New HIPAA Provisions for Patient Rights

Do not be surprised if a patient asks you to not bill their insurance company for a specific service.  It may sound like an odd request, maybe even something that is prohibited by insurance companies, but patients now have the right to restrict you from disclosing treatment information to their insurance carrier.

The Health Information Technology for Economic and Clinical Health Act (HITECH Act) was updated at the start of the year to include additional privacy and security protections.  The HITECH Act is part of HIPAA that governs data security for all health care organizations.

Under the new HITECH Act provisions, your dental patients can request that you not bill certain services to their insurance company. In order to comply with the law, your dental front office team needs to understand what is required of the act.

First, patients must pay in full at the time of service and sign a “Restriction on Use and Disclosure Form.”  You must receive payment and the signed HIPAA form to honor the request for restricted disclosure.

Secondly, once the restricted use form has been signed, your team must flag the file.  You cannot disclose the restricted service during an insurance audit or in a future treatment narrative for the patient.  If the patient transfers to another practice, you must also inform that practice of the restricted disclosure.

Finally, the HITECH Act supersedes all contractual obligations with insurance companies to submit treatment.  Dental teams must remember that when the restricted use form has been signed the patient’s treatment is private.

An excellent article that steps through the new provisions can be found in the recent issue of Insurance Solutions newsletter.

While you will most likely receive only a few requests related to the HITECH, it’s important to know how to respond.

Leave a Comment

Your email address will not be published. Required fields are marked *

Notify me of followup comments via e-mail.