What are doctors required to tell health insurers?
Dr. Keith Roach
Question: If I share confifidential information with my doctor, how much of that information is reported to my insurance company? I am required to sign the HIPAA form that allows information to be shared in order to provide treatment. What are the limits and boundaries of insurance companies’ knowledge? Your answer determines how honest I can be with a doctor. — S.F.L.
Answer: Your insurance company has access to your medical records. It receives the billing information from your doctor and can review the medical records to ensure appropriate billing and quality. It may not disclose this information except as provided for in the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
It happens occasionally to me that a patient asks me not to put some personal facts about himor herself into the medical record, and I always agree not to do so, with the caveat that there are a very few situations in which I, as a physician, am required to divulge privileged information. The most important is if a patient tells me he or she has a plan to injure a particular person.
I hope you will be honest with your doctor about whatever situation you are concerned about, but I would encourage you to discuss privacy, including your desire for the information not to be entered into the medical record.
You also have the option of paying for the visit yourself, in which case the insurance company gets no information.
Q: Plastic pill crushers and a mortar and pestle are very painful for my arthritic hands. The pharmacist offffffffffffered me no better option for crushing pills. Then my aging brain had a moment of lucidity — an electric coffffffffffffee grinder! It works perfectly and can handle several difffffffffffferent pills at the same time. Please let your readers know. — S.L.P.
A: I think it’s brilliant; however, do make sure the machine is clean, and I would use it only for medicine. Finally, check with the pharmacist to make sure the pills can be safely crushed. Some cannot be, especially those with an extended-release formulation.