected to do. I told her to follow appropriate corrective action if she felt I was being insubordinate. As of quitting time, I've not heard another word about it.

BTW, more than one person has been yelled at for assuming that the patient they had contacted wanted to have anything to do with our office, seeing as how they had not sought our services themselves! The threats of patients filing complaints are already starting and administration doesn't seem to get that this is an issue because the patient signs a confidentiality for that states their records can be accessed in the course of treatment...and a physical is a "course of treatment".

Any constructive feedback is greatly appreciated. I feel strongly enough about this to put my job in jeopardy and I'd like to know if I'm overreacting or not.

I am not a HIPAA expert, but I don't think this is a violation. I get phone calls from my dentist and primary care doctor when my yearly check-up is coming up.

Although I find it annoying when they continue to call me, I do appreciate one phone call to let me know that it has been a year since my last check-up.

I can understand from a financial stand point why a medical practice wants to make these phone calls. They need to bring money into their practice to pay salaries, bills, etc. They are in the market to provide a medical service to make money, thus reminding people that their year check-up is coming up will probably bring in more money to the practice.

This is not Hipaa violation. Its common and ok for offices to keep record of physicals, paps, vaccinations ect so they can send their patients notices that it is time for a check-up (I get them every year from my dentist and Gyno). Its sad that your office is only doing it for monetary reasons, of course they need money to run their office...but if the reason for Tx of the patient is money alone...that is just sad...

I can see the point that most offices do this as a regular service to their patients. My issue comes with being directly told we are doing this for monetary reasons. I pointed out that it would also benefit the office if we did daily reminder calls for the next day appointments...we average about 45 no shows a day! It seems an appropriate use of resources yet it is never done! We get numerous calls on a daily basis asking us to please do reminder calls because a patient has received a notice regarding the potential ramifications of future no shows (fees and possible termination from our clinic). It never fails that the suggestion to admin falls on deaf ears. I was even told compensation is higher for physicals and that is why those calls are top priority right now.

I don't know...maybe I just needed to vent. Thanks for listening and for providing feedback. :nuke:

I do not think this is a HIPAA violation.

I can see the point that most offices do this as a regular service to their patients. My issue comes with being directly told we are doing this for monetary reasons. I pointed out that it would also benefit the office if we did daily reminder calls for the next day appointments...we average about 45 no shows a day! It seems an appropriate use of resources yet it is never done! We get numerous calls on a daily basis asking us to please do reminder calls because a patient has received a notice regarding the potential ramifications of future no shows (fees and possible termination from our clinic). It never fails that the suggestion to admin falls on deaf ears. I was even told compensation is higher for physicals and that is why those calls are top priority right now.

I don't know...maybe I just needed to vent. Thanks for listening and for providing feedback. :nuke:

I definitely see where you are coming from. It sounds like a very frustrating situation.

I agree that to be told it was for monetary reasons is kind of crummy but to be honest, isn't any recall system or calling the day before an appointment for monetary reasons? Like you mentioned, calling to remind of an upcoming appointment would probably prevent many no-shows & increase profit.

Recalls, reminding that they are due for physical, labs, procedures ( I got my 5 year reminder for my colonoscopy last week) not only gives the patient the opportunity to schedule them & probably follow-up appointments, but can also be a source of information such as "we have changed providers so are not interested in coming in." Where I work several of the providers have closed practices because they have so many patients they can't handle more. However, I often wonder how many of those patients are still really their patients. I was flabbergasted the first time I saw the size of our records room and the many rows of files in it. Being in contact with patients who haven't been heard from in a few years makes sense to me.

Dixie

No its not a HIPAA violation.

Try to think of it this way...why do people need check-ups? Cancer screening, disease management, heart disease screening, health education, wellness counseling? I had a friend recently who went in for a check up and they found a weird mole on her shoulder. Had it removed and it turned out to be a melanoma. Thankfully it was removed in time before it spread. If she hadn't gone in she might have ended up with a really bad situation.

with caller ID and voice mail, i can see where this may rise to a HIPAA violation......i presume you are at least expected to talk to the patient, and not leave a message? and using a "blind" # ie one that doesnt show up on caller ID?

with caller ID and voice mail, i can see where this may rise to a HIPAA violation......i presume you are at least expected to talk to the patient, and not leave a message? and using a "blind" # ie one that doesnt show up on caller ID?

Our switchboard number shows up on caller ID. And I truly do understand the importance of a yearly checkups, I just hate that it has come to the point where the only reason anyone cares that these patients have not had a physical is because of money. I'm going to go in with a more open mind today and offer suggestions to make it seem less "slimey". What about calling patients we have not seen at all in the past year instead of including those who come in on a regular basis for acute care or DM monitoring etc? That sounds slightly more reasonable to me. Thanks for all the replies! They have helped me see this in a different light. I still don't like it, but I can cope a little better if I can offer alternative suggestions.

I don't think it's a HIPAA violation, but I do believe it's a high-pressure "sales" tactic on a practice that's obviously scrambling for money.

I think a letter is appropriate and allow the patient to call the practice.

If they don't get the phone call, then they know the patient has moved on.