Optometry Coding & Billing Alert

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

Louisiana subscriber

Answer: When a patient signs an NPP, the patient recognizes that he received a copy of your practice's NPP. The patient actually signs an acknowledgement of receipt. If the patient and the clinic personnel actually read the NPP, they will notice that it says that there are certain uses and disclosures of PHI that the organization will perform without specifically informing the patient, and certain uses and disclosures that require the practice to inform the patients first and obtain their authorization.
 
A patient should not often have to sign an authorization under the regulations. Unfortunately, most providers are undereducated about the regulations and, therefore, fear them. Thus they decide to overuse the authorization form. This is where frustration breeds for patients and families.
 
According to the regulations, you need an authorization when the use or disclosure is NOT for treatment, payment, operations, or required by law for reporting, such as to the Centers for Disease Control.
 
A patient should sign an authorization to release information for workers' compensation cases, attorneys, employers, or schools (except for immunization records).
 
A patient should not sign an authorization to send medical records to a new provider, or lab reports to a specialist, because these are treatment functions between two covered entities. A patient is required to sign an authorization when your practice shares information with a noncovered entity.
 
Patients need to know that an organization not covered by HIPAA will receive their PHI and that your practice is not responsible for how it may be used.

 - Advice for Reader Questions and You Be the Expert contributed by David Gibson, OD, FAAO, practicing optometrist in Lubbock, Texas; and Charles Wimbish, OD, president of Wimbish Consulting Group in Martinsville, Va.