Optometry Coding & Billing Alert

Question: Our office has been told that having a patient sign-in sheet with the patient's name and reason for visit is a violation of HIPAA. How should we have them sign in? Does this also mean we can't call their names for an appointment and must assign them numbers?

California Subscriber

Answer: This is an example of HIPAA being interpreted too stringently - many experts were forecasting difficulties like these in the days before HIPAA was actually released. It is perfectly acceptable for an office to have a sign-in sheet as long as the information on it is limited.

The HIPAA rule considers a sign-in sheet a case of incidental use for disclosure. Calling a patient's name in the waiting room qualifies as incidental use as well.

What should not be on the sign-in sheet is information that is unnecessary for signing in, such as the patient's reason for seeing the optometrist. If writing down the name of the doctor they are seeing will have the same effect as writing down the ailment, it should not be on the sign-in sheet either. One easy solution: Use the patient's initials.

- 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.