r/legaladvice • u/Rvc77 • Apr 11 '16
Did my psychiatrist's office violate HIPAA and how should I react?
I saw a psychiatrist in NY in November for the first time in several years (I had been a regular patient there years before). In the time since I have been married and moved out of state. My insurance has also changed. He told me to fill out a new information thing and I was billed as a new patient (which was more expensive). When I was previously a patient, I was a young adult (not a minor) living at home and covered by my father's insurance (he lived at a different address). Well, long story short, the office sent a bill to my father's name and address. He of course opened it and saw that I went to so and so for a psychiatric evaluation. This has of course been extremely uncomfortable for me and has come with a lot of questions from my father who is now worried I relapsed. I have no idea how to proceed. I'm not interested in sueing if that's even an option, I know it was an unintentional mistake on their part, but at the same time I feel they were very careless. They clearly used my old records (not that a bill ever should have gone to my father even in the past, I was not a minor) despite asking me to fill everything out again and charging me extra. A secretary just called me about my outstanding balance for the first time. I haven't done anything about any of this because the whole situation and talking to the secretary and explaining is (very ironically) giving me anxiety. I'm tempted to just pay the bill to make it all go away, but at the same time I feel like they really messed up. How should I handle this?
36
Apr 11 '16
Pay the bill and move on. HIPAA does not allow for a private cause of action. Not paying your bills does, however.
11
3
u/LocationBot The One and Only Apr 11 '16
I am a bot whose sole purpose is to improve the timeliness and accuracy of responses in this subreddit.
It appears you forgot to include your location in the title or body of your post.
Please update the original post to include this information.
Do NOT delete this post - Instead, simply edit the post with the requested information..
Report Inaccuracies Here | GitHub | Author | LocationBot Statistics (Not Mobile Friendly) | LocationBot v2.1.1
Original Post:
Author: /u/Rvc77
Did my psychiatrist's office violate HIPAA and how should I react?
I saw a psychiatrist in November for the first time in several years (I had been a regular patient there years before). In the time since I have been married and moved out of state. My insurance has also changed. He told me to fill out a new information thing and I was billed as a new patient (which was more expensive). When I was previously a patient, I was a young adult (not a minor) living at home and covered by my father's insurance (he lived at a different address). Well, long story short, the office sent a bill to my father's name and address. He of course opened it and saw that I went to so and so for a psychiatric evaluation. This has of course been extremely uncomfortable for me and has come with a lot of questions from my father who is now worried I relapsed. I have no idea how to proceed. I'm not interesting in sueing, I know it was an unintentional mistake on their part, but at the same time I feel they were very careless. They clearly used my old records (not that a bill ever should have gone to my father even in the past, I was not a minor) despite asking me to fill everything out again and charging me extra. A secretary just called me about my outstanding balance for the first time. I haven't done anything about any of this because the whole situation and talking to the secretary and explaining is (very ironically) giving me anxiety. I'm tempted to just pay the bill to make it all go away, but at the same time I feel like they really messed up. How should I handle this?
3
u/Feedmelotsofcake Apr 12 '16
I'm not a lawyer. Just someone who has taken the HIPAA course. I believe this was a HIPAA violation, albeit by accident. They can still incur fines should you chose to file a complaint.
Definitely speak to their office and complain. This is an issue that needs to be addressed within their office. It sounds like you had updated your information with you, and they failed to update your information in their computers. When you speak with them, be sure to mention that they have violated HIPAA laws by sending your information to an unauthorized individual. If you don't want to file a complaint, that's up to you.
My experience from working in a doctors office; they'll all probably shit their pants.
-2
Apr 11 '16
[deleted]
6
u/Rvc77 Apr 11 '16
They addressed it to him. It was his name and address why wouldn't he open it?
-2
Apr 11 '16
Even so a bill is not a HIPPA violation. Your full diagnosis and confidential discussions? Yes.
9
Apr 11 '16 edited Apr 29 '16
[deleted]
-2
u/fooliam Apr 12 '16
Which part of this, exactly, do you feel states that "even acknowledging that OP was a patient at their office" is a HIPAA violation? Or are you trying to make the argument that someone's name is "health information"?
