Doctor sueing us because he says we are in violation of the HIPA Act....HELP!?

Question

My girlfriend was in a car accident last year. she needed chiropractic care for her back, which was covered under her insurance.

she called me and "told me" to call her chiropractor to cancel her appointment one day. i called well within the 24 hour cancel period.

now, she is being sued by the doctor, saying that she is in violation of the HIPA act.

my question is does the doctor have a case?????

my girlfriend called me - which means she gave me permission - to cancel. I was not asking for any medical records. there is no privacy infringement.

we dont want to go to court over it because it is a ridiculously small amount (the court fees would probably be more than the bill) but yet we dont feel we need to pay the cancellation/late fees because we called within his time frame - which he acknowledged we did call within the time frame!

please help!

Answer 1

The HIPPA Act does not cover who calls to cancel an appointment.  You are NOT in violation of the HIPPA Act.  The privacy protection of the HIPPA Act protects personally identifiable information of any patient from being disseminated BY THE DOCTOR'S OFFICE, hospital, etc.  

If the chiropractor's office policy is not to accept cancellations from a third party, then he should be honest and say that.  It sounds like the chiropractor is trying to make a case to charge for the cancelled appointment.

Of course, if a lawsuit has been filed, you must respond and defend because the chiropractor can get a judgment against your girlfriend and garnish her wages or file a lien against real property she may own.  I am guessing the case was filed in small claims court.  If that is the case, your girlfriend needs to show up on the date shown in the paperwork that she was served with and explain the situation to the judge.  She should review the HIPPA Act (http://aspe.hhs.gov/admnsimp/pl104191.ht... and research it thoroughly so she can present her argument to the judge knowledgeably.  

If the claims are truly based on the HIPPA Act, the case would have to be filed in federal court because HIPPA is a federal law.  If the case was not filed in federal court, and the complaint states clearly that the claims are based on the HIPPA Act (which would be shown as "Public Law 104-191") then your girlfriend should ask for a continuance because she wants to research and possibly make a motion to remove the case to federal court since the claims are a federal question, and see how quickly the chiropractor drops his claims.  (Of course she would not actually make such a motion, but I will bet the chiropractor will not want to pay attorneys fees to fight in federal court.)

Answer 2

That guy is a moron the HIPA act was put in place to protect the patient not the doctor, and he is really the only one that can violate it lol...not the patient herself...had you called up and asked for medical information THAT would be a HIPA violation that he is guilty for.

Answer 3

that is not in violation - your MD sounds off the wall to me. b/c ya'll are in a relationship is a totally different story than someone who tells/give out medical information on another.  

Answer 4

You called WITHIN 24 hours of the appointment time?  Most health professionals require that you call earlier than that.  You have to call NO LATER than 24 hours before the appointment.

Your girlfriend can't give you verbal permission - she has to give the doctor WRITTEN permission.  But for scheduling or canceling an appointment?  I don't see how that would violate the privacy laws - it isn't uncommon at all for the patient to be too sick to make the call to schedule an appointment!

Having an unpaid balance on her account is a very different issue from a HIPPAA violation.  If they are suing her for the unpaid cancellation fee, it's because you called too late to cancel an appointment without the fee.

If their practice wants to set a policy that only the patient can make or cancel their own appointments, then the person you talked to on the phone should have told you right then that your call wasn't going to get the appointment canceled and that your gf would have to call herself.  And if they want to say that ONLY people named on the patients HIPPAA form can make or cancel appointments, then they should have gotten her file open while you were on the phone to verify whether you are or are not named on the form as someone who is allowed to talk to the doctor about her.  

I can't see how canceling an appointment for someone else violates the privacy laws and if it does, it was their office staff who had the burden of telling you to get your gf to call in.  So that part is bogus, in my opinion.

The unpaid cancellation fee isn't bogus if you called less than 24 hours before her scheduled appointment.

Answer 5

Once again.  

Government run amok.  

It's nobodies business how we handle our business.

Answer 6

I assume you meant you called well BEFORE the 24-hour cancel period, thus giving the quack the ability to replace with another patient.

If she's been "sued", presumably for lost fees, then she needs to file an "answer" and any necessary counter-claims (things she wants to be compensated for: her lawyers, time off work, travel expenses, etc), as otherwise the court will issue a default judgment.  Simply state the facts and recite any evidence you may have (phone records, witnesses, notes,  etc).  If you messed up (called too late), you will lose, and will eventually have to admit it. If the doctor can't prove his case (by preponderance of evidence) then he/she loses.

She can also interview whoever took your call, whoever else was in the office that day, ask to see the call logs,  ask to see her file, etc.

