Hospital refuses to allow me to talk to their billing department - are there any laws/regulations that I can use to help them change their minds? Background here: Hospital billed me for services that I explicitly refused. Are there any legal ramifications for hospital?. In short, my wife visited a hospital and was grossly mis-billed. In total we were charged about $2000 for services/procedures that either didn't happen or were explicitly refused. As an example, a doctor said that he would do an abdominal ultrasound and then, if that did not give him clear answers, would follow up with a transvaginal ultrasound. The transvaginal ultrasound was not necessary and did not happen (and in case you're not familiar, it is not the sort of thing that a doctor does without you noticing). However, there was almost $1000 on my bill for a transvaginal ultrasound (as well as a smaller charge for the abdominal ultrasound that did happen). I've been talking to the hospital to get these charges off my bill but I don't feel like it has been going well. In particular, I would now like to go through the entire bill with someone from their billing department to make sure that they haven't misbilled me for other services that I haven't noticed. All the billing information is in hospital codes, so while I've made sense of some of it, I haven't made sense of all of it. I came into their billing department to discuss this and discovered that their billing team does not talk to customers under any circumstances. Instead only their "Customer Care" team does. They don't know anything about billing codes (I was told that if I wanted to know what I was being billed for I should "google" it) and can't make any changes to my bill - only flag it for a dispute. I'm very unhappy with this arrangement. I would very much like to talk to someone from the department that screwed up my bill this badly. I would very much like to talk to someone who can actually walk me through my bill. I plan on calling them next week, expressing my unhappiness with the situation, and do everything I can to get a billing person on the phone. I suspect that what they are doing is perfectly legal, but I'm certainly no expert, so I figured I would come here to ask. Are there any laws or regulations which I can use to convince a hospital's billing department to talk to me, despite the fact that they have a clear policy otherwise?
Disclaimer: I am not familiar with US law, so this answer is from a general perspective. It should apply in most jurisdictions, though. Are there any laws or regulations which I can use to convince a hospital's billing department to talk to me, despite the fact that they have a clear policy otherwise? No, I don't think so. A company or organization is generally free to decide for themselves who will or will not communicate with you - I don't think there is any law giving you a right to choose. How would this even work? What if the people you ask to talk to are overworked, on vacation or just not qualified? However - you do have another, more important right: To be considered valid, a bill must provide credible evidence that the charges are justified. You cannot just ask someone to give you money, you must actually provide a reason why you are owed money. In this case, this means the hospital must send you a bill that you can understand and verify. To get this: First, stop bugging them over the phone. Once a point is reached where legal action seems likely (like in your case), any information you get is only really useful to you when in writing. So do everything in writing. It's fine to talk to them if it helps solve the problem - but insist on getting things in writing afterwards. The first thing you need to write is a formal letter that you refuse to accept the bill, because you cannot verify it. Outline in details what parts you cannot understand/verify, and ask for the information you need (such as what the codes mean). Once you have received a satisfatory explanation of the bill (which may take multiple letters), you go through it with a fine comb, and dispute any items that you think are unjustified. You may need the help of a lawyer to exercise these steps, but in principle you can probably do it on your own, too. Whether you get a lawyer is ultimately a trade-off (making a mistake may cost you money, but hiring a lawyer costs money, too). A first consultation with a lawyer is probably not too costly (ask first!), and may help you to decide whether you need more assistance.
Federal and state laws do protect a variety of different types of personal information in particular contexts, but there isn't really any information that is necessarily personal and protected from disclosure in all contexts. For instance, the Health Insurance Portability and Accountability Act generally protects a person's health records from unnecessary disclosure, and the Federal Education Rights and Privacy Act generally protects a student's educational records from unneccessary disclosure. But that doesn't mean that all of an American's health information is protected, or that all of the information that a hospital holds about an American is protected. The hospital can typically disclose the fact that it is treating a specific person, and if that person provides his health records to a government employer, that employer may be required to produce them in response to a request under the Ohio Public Records Act. But Facebook isn't a health-care provider, so it isn't required to protect medical records, and it isn't a school, so it isn't required to protect educational records. At the federal level, I don't know of any privacy laws that require it to maintain the privacy of its users' information, though it may be required to do so under state laws, or as a contractual matter because of its privacy policy. But that doesn't mean it has nothing to worry about. Like any business in the United States, it is prohibited from engaging in deceptive trade practices, so it can't make broad promises to protect users' privacy when it has no intention of honoring them. That's why it ended up paying $5 billion for privacy violations in the past and remains under court orders requiring it to better protect users' data. Further, Facebook has users all over the world, so it is required to comply with the international privacy regulations like GDPR that can be far more stringent.
