Urology Coding Alert
Check HIPAA Rules Before Denying Record Requests
Question: We have a patient with a large balance who has not responded to requests for payment. They sent a request asking for a copy of their health records. Can I withhold the records until the patient pays for the services we’ve already provided? Codify Subscriber Answer: No, you cannot withhold protected health information (PHI) for reasons of non-payment, according to the Department of Health and Human Services (HHS). “A covered entity may charge an individual that has requested a copy of her PHI a reasonable, cost-based fee for the copy. See 45 CFR 164.524(c)(4). However, a covered entity may not withhold or deny an individual access to her PHI on the grounds that the individual has not paid the bill for health care services the covered entity provided to the individual,” HHS says on its website. Caution: Since the HHS Office for Civil Rights (OCR) instituted its HIPAA Right of Access Initiative in September 2019, the agency has investigated and settled 38 cases, including monetary penalties for the providers. Ensuring that patients have swift and affordable access to their medical records — no matter their financial situation — is a part of HIPAA and remains a primary focus of the Feds. You may want to include Right of Access protocols in your compliance planning and offer training to staff to protect these critical rights.
Related Articles
Urology Coding Alert
- Modifiers:
Let 4 Examples Show Which Modifiers Apply to Halted Urology Surgeries
Hint: If the urologist doesn’t even see the patient, you can’t report a procedure. Not [...] - News You Can Use:
Look Ahead to New Neurostimulator, Remote Uroflometry Codes in 2024
Category III codes will accommodate new technologies. Each new year brings new codes, and 2024 [...] - Payer Policy:
Decipher Cigna’s New Modifier 25 Payment Process
Remember to appeal when warranted. If your urologist sees patients with Cigna insurance, you’ll want [...] - Mythbuster:
Break Your Modifier 25 Bad Habits to Improve Claim Acceptance
Even before Cigna and other payers began implementing policies such as the one explained in [...] - You Be the Coder:
Don’t Stop at NCCI Edits
Question: I heard there are new guidelines this year for reporting percutaneous nephrolithotomy (PCNL) procedures. My [...] - Reader Questions:
Capture Urethral Injury Cause With Y Code
Question: My urologist saw a patient who had an unintentional urethral injury from self-insertion of a [...] - Reader Questions:
Ensure Management With OTC Medications
Question: My provider sometimes tells patients to take ibuprofen or other commonly available over-the-counter (OTC) pain [...] - Reader Questions:
Check HIPAA Rules Before Denying Record Requests
Question: We have a patient with a large balance who has not responded to requests for [...]
