When I go to see a doctor under my medical insurance that I get through my employer are they notified?

Question

I'm curious what the process is when a medical claim is filed. When I go see a doctor that participates with my medical insurance I get through my employer do they recieve anything that says I saw a doctor and for what? Or is everything like the EOB just sent to me and that provider?

Answer 1

No, your doctor will send his medical claim to your insurance provider to pay the bill and that is all.

What you see the doctor for is between you and your doctor.

Its called "privacy law".

Answer 2

Absolutely not...the employer gets nothing. It is private and cannot legally be shared without your consent.

Answer 3

Anytime you go to the Doctor's office, it is strictly confidential and they will not send any information to anyone.

If you get injured at work, however, your employer will get information on your injury, along with any recommendations for follow-up, only because their worker's compensation insurance (separate from your private health insurance) needs that information in order to pay out benefits.

Answer 4

I believe under federal law, your doctor cannot share information with anyone unless you give prior consent. The medical provider cannot even say whether you are a patient, I think.

Answer 5

The employer is not privvy nor do they care about that info. If they wanted that info, you would have to give them written authorization-that's a Federal HIPAA requirement.

You see the doctor, the doctor sends the claim to the insurance company and sends the doctor the payment with the EOB. A copy of the EOB is sent to you from the insurance company.

Answer 6

Only your insurance company is notified of your doctor visits. It would be unethical *and* illegal for your company to be notified (unless for some reason you had signed a release allowing your doctor to provide that information to your employer).

Answer 7

At most your employer may get a report each month with costs but names are never associated with them (this is common on a self-insured plan). HIPAA prevents your health info going to anyone without your consent.

Answer 8

corgi1922 is the closest one to being correct.

With group health insurance each year the insurance company reviews all the claims for the group and will raise the rates accordingly. If someone in the group has a major medical problem the employer will know about the condition but the persons name will not be revealed.

There are some groups that use self-insured plans and they will get a statement each month.

Others were correct each individuals EOB does not go to the employer.

Answer 9

I really don't think your employer gets notified. That would be so wrong and I hope that is not happening to me. There are strict privacy rules and regulations about that stuff. Just because they provide your medical insurance, doesn't mean they get to know all your personal business.