As a short answer, guidance from the Department of Health and Human Services has clarified that HIPAA does not require hospitals to provide separate rooms. As a longer answer, HIPAA is very deeply misunderstood. It does not prohibit "leaking" patient information; it prohibits unreasonable and unpermitted disclosures of protected health information (PHI). Among the PHI disclosures that are permitted are uses that are for the purpose of delivering medical treatment. Of course, the covered entity (in this case, the hospital) is required to take reasonable measures to safeguard that information. One of the areas that trips people up is figuring out exactly what it is we're safeguarding that information from. A lot people assume that the HIPAA imposes an absolute rule against disclosure of PHI, but it's more accurate to say that HIPAA requires reasonable safeguards against the unauthorized use of PHI. With that standard in mind, it becomes easier to see why you don't need to universally separate patients. In all likelihood, neither you nor your roommate is likely to use the other's PHI in any way not allowed under HIPAA. We can look at your question as proof: You've disclosed a person's health condition and medical history, but you were a reasonable person and omitted the man's name, birth date, record number, and anything else that might allow us to link that information to an individual. Hospitals -- and the law -- recognize that most people have no interest in a random strangers' medical information, let alone plans to do something nefarious with it. Because there isn't much of a threat there, the hospital isn't required to take exhaustive measures to protect the information. But when you put all that information for every patient for every doctor for every department for every hospital into a single database, the information starts getting a lot more valuable. That's why there are much tighter regulations surrounding protection of electronic records. Of course, the roommate situation might be different if the hospital had a patient that they somehow knew had a history of identity theft or even a history of disclosing PHI. I've never heard of this happening, but I'd imagine that that knowledge would require the hospital to either segregate that patient or otherwise take extra care to avoid disclosing any information about a roommate.
Your description of the facts is vague enough that we can't offer an informed judgment, but to remedy this, I will paraphrase your account of the facts (you can decide whether this is what you were trying to say). I was sitting outside of the Sprint store today waiting for my step daughter to come out. While waiting, two police officers walked up to my car and asked me to turn off my vehicle and come inside. When I voluntarily went inside, the store staff said that they called the police because they had had some sort of problems with people applying for service and absconding with the phone to resell on the black market, and they thought that was part of some such criminal plan. Because of that, they refused to give her a phone or service contract. But then they also told us to never come back, threatening arrest for trespassing. I have never been in that store before. Were my rights violated? No, neither by the police nor by the manager. The police, or the store manager, can legally request you to come in for a conversation: what matters most is whether you were forced to come in against your will. By your report, you were not, so your rights were not violated. The police are irrelevant to the remainder of the question. What remains is whether your rights were violated because the manager told you to go away and never come back under pain of prosecution. The store is private property, meaning that the owner has wide latitude to grant or deny permission to enter. If they hate pink hair and your hair is pink, they can legally "ban" you. If they suspect you of involvement in a criminal activity, that can most certainly legally ban you. That does not mean that it was a righteous or justified decision on their part, or a good business choice, but it is their legal right. So, no, your rights were not violated.
