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Phillips Esq.
Phillips Esq., Attorney-at-Law
Category: Legal
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Experience:  B.A.; M.B.A.; J.D.
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Hello, My question is regarding HIPAA law and a possible

Resolved Question:

Hello,
My question is regarding HIPAA law and a possible violation.

Previous to may of 2013 my children were uninsured and I paid out of pocket for everything. My mother also made two low payments to the pediatricians office between February and may. My children are now covered under medical assistance. Since MA will back pay my clinic got reimbursed when I should have. I got a phone call from the pediatricians office saying they needed to speak with my mother before sending a reimbursement check to anyone. I expressed I thought that was questionable but said I would have her call. My mother called this morning and requested any refund check be sent to me. The clinic refused and said it was the law to send it to her. MA reimbursed 5 clinic visits 3 of which I paid in full. My concern is that they didn't get a release to talk to my mother, she is not the emergency contact and there refusal to send me the check at her request or to split it between her and I. Any help would be greatly appreciated.
Submitted: 1 year ago.
Category: Legal
Expert:  Phillips Esq. replied 1 year ago.
Thank you for giving me the opportunity to assist you. Kindly use CONTINUE or REPLY button to ask for clarification or follow-up questions.

I am sorry, I am not following your narrative here.

Why would the doctor's office be contacting your mother in the first place?

Why would they make out a check to her when she is not the mother of the minor children?
Customer: replied 1 year ago.

My mother made two payments to the pediatricians office. Those two visits were reimbursed from the state to the clinic. because of that all 5 visits that were reimbursed go back to her evem though she didnt pay all of them I'm not sure why they would need to speak to her. That's part of the problem I'm having.

Expert:  Phillips Esq. replied 1 year ago.

Thank you for the information:


My mother made two payments to the pediatricians office. Those two visits were reimbursed from the state to the clinic. because of that all 5 visits that were reimbursed go back to her evem though she didnt pay all of them I'm not sure why they would need to speak to her. That's part of the problem I'm having.



Response: I am with you here. I am not sure what legal basis the doctor's office had in contacting your mother. Your mother as the grandmother is not a responsible party for her grandchildren's medical bills when she is not a legal guardian. Regardless of who paid the bills, the clinic must pay the check to you and not your mother. After all, if the bills were not paid, the clinic would have come after you and not your mother.



The clinic violated HIPAA by speaking with your mother about your children's medical bills. Regardless of her paying some of the bills, the doctor's office has no legal basis to contact her regarding the reimbursement check. The check should go to you.



You may file complaint against the clinic with U.S. Department of Health and Human Services, Office for Civil Rights. This is the division charged with the enforcement of HIPAA:



http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html



Customer: replied 1 year ago.

Thank you very much! I had a feeling they had.

Expert:  Phillips Esq. replied 1 year ago.
You are quite Welcome!
Phillips Esq., Attorney-at-Law
Category: Legal
Satisfied Customers: 13133
Experience: B.A.; M.B.A.; J.D.
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