Hi Group:

Can anyone give the meat of the matter on what we are supposed to do when collecting medical accounts and what we should be "worried" about?

We are judgment collectors and sometimes we collect a judgment for a doctor against a patient. We usually ask for all pertinent info on the debtor: ie. full name, address and ssn. We do not ask for any personal/medical info, however, we have heard conflicting reports on what is and isn't personal info and covered by HIPAA. Of course this wouldn't only be for judgments, it could be for regular collections as well, since HIPAA covers it all.

We would like any comments so that we can be compliant.

Anyone have any thoughts on the subject of HIPAA?

Thanks.

There's really nothing to be afraid of. I think it was Bill Lindala that said something about this in a previous post somehwere and likened the enforcement of HIPAA to the original enactment of the FDCPA. Everyone was running scared needlessly.

Here are some web-sites that answer some questions:

http://www.hipaahelpnow.com/hipaa_pedia_payment.htm
http://www.hipaadvisory.com/regs/
http://www.hipaacg.com/

Great websites Anthony!

I agree completely with what you said about people running scared for no reason and it does sound like something that I may have said! I guess that I talk and write too much, because everything that I have said, kind of runs together!

The main thing, JHat, is that from everything that I have heard and read, HIPAA will not interfere with the FDCPA, nor will it interfere with our normal collection activities. The one thing that you DO need to have, is a business associate agreement with each of your medical clients. Granted, it is their responsibility to provide that to you, but ACA also has an agreement that they have prepared for it's members that can also be used with your medical clients.

Either way, it is important to have someone in your company that is knowledgeable and versed in HIPAA, so that you are prepared. Once again, this is not legal advice and you should consult with your own legal counsel for any legal advice.

Take care!



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Of course, that's just my opinion. I could be wrong.--Dennis Miller

Premier Consulting Group, LLC - Your Success Is Our Responsibility

I have a question. Does anyone know of a good link for HIPAA training? I have new collectors that not only need to be trained for collections, but also in HIPAA compliance.

Thank you

The Education Department at ACA International is just now working on a HIPAA training program that will have 3 parts--one for owners/managers, one for supervisors, one for collectors. It will be distributed on videotape and DVD. I suggest you watch the ACA International website for release details, probably within the next 90 days. www.acainternational.org.

Hi group! I'm wondering how everyone in medical collections is making out with the implementation of HIPAA? Has anyone had any particular horror stories or has anyone found any particularly good websites? That kind of thing. Thank goodness we've had no real problems, except trying to convince debtors that we're no permitted to have their medical information when they want to know what procedures were done. Has anyone found a really effective way of dealing with that issue?

Any help/input is greatly appreciated!

Thanks!

Sherry

Hi Sherry:

About 80 to 90 percent of our business is medical and thankfully, we have not had any issues. My wife also works for a large medical group in the Milwaukee area and they haven't had any "real" issues either.

The law is still very new and I have actually been holding my breath, just waiting for some backlash, but so far, so good!

Take care.



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Of course, that's just my opinion. I could be wrong.--Dennis Miller

Premier Consulting Group, LLC - Your Success Is Our Responsibility

Sherry,

As a business partner of the medical provider, you are allowed to have the patient's PHI including diagnosis, procedure codes, etc. Our investigations into HIPAA and the education we have done with our staff are that we have a business relationship with the hospitals we work for, and as a result of that, our clients are allowed under HIPAA to release such information to us for the purpose of the collection of the account. We are very cautious about who we release information to of course.

Regarding previous posts that the HIPAA enactment was much like the FDCPA enactment and people are "running scared", I think its important to note that if your clients are worried about their HIPAA compliance, they will be worried that you as a vendor are compliant as well. So, as an agency providing services to medical clients, you have to be educated and HIPAA compliant probably more-so than your own clients.

The best advice is and always will be to seek the advice of your own legal counsel about your business practices and HIPAA compliance.

