The physician has rendered services to a new patient at the hospital. The only information available is the patient’s name, location, and diagnosis.

Question

a. Describe examples where patient information can be obtained for registration and medical billing purposes.
b. Explain the requirements of HIPAA for requesting and using information from medical providers and facilities.

Answer 1

a. Describe examples where patient information can be obtained for registration and medical billing purposes.

Student answer should include the following: (1) The admissions department of the facility; (2) The nurse’s station at the facility or ward, where the patient is located. Send a letter requesting information to the patient, or call the patient for information. (3) Contact the physicians’ offices also providing care to the patient (such as the referring or attending physician). (4) If applicable, contact the operating-room scheduling desk or the Social Services department of the facility.

b. Explain the requirements of HIPAA for requesting and using information from medical providers and facilities.

HIPAA requires a business-associate agreement in order for PHI to be disclosed to another covered entity. Once the business associate obtains the information, use of it for business management and administration is permitted under the HIPAA guidelines, which include medical billing and reimbursement.