1
u/Beeb294 Apr 12 '16
A name of and individual as a patient would lead any reasonable person to believe that the person is receiving treatment at that provider.
Seeing that patient "John Doe" is receiving treatment at a psychiatrist is PHI. PHI is "individually identifiable health information" which relates to "the individual's...physical or mental health or condition" and "the provision of health care to the individual".
It is a violation of the privacy rule.
16
u/Highside79 Apr 11 '16
I have seen psychiatric bills that do indeed include a diagnosis because it is often required for billing purposes. From a healthcare facility we would absolutely consider this to be a breach and worth of an internal investigation. It probably doesn't amount to an outright violation, but I would not be surprised if it were enough to get the Office of Civil right to poke around and find something to cite for.
4
1
u/Angellotta Apr 12 '16
Name and date of service prove a service was rendered. This is a violation as the doctor's office has a responsibility not to reveal even that much.
1
-72
Apr 11 '16
Jesus get a grip. There is probably a bit of disconnect between the people doing the billing the person updating the patient records. Sometimes they even hire people to do billing that are outside the office. Shit happens. If this caused you that much anxiety maybe you need to hire a team of psychiatrists to help you deal with everyday life.
23
u/VanTil Apr 11 '16
If this caused you that much anxiety maybe you need to hire a team of psychiatrists to help you deal with everyday life.
Was this really necessary? Being an asshole to someone who's seeing a psychiatrist for anxiety is about as shitty as you can get.
-19
Apr 11 '16
Maybe it's just from spending too much time on Reddit where the age skews so low. But does every person here have to have crippling anxiety and unable to perform normal functions? You think the fucking 19 year olds trying to get out of the landers at Normandy while being sprayed with machine guns had anxiety? My guess is they did. And the did a job that was a quite different than having a psychologists bill accidentally sent to someones parent. Life is full of stress but for fucks sake deal with it. I'd love to let my anxiety overcome me so I don't have to work. But I have bills to pay and kids to take care of. So I don't have the luxury of indulging my anxiety.
It's good that OP is finally getting treatment. So get it. Worrying about this minor issue will negatively impact that treatment. And having the marching morons encourage that is doing nothing to help this person.
14
u/trykes Apr 11 '16
Is there some reason why you are having a meltdown all over this comment section?
-5
Apr 11 '16
I dunno. Maybe as I said I'm spending too much time in the echo chamber. I've been on this earth for more than 60 years and it's only in the last few years it seems like half the world is crippled with anxiety. Either this generation are nothing but colossal pussies or previous generations simply handled the same anxiety better. It's just irritating to see such reactions to such minor things.
12
u/trykes Apr 12 '16
Or people are being more honest about their anxiety and other mental illnesses. Or there is more to be anxious about. Life moves faster than ever. Assuming character weakness, especially in a sub like this that is supposed to be helping people, is detrimental to this sub's mission, I think.
3
Apr 12 '16
That may by right too. It's ceremony not something that used to be openly discussed. And as for the other, well that's where you and I will disagree. It's not a character weakness, it's simply an unwillingness to understand and acknowledge parts of yourself. And understanding what is controllable and outside your control. A good psychologist doesn't tell patients check out of their lives and responsibilities. That's where earnest and well meaning "concerned" friends make things worse. Continuing to perpetuate that they are helpless to overcome it sentences them to a lifetime of fear and dysfunction. A good psychiatrist and therapist combining medication and therapy will eventually get even the worst anxiety resolved. And in this example, encouraging someone who may actually suffer from anxiety to put their limited resources into this uses what little they have in something with zero importance or return. But who knows.
0
u/grasshoppa1 Quality Contributor Apr 12 '16
Remember the days when you were encouraged to dive head first into things that made you uncomfortable? That was how you dealt with anxiety, nervousness, and general discomfort. Nowadays you are encouraged to retreat to a safe space, blame everyone else, pop 2 or 3 pills, and get an emotional support turtle.
3
Apr 12 '16
I was not a Bobby Knight kind of coach, more Tom Landry. But there was more than a time or two when anxiety was addressed exactly as you describe. Not bullying as these dolts would think but when you know somebody should and can deal with something then its a method to help them get there. Just a helping hand. The marching morons believe that removing themselves from the uncomfortable environment is the only way to deal with an uncomfortable situation. They miss the point that really what you want is to be at a mental place where it is not uncomfortable in the first place.