Find out who licenses chiropractors in your jurisdiction and ask them about the rules of professional conduct (if any), and how to file a complaint against a doctor in a fee dispute.

Also, your story has NOTHING to do with HIPA Act protection, as a patient can give out her medical information to anyone she wants! It only limits how others can share the information among themselves, so you might mention the doctor's ignorance to the licensing bureau.

Answer 7

There are two sides to every story, and I wonder what the Doctors side is in this one?  From what you have told us, there would be no reason at all for the doctor to sue you.  He certainly is losing a client, and I have never heard of a doctor suing over a cancellation fee.  Maybe turn you over for collection, but no further than that.  From what I know about HIPA you did not violate anything there.

Answer 8

Just wait it out and let the Doc incur the expense of suing.  It's unlikely that he would want to spend the money and is threatening you just to see if he can wear you down so you WILL pay up. Don't worry ... if you can prove that you called within a reasonable time, even if he does sue, you are likely to successfully quash his action.  

Answer 9

It is not that she is out of compliance with HIPPA, as she is not obligated to comply.

It is that he is obligated to comply, and part of that is that information regarding appointments, especially setting and changing appointments can only be done by the patient, or someone authorized in writing or by HIPPA policy.

Boyfriends are not authorized by policy - same has happened to me.

Basically, be honest.

You and she did not follow the office policies exactly, and now you are trying to weasel out of fees you owe.

You can either pay the fees now, or got to court and pay the fees then, plus court costs. You won't win in court as he has a professional obligation to NOT take appointment changes from you.

Also, why is this even a case if the insurance agreed to pay?  

Answer 10

You nor your girlfriend are bound by HIPA in this case. He has nothing. No case what-so-ever. You or your girlfriend can talk about your medical records, diagnosis, infections, diseases, or paper cuts with each other, to your friends, and even complete strangers. These laws only applies to individuals that have access to privileged information (like your medical files). It basically makes it illegal for them to discuss your medical history with anyone without your consent. So even if you were bound by HIPA, you were given consent by your girlfriend. End of story!

Go to court, if it is as cut and dry as you say, he will have to pay the court fees when he loses.

Answer 11

This "doctor" is suing her for a missed appointment (LAME, btw) and she is not in violation of anything - the HIPA act merely prevents the DOCTOR from disclosing any medical information to anyone not authorized by the patient to have it.  This has nothing to do with the HIPA act & if he's taking her to court over one missed appointment, then this guy has loads of problems - sounds like a flake to me.  Since it was cancelled within the time frame, he has no case & I wouldn't worry about it until any actual court documents show up at her door (highly unlikely).

Answer 12

Chriopractors are nothing more than snake oil salesmen whose treatments require you to come back weekly for more treatments.

Next time have your GF see a physical therapist.  They can legitimately solve back problems, and show her what she is doing wrong to avoid future problems with her back..

As for the lawsuit, it sounds like a bunch of baloney.  I bet he wants to be paid for the missed appointment and thinks you'll settle out of court instead of fighting it.  

Talk to an attorney and countersue for your expenses.

Answer 13

HIPAA is not a two way street. Part of it protects the patient from having his/her doctor release medical information without the patient's consent. The patient can give that information out on their own if they want to. (There are other parts to HIPAA, but they don't apply here.)

So it does not sound like the chiropractor has a case. I'm sure he will be laughed out of court, if it gets that far. But, I'm no lawyer, so don't take any of this as legal advise.

Answer 14

First of all HiPPA is a federal law that pertains to the release of personal medical information.  I could take hours explaining to the entire process. Instead, it is a very complex process and it is not a simple to filing a law suit.  

It appears that, the doctor is trying to scare your girlfriend into paying the bill and you got stuck in the middle of it. Have her send any kind of payment that she can dish out and keep making them as consistently as possible. They will take what she sends them. However, if she sends noting then they can send her account to a collection agency. Once that happens, then the situation has taken the first steps in becoming a legal battle.



Now here is the real problem for you.

Unless you were in the room when she was seeing the doctor, you only know that she is telling you. If fact that she “told” you to call could put in the middle of something much bigger.  You said that you called more than 24 hours before the appointment.  Weather you know it or not, there is more to this situation than what is described in your posting.  That is probably why she has you call the doctor.  

It is alright to do favors for friends, but in the future have sign a release form from her doctor’s office and fax it back for them to keep it her file.  Both of you should keep a copy for your records, just in case they lose or misplace it. With your name on that form you will not have to worry about these kinds of problems in the future.  Otherwise the best advice I can give you is to avoid getting sucked into something that has nothing to do with you.