Optometry Coding & Billing Alert

Question: I often have a hard time explaining to patients why they must sign a PHI authorization form if they-ve already signed a notice of privacy practices (NPP). What is the difference between the two?


Louisiana Subscriber

Answer: The NPP just informs patients how you will use their information. It does not grant your office special permission to do anything with the patient's protected health information (PHI). It is a document that is part of a host of patients- rights and providers- obligations.

Tip: If patients do not want to sign the notice, make sure to document your good-faith effort to obtain the signature and that the patient refused. The signature on the notice only shows that the patient is aware of the privacy practice--it doesn't lend any special consent.

That's what the authorization is for. If your use of a patient's PHI isn't covered under the -Treatment, Payment or Operations- provision of HIPAA, you need the patient's authorization to use the information.

For instance: An authorization is needed for staff to disclose information about a patient to callers or others outside the facility--such as an ophthalmologist looking for the most recent IOL pressure test results.

The authorization is something that has to be obtained if no other HIPAA permission applies for a particular use or disclosure. If a patient refuses to sign the authorization, then don't use or disclose that patient's PHI.