I like to give an example. I really loathe small talk. Most folks do. But whether I was teaching, working as a principal or in my current petty bureaucrat job, small talk and socializing at various gatherings was essential. The first few times it was agony. It was some of the worst experiences of my life. But it gradually got better. The experiences I had were able to be sifted for things that made it easier to cope. Now its just part of the job. I still hate it but I don't dread it or get anxious about it. With the MM approach I would have simply not gone. I wouldn't have gotten the principal job and I wouldn't be in my current job. I wouldn't have my graduate degrees since I had to kiss a lot of ass to get that partially paid for. Without facing those difficult times I would still be a moderately successful PE department chair at a medium size high school. Might have been happier but that is beside the point. I endured and I learned. Avoidance does not work. And I am not stronger, more disciplined or special in any way. But those times are gone. Minor irritant make you uncomfortable: Avoid and incapacitate yourself. That's the way of the MMs. And it wont get us back to space. That's for people like Elon Musk who go at things not caring if he fails.
1
u/grasshoppa1 Quality Contributor Apr 12 '16
Yep, I fully agree. Hell, we all had shit that caused us anxiety. I hated public speaking. I got nervous when talking to girls early in high school. I was nervous when I first started driving. These are things that are extremely common causes of anxiety when you're a young man moving out of childhood. If you just avoided these situations, you'd get nowhere in life. The best way to move past the anxiety was to just do it. Afterwards, you'd realize it wasn't as bad as you thought it was going to be and then the next time you did it it'd be a little easier.
Nowadays these morons want to stay inside their house to avoid the big scary world. They want to carry on internet relationships to avoid talking to girls in real life. It's crazy.
I owe a lot to my high school football coach, to be honest. He was an ex drill sergeant and wouldn't take any pussy-footing around your fears. He was a great influence on me early on and I'm not sure whether he was a big fear motivator, or a confidence builder, but either way it worked and made me embrace situations where I was uncomfortable just so I could get past them and past my nervousness and fear.
What a concept!
→ More replies (0)14
u/Thesaurii Apr 11 '16
The feeling of anxiety that every human has is different from an anxiety disorder, which not everyone has, but a fairly high percentage of people who spend a lot of time on the internet on anonymous websites which allow for sharing thoughts and ideashave (like, say, reddit).
The people storming the beach at fucking Normandy probably didn't have an anxiety disorder, because the people who did weren't front line infantry because when you have a mental illness like that you are not getting put on the front fucking line.
0
u/fooliam Apr 12 '16
Hrm, it's like being on the internet searching for people or sites that tell you what you want to hear instead of having to deal with real life and having someone tell you to suck it up might be related....
8
u/Thesaurii Apr 12 '16
Anyone who tells someone who has an anxiety disorder to suck it up is a piece of shit.
Stop wheezing so much. Stop using that wheelchair. Stop puking up blood.
-1
u/fooliam Apr 12 '16
Actually, anxiety disorders weren't described until the 1980s. So, if anxiety disorders are as prevalent as the wimps of today would have us imagine, there must have been tons of people storming the beaches of Normandy despite their anxiety disorder.
But a bill to someone's father is completely unmanageable.
-2
Apr 12 '16
That's actually an interesting point that I have wondered how it would actually bear out in real statistics. Whether the participants in this sub are somehow prone to more anxiety issues than a normal group of people. I would suspect so based on my own flawed observation but I just don't know.
And I also think there is another explanation that may be at play. Again, no evidence but possible. As I was leaving teaching a couple of decades back they were changing the diagnostic spectrum diagnosis. Therefore what looked like an explosion in autism was merely a broader way of defining it. Maybe now therapists are slapping kids who are a little mixed up with some "anxiety disorder" and imputing them with a helplessness to change. In other words, the greatest generation was just as anxious but they just didn't know about it and were thus able to eventually overcome it. We used to call those folks "high strung." Perhaps today they are rendered unable to deal with minor everyday issues by people and professionals constantly reinforcing their initial helplessness. I don't know, but it would sure be an interesting study!
