How to remove Paid Medical Entries using HIPPA?
Date: Fri, 04/15/2005 - 07:15
How to remove Paid Medical Entries using HIPPA?
MY NAME
MY ADDRESS
Indianapolis, IN
Date: April 15, 2005
St. Vincent Hospital & Health Care Center
Correspondence
P.O Box 40970
Indianapolis, IN 46240
Re: Acct Ref. # 3705964; Letter from Mutual Hospital Services dated 3/21/05
Dear Sir/Madam;
This letter is in reference to account #3705964 for services provided to [SONS NAME] (My Son) on June 6, 2000.
In regard to the bill on this account in the amount of $226.00 as Listed with Equifax, $222.00 as Listed with Experian, and $222.00 as Listed with Transunion:
This account is in error.
It has either been paid, is a billing error, or was not transmitted in a timely manner to my insurance company.
It is not a valid bill and has been properly disputed; therefore I request complete deletion from all your records and archives.
Please be advised that under Federal Statutes the Fair Credit Reporting Act, (15 U.S.C. § 1681 et seq) you may be held liable for the actions of (collection agency name).
(a) Duty of furnishers of information to provide accurate information.
(1) Prohibition.
(A) Reporting information with actual knowledge of errors.
A person shall not furnish any information relating to a consumer to any consumer reporting agency if the person knows or consciously avoids knowing that the information is inaccurate.
In addition, the HIPAA is in effect in this situation even though the health care services you provided were prior to enactment.
The Privacy Rule prohibits a covered entity from using or disclosing an individual's protected health information ("PHI") unless specifically authorized by the individual or otherwise allowed under the Privacy Rule.
In general, PHI encompasses substantially all "individually identifiable health information" that is transmitted or maintained in any medium. "Individually identifiable health information" includes health information that is created or received by a health care provider, health plan, employer, or health care clearinghouse, and that relates to an individual's physical or mental health or condition, including information related to an individual's care or the PAYMENT for such care.
The Privacy Rule also requires covered entities to provide notices to each individual whose PHI will be used or maintained by the entity. The notice must contain specific disclosures and other information, including the uses and disclosures that the entity may make of the PHI, and the individual's rights and the covered entity's obligations with respect to the PHI.
The Privacy Rule includes specific delivery requirements of the notice, depending on the type of covered entity. The proposed revisions also require that a covered health care provider make a good faith effort to obtain an individual's written acknowledgment of receipt of the notice. Covered entities are required to adopt policies and procedures to safeguard the privacy of PHI.
The Privacy Rule establishes standards that covered entities must meet, but allows them to design their own policies and procedures to meet those standards. The requirements are scalable to account for the size and resources of the covered entity. Each covered entity generally must
(1)
adopt a written privacy policy designating who has access to protected information, how the information will be used within the entity, and when the information may be disclosed;
(2)
take steps to ensure that its business associates protect the privacy of the covered entity's PHI;
(3)
train employees with respect to the privacy policy; and
(4)
designate a privacy officer who will be responsible for ensuring the privacy policy is followed.
Your furnishing of my account information to Mutual Hospital Services, is not in compliance with HIPAA, and any subsequent reporting of this account on my credit reports to Equifax, is a clear violation of Public Law 104-191 ("HIPAA") since there can be no permissible business purpose in divulging protected health information to anyone on an account that has no payment due. I am particularly concerned about the copy of the invoice that Mutual Hospital Services sent to me (see inserted copy for inspections) that detail exact medical procedures that were performed, which is a plain violation of the HIPPA act as this was provided to a non-authorized requestor and I hereby also request that any and all copies of said non-authorized release of private information of this type to be rescinded and deleted for all such records of the un-authorized possessors.
The Privacy Rule establishes substantial rights for individuals with respect to their PHI. These rights include the right of individuals to access their own PHI, to request amendments to their PHI and to request an accounting of the disclosures of their PHI.
In regards to the above paragraph, I would like to have submitted to me an accounting of all disclosures of this particular transaction and the individuals who have had access to it and what their reasons were for and in what capacities they were excising in order to access this said information about my son.
You are required under the FCRA to accurately report the status of any account to the credit bureaus, and you are prohibited under the HIPAA privacy regulations from doing so on a PAID account, as there is no permitted business purpose.
Therefore I am requesting you promptly rescind all such account information furnished to Equifax, Experian and TransUnion Credit Reporting Agencies and require them to purge their records of all reference to this account, and that you insure that any and all reporting of this account is immediately deleted from my credit reports.
This simple procedure to request the deletion of ALL reference to this account from the records of Equifax, Experian and TransUnion Credit Reporting Agencies and to require them to have this account information deleted in it's entirety from my credit reports will resolve this problem completely.
Please respond, in writing within 10 days that you are processing this request.
I am reserving the right, to take appropriate legal and civil action including reporting to any applicable regulatory authorities any lack of cooperation or compliance with this request.
I hereby waive my rights under HIPAA for the single purpose of your transmission of this request and accompanying documentation in any required report you must make to your E &O insurance carrier.
I have also included a copy of the Letter I have received from Mutual Hospital Services dated 3/21/05.
Sincerely,
[My NAME] .
Well Jtucker.... It is one more strong and nice effort from your
Well Jtucker.... It is one more strong and nice effort from your side. Let's keep fingers crossed and pray for good
Roxette
Hi, Jtucker! We are both from Indiana. Nice to see you. :)
Hi, Jtucker! We are both from Indiana. Nice to see you. :)
I work for a competitor of Mutual Hospital Services, so I can shed some light on the revenue process in a hospital setting. Any account that either is listed as self pay of self pay on balance after primary insurance will go to an agency contracted by the hospital, such as Mutual, upon the date of the first bill. Rest assured that your diagnoses and procedural information are not disclosed to the agency. The only reason this agency would even have access to your itemized statement showing a listing of procedures, medications, room charges, etc, is in the event of a disputed bill. Even at that, there is no way, by looking at this document, that one would be able to determine why you were in the hospital and what exactly you had done. It is simply a list of charges and explanations for those charges. Thus, there is no direct violation of HIPAA.
I hope that helps. HIPAA is extremely complex, and I am by no means an expert. However, I am familiar with this particular process and thought I might be able to shed some light on it. I would be interested to hear how the St. Vincent's responded to you. And irregardless of whether or not this was a HIPAA violation, this charge most certainly needs to be removed from your credit report. Grrrr...I would be irrate if someone did that to me and failed to listen to me after I'd already called it to their attention.
Oh, by the way, is this listed as St. Vincent or Mutual on your credit report? If it's Mutual, you might have to call and yell at them. Their # is 1-800-355-4923. Complain away. After all, I don't work for them...lol
Thanks Gena for your feedback. I hope Jerry might have taken the
Thanks Gena for your feedback. I hope Jerry might have taken the necessary actions by now or might be in the process of solving it. Let us wait for Jerry to post his reply.
I have paid my Mutual Hospital Bill in the amount of $22,765.04.
I have paid my Mutual Hospital Bill in the amount of $22,765.04. Court Certified, Paid Copy was mailed to Experian Credit Agency, requesting correction of this derogatory information and nothing has been done since 08/01/2007.
PLEASE HELP.