Good luck!
Dixie

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Originally posted by: dixiesokol
Sherry,

As a business partner of the medical provider, you are allowed to have the patient's PHI including diagnosis, procedure codes, etc. Our investigations into HIPAA and the education we have done with our staff are that we have a business relationship with the hospitals we work for, and as a result of that, our clients are allowed under HIPAA to release such information to us for the purpose of the collection of the account. We are very cautious about who we release information to of course.

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Do you release the information to the collectors on the floor? I ask this because, given my experience with my former employer, I would be very concerned if collectors had PHI. Many of them would, it would seem, be tempted to sell the information for drug money. I'm not making this up - they had a "no cell phone" policy in addition to the "no gang attire" one. Turns out that a few enterprising collectors were reading off debtor's SSNs and other personal info.

The depths they'll go to for cheap labor . . .

Mostly the info in our agency stays between myself and the floor manager. Not that I don't trust my collectors, but I am overly cautious about who I release that info to.

I can't believe the no thug wear rule. I can't begin to imagine where you worked previously. But I have noticed a lot of businesses have the no cell phone rule.

Sher

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Originally posted by: Sherry
Mostly the info in our agency stays between myself and the floor manager. Not that I don't trust my collectors, but I am overly cautious about who I release that info to.

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Most of the info? I assume you mean that the collectors mainly only know that "an account with Dr. Quack has been assigned for collections against you . . . "?

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I can't believe the no thug wear rule. I can't begin to imagine where you worked previously. But I have noticed a lot of businesses have the no cell phone rule.

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Believe it. It was in the dress code - "no gang attire or clothing resembling gang attire." It was at a large agency in the Seattle area. I wasn't exaggerating as to the reasons for the no cell phone rule - personal information was being collected and sold.

Yep, that's about all they get and the person's SSN and DOB. If our client provides it, they will get some info on the account, such as "Bal after insurance" or "Insurance denied".

Sher

How do you handle consumer requests for validation (e.g., itemized statements)? How do you deal with that if you're going to sue someone? If the debtor appears and all you have are printouts from your collection system, the judge is going to laugh at you.

At this time the floor supervisor and myself handle any validation requests. As for sueing people, we aren't persueing that at this time. Did I mention we are a very small agency? There are 3 Collectors, the floor supervisor, a sales manager, one full time and one part time clerical, CFO and the owner.

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Do you release the information to the collectors on the floor? I ask this because, given my experience with my former employer, I would be very concerned if collectors had PHI. Many of them would, it would seem, be tempted to sell the information for drug money. I'm not making this up - they had a "no cell phone" policy in addition to the "no gang attire" one. Turns out that a few enterprising collectors were reading off debtor's SSNs and other personal info.

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Sometimes when I read your posts, I am really grateful to be living in the heartland of America, Indiana, where this is not an issue for us. First of all, we DO allow collectors to have the PHI. It makes for more effective collections if they can speak reasonably intelligently about the account. The reason is that in the area I live, collectors are considered proffessional people, not drugged up gang members carrying switchblades and guns to work! Our agency has a background check and drug screen before we hire anyone, and we have applicants checking up with us every month or so to see if we've had any openings. So, people here LIKE working here, and they are supporting families, buying houses, cars, etc, just like upstanding, law abiding citizens. I know from your experience that's hard to believe, but I've been working in collection agencies in central Indiana for 20 years and have NEVER encountered someone stealing identities, committing fraud, or otherwise engaged in criminal activity with ONE exception:

about 18 years ago, a collector left her desk to go on break. She left her purse open and on the floor next to her chair. Another co-worker (different agency than I'm at now) helped herself to the first collector's JC Penney credit card, went out, and charged up about $300 worth of stuff, then RETURNED the card to collector A's wallet at another time! Back then, $300 seemed like a fortune to most of us...anyway, the funny thing is, the two collectors worked side by side for a few months after the theft and collector A kept talking about the fraud on her JC Penney card, and collector B kept commiserating, and then when it all came out that it was collector B who stole the card, collector B just calmly packed up her desk and left at lunchtime, never to return, at the quiet request of agency management. That is the ONLY criminal activity I have ever had any knowledge of in our area, so your stories about your previous agency policies amaze me!