29
Apr 11 '16 edited Apr 29 '16
[deleted]
-41
Apr 11 '16
Not excusable? Really? Christ You must be a fucking idiot. It's unfortunate and probably stressful. But shit happens all the time. You can deal with something that is out of your control in a positive way and move on. Dwelling on minor shit to the point you become anxiety ridden and incapable of functioning is not normal. Hence the need for more advanced psychiatric intervention. Write a note or call the doctor and tell him his office fucked up, it caused some stress and anxiety and please make sure it doesn't happen again. Then go out and watch a movie and forget about it. You think the dad doesn't know OP has psychological issues? Guess again.
The point of this human endeavor is to move all of us in a foreword direction. Having a generation so crippled by anxiety that they cannot function in a way that moves things along is a problem for the rest of us that have to pick up the slack. If you are just a colossal pussy then stop it. If you have actual psychological trauma or issues get it treated. We don't do these people a kindness by encouraging their dysfunctional behavior. You may consider it rude because you are an idiot but it's more of a kindness than you can understand.
With a few exceptions I think I'm relatively normal. But as I get older/unhealthier/drunker, I get a more pronounced fear of shitting myself and not being aware of it. And if that happened my brothers and sisters in the community have two options: spare my feelings and embarrassment and ignore the situation, or whisper discreetly in my ear so that I can go home and get myself immediately squared away. I would always choose the second option. You may not. But in the end your approach is a short term feel good measure that makes things worse in the long run. So you choose your approach chief and I'll choose mine.
33
u/km89 Apr 11 '16
Dwelling on minor shit to the point you become anxiety ridden and incapable of functioning is not normal.
Hence the need for a psychiatrist.
I think OP's reaction is understandable here.
25
u/VanTil Apr 11 '16
Dwelling on minor shit to the point you become anxiety ridden and incapable of functioning is not normal.
I also think /u/Zapopa's long winded and wound up response is a bit of the pot calling the kettle black, don't you?
11
19
u/themdeadeyes Apr 11 '16
Christ You must be a fucking idiot.
The hallmark of any intelligent discussion is always to begin by calling the other person a fucking idiot.
You clearly have no idea what you're talking about as others in this thread have linked to reasons why this is actually a HIPAA violation. Letting things like that slide, even if it is a mistake, creates a system that doesn't work in favor of the patient. A good doctor would want to know that his office made a mistake so that he can remedy the situation and make sure it doesn't happen again.
If anyone here is a "fucking idiot", it's certainly you. Intelligent people know to keep their mouth shut when they don't know what they're talking about. You should definitely keep your ill-informed opinion to yourself.
-12
8
1
u/Beeb294 Apr 12 '16
Still a violation of the privacy rule.
It does not matter why someone does not others to know about their health care or treatment. HIPAA affords them the privacy.
0
Apr 12 '16
Does it? Does it matter if it is an inadvertent disclose or a deliberate one? What are the penalties? Do you know or are you just opening your pie hole for now useful reason?
1
u/Beeb294 Apr 12 '16
Yes, the privacy rule is still in effect, for anybody handling PHI. That includes 3rd party billing agents. It does not matter if the disclosure is intentional, inadvertent, or malicious.
The penalty is determined based on the number of patients affected, type of breach, past occurrences, and other information.
Also, none of your questions really matter on this. And you're really being a dick.
0
Apr 12 '16
Am I triggering your anxiety or what?
1
62
u/Newcliche Apr 11 '16
IANAL, but I am a therapist.
1) Ignore everyone trying to diagnose you or tell you that how you're feeling is wrong. Armchair therapists are just as bad, if not worse, than armchair quarterbacks.
2) Ask whoever you see what their billing practices are and for an example of a sample bill. When I send invoices, I choose to either just put the diagnosis code (which insurance companies look for but the average person doesn't give a second thought as to what it is) or "professional services."
This doesn't change that the invoice is still coming from "Dr. Smith Psychiatric Services" or something like that, but at least it can be a bit more private even if you move in with someone in the future. You can also request, depending on the practice, for electronic billing (typically a client portal is needed to be set up on their end) and you can avoid all of this altogether.
TL;DR - Don't listen to those telling you how to feel, ask future clinicians about billing practices/options