Patient Information, Insurance Companies and Payment

Today we are going to talk about patient information and the unethical conduct of the insurance companies. So strap in and let's get to it.

A patient can request their personal information such as treatments notes from a health care practitioner or a health information custodian. A patient may also allow a 3rd party such as an insurance company, with written consent, to gain access to their personal information from a health care provider or health information custodian. 

All of this seems pretty standard. Right. Well there is more. This is the part insurance companies don't want you to know. 

This is from the Privacy Commissioner of Ontario's website.

Under PHIPA, a health information custodian may charge you a fee to access your personal health information, but the fee must not exceed the amount of reasonable cost recovery.

At their discretion, health information custodians may waive the payment of all or any part of the fee that is required if, in their opinion, it is fair and equitable to do so.

A health information custodian could also a charge a fee for transferring your personal health information to another health information custodian.

In 2010, our office issued recommended fee guidelines on the amount of the fee that may be charged to patients for access to their personal health information. For more information, please read Health Order (HO-009).

What does this mean. It means when a patient or an Insurance company requests patient information it is within your right as a therapist or a health information custodian to charge a Fee. If the insurance company is requesting patient information you have the right to charge them a fee. 

Well what do insurance companies do. They refuse to pay and if the health care provider doesn't provide the information for FREE they will blacklist the provider or even the clinic or threaten not to pay their future patients or put all their current patients payments on hold. They are using threats to rob you. It is as simple as that. 

If an insurance company requests patient information from you (and have the proper consent) you should charge the insurance company for providing the information. Why. Well simply put it will take you time, energy (perhaps even money) to retrieve and send the information to the insurance company. Your time has value. 

The Insurance companies are robbing therapists. An sane person can see this is a crime though the insurance companies are getting away with it using threats. Insurance companies here are no better than a mugger with a knife asking you for your wallet. 

We will be covering this matter in further detail in future posts especially since lot of therapists have reached out to us with their stories.