Back to PHI--the collectors are a part of our business and because we have a business relationship with the client, we are allowed to impart PHI to our collectors. We try to keep things on a "need to know" basis. In other words, I wouldn't ask one department if they have an account on another department's debtor unless they have a "need to know" something, like a bankruptcy was filed. Then, we have a person do a search on the name on bankruptcy paperwork. Since bankruptcies are a matter of public information, there is no exchange of PHI.

Still, the best advice is and always will be: seek the advice of competent legal counsel. During the first few years of HIPAA, we will see lawsuits challenging the practices adopted by healthcare providers and their business associates. Its better to be safe than sorry in my opinion, and I feel safer with a valid legal opinion.

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Sometimes when I read your posts, I am really grateful to be living in the heartland of America, Indiana, where this is not an issue for us.

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Can't say as I've been to IN, but I hear it's an interesting place. I hear it's quite conservative in a sea of labor-dominated liberal big states. Anyway . . .

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First of all, we DO allow collectors to have the PHI. It makes for more effective collections if they can speak reasonably intelligently about the account.

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To what degree of specificity? "Mr. Consumer, I'm calling you about the money you owe for treatment of your bladder control problems . . . "?

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The reason is that in the area I live, collectors are considered proffessional people, not drugged up gang members carrying switchblades and guns to work! Our agency has a background check and drug screen before we hire anyone, and we have applicants checking up with us every month or so to see if we've had any openings. So, people here LIKE working here, and they are supporting families, buying houses, cars, etc, just like upstanding, law abiding citizens.

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Considering you're in central IN, it's not that hard to believe. Being a smaller agency, you're probably more concerned with (gasp) quality than with cheap. So your collectors buy houses and raise families, huh? Here, a collector would be hard-pressed to afford a studio apartment. At most agencies, the pay is so bad they qualify for Section 8 housing and food stamps. These aren't the kind of people I want having access to my medical chart.

What kind of background check do you do? Drug testing (a/k/a, the "whiz quiz")? Criminal background check?

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Back to PHI--the collectors are a part of our business and because we have a business relationship with the client, we are allowed to impart PHI to our collectors. We try to keep things on a "need to know" basis.

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This goes to my previous question - how much information is shared? How much does the guy on the floor, behind the phone and the fake name, know about me?

I'm glad you look at your collectors and your business that way. I'd have to say you're the exception to the rule. Most places figure they can teach anyone to collect. In fact, the stupider you are, the better - you won't make trouble and you especially won't ask for a raise. And you'll buy the line of crap agency management dishes out when they explain why the commission on that huge payment goes to the house, not you.

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Still, the best advice is and always will be: seek the advice of competent legal counsel. During the first few years of HIPAA, we will see lawsuits challenging the practices adopted by healthcare providers and their business associates. Its better to be safe than sorry in my opinion, and I feel safer with a valid legal opinion.

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Usually these lawsuits are what happens when someone pushes the limits and gets their butt slapped in the process. Well, it happens to the big boys. It happened to Nationwide, after all.

*bump*

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Associate Editor
insideARM.com

From this forum I have got more ideas to my article preparation about HIPAA and collections. All comments are very much informative. And I especially need to thank you for sharing this kind of topic.
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george
hipaa

Wow, a blast from the past. Wonder whatever happened to Dick Hertz (his desk name as a collector lol)? Former collector turned consumer advocate attending law school last I knew.

AJ, there is hope for scumbags like you yet.

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...the FDCPA enlists the efforts of sophisticated consumers....as "private attorneys general" to aid their less sophisticated conterparts, who are unlikely themselves to bring suit under the Act, but who are assumed by the Act to benefit from the deterrent effect of civil actions brought by others.

How unseemly. We'll have no name calling on this board!