http://www.healthinfoprivacybc.ca/confidentiality/when-can-and-cant-they-tell-others is a pretty good summary. Different rules apply to private practices than public clinics and hospitals. I will assume that the clinic on campus is private. This is a summary of the summary about who your information can be shared with: Health care professionals can share information within your "circle of care". Specifically, they are allowed to assume your consent to this but you can explicitly withdraw that consent. This would include doctors within the same practice. Admin staff can access your information for administrative purposes. Anyone you have authorised them to share it with e.g. relatives, friends etc. The Medical Services Plan for billing and admin If you are unable to drive If there is suspected of child abuse If you are wounded by a gun or a knife If you are a danger to others For your specific questions: I asked about it and they said it's confidential, but confidential to the clinic. Correct, unless you explicitly revoke this. the counselling department can share information with the doctors This is tricker, these people may be either within your "circle of care" or they may be part of the same organisation. Notwithstanding, councillors are not doctors and are governed by the everyday laws related to confidentiality i.e. information given in confidence is confidential and everything else isn't. If you are told the limits of the confidentiality i.e. they tell the doctor, then those are the limits unless you renegotiate them. he would know I only have one kidney? Well you said "the counselling department can share information with the doctors" and this would require the information going the other way i.e. the doctor sharing with the councillor. Even if this type of sharing was OK in general (and I'm not sure it is, see above); the information shared should only be what is required for the councillor to do their job - the number of kidneys you have is probably irrelevant to this. What laws apply to situations like this where confidential information in one entity (medical office) decides to share it without the consent of the patients to another entity (the counselling dept.)? Well, we are not sure there are 2 entities: legally there may only be 1 - the university. Anyway, the laws are the Personal Information Protection Act and common law (Smith v. Jones, [1999] 1 SCR 455)
There are regulations governing occupational safety, whereby e.g. an employer can be fined for forcing employees to work in a literally toxic environment, for instance breathing chlorine gas. You could file a complaint with a state or federal agency (OSHA). You would need to hire a labor lawyer to get advice about your specific circumstance, to see if there is indeed a provision that covers what you describe, though I doubt it would. OSHA's blurb on disease don't obviously cover your situation (they describe situations that govern healthcare workers in intimate contact with infectious materials). However, certain diseases such as TB or Ebola cause a general health quarantine to be imposed, so if a worker comes in with such a disease, action would be taken by the health department. This does not cover sniffles, and probably not pertussis (but that's a local decision). There are also regulations pertaining to disabled employees, whereby an employee who is disabled by having a severely compromised immune system can be entitled to reasonable accommodation, for example allowed to work in a closed room away from others (if the job is not a receptionist job). That entitlement only applies to the employee, and is controlled by objective health danger (requires a doctor's note), and not the comfort level of the employee.
Since they have allready given you a form to fill that you have sent back with the original receipts, I will assume that the major preconditions have been fulfilled (mainly that they have asked you to come in writing and have not exclude reimbursement). This a case of civil law based on §670 BGB. Since they have not fullfilled their obligation, you must send them a reminder (Mahnung) in the form of a registered letter, requiring them to do so within a reasonable timeframe (like 10 working days after receipt of the letter). look for standard letters on this topic (Mahnungen) The letter should be descriptive in nature (i.e. a Judge, after reading a copy of the letter, will understand the whole situation). Nowadays such a letter should be sent through your local Amsgericht, so that they can certify that your copy of the letter was included in the original letter. If they don't react to this, then you must charge them. This is a basic description of the needed method. Look up the details of the process and/or for someone to assist you. Section 670 Reimbursement of expenses If the mandatary, for the purpose of performing the mandate, incurs expenses that he may consider to be necessary in the circumstances, then the mandator is obliged to make reimbursement. Sources §670 - German Civil Code (BGB) Wer trägt die Reisekosten für das Vorstellungsgespräch? - ingenieur.de
Yes You asked for work to be done in the expectation you would have to pay for it and they did the work - that’s a legally binding contract. It appears that you did not agree on a price and possibly not on a time for making payment. If that is so, you agreed to pay a reasonable price in a reasonable time. They have issued an invoice stating what and when they believe is reasonable. You dispute parts of that invoice. That’s fine, people are allowed to have disputes. You have paid the undisputed amount I hope? Notwithstanding, your negotiations with the other party can go back and forth and things can be put on and taken off the table. But you don’t have a deal until you have a deal. At any time, either party can walk away and assert their rights. Or make a take it or leave it offer, commonly called playing hardball. Since it is undisputed that you owe them something, they can refer the debt to “collections (be that internal or an external debt collector). You should pay the undisputed amount immediately and you can continue to dispute the remainder. They will make a deal, initiate legal action, or let the matter die.