Where Should I Report Billing Staff for a HIPAA Violation?

A Question to the Workplace Doctors about a billing office employee who violated HIPAA by gossiping about a medical condition. 

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The billing office at my local hospital had gossiped with my previous doctor’s billing nurse. She in turn gossiped with the office staff. I ignored that incident. My current doctor is in a medical office building with the same billing department. Recently, while visiting my dentist, things were said to me that could only have come from the hospital billing department and my doctors office. To say I’m upset is an understatement. I do not want to ignore it this time. However, I do not want to change doctors as this doctor and hospital are the best in the area. Should I discuss it with my doctor, administration, or HIPAA ?

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Hello and thank you for contacting us about your concerns. I’m including a link to Health and Human Services, specifically the section about HIPAA (Health Insurance Portability and Accountability) complaints. We are not experts on this topic by any means, but can provide some general things for you to think about.

http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html

The first thing to consider is the nature of the gossip that you believe you can prove came from the billing office at the hospital. The only information that comes under HIPAA regulations is information about a medical condition, past or present, or the treatment plan for it. Gossip about you in general doesn’t come under HIPPA regulations.

If you think one or more people at the hospital billing office gave out information about your medical condition or the treatment you received for it, write down exactly what was said to you, as much detail about it as possible and why you think you can trace it back to a person or group. You’ll need that for any complaint, whether to HHS or to an employer or doctor.

Although it would be easier and quicker to simply tell your doctor what you heard and ask for an investigation of a HIPAA violation, I doubt there would be an in-depth investigation of the matter. If you complain to the hospital, they might be more likely to look into it. If you complain to HHS, you are more likely to have the matter investigated fully. (The investigation would probably depend upon the circumstances of the case.) At least it would be much more intimidating for the person who did the gossiping.

If a violation is found, there are some severe penalties attached to it. Unfortunately, none of that can now close the door on the information that was leaked.

You mentioned being worried about having to change doctors. Your doctor will probably be as appalled as you are, to think something like this occurred, so your medical treatment won’t suffer. And, you may find that the person doing the gossiping is a problem in other ways as well—that usually is the case.

If you have someone locally whose opinion you trust, I think it would be wise for you to look at the HHS complaint form for a HIPAA violation and talk to that person about the incident and the complaint process and get more personal advice.

If you have the time and wish to do so, let us know how this is resolved. It will help us when we hear about similar cases.

Good luck to you!

Tina Rowe
Ask The Workplace Doctors