In the ever-stricter world of protected health information (PHI) and HIPAA compliance, nothing can be left to chance. Healthcare facilities are no longer interested in inferring anything from the authorizing documents. All requests must be explicit and direct. Interpretation is out of the question: if there is even the slightest ambiguity on the stipulation, authorization, or subpoena nowadays, the request will likely result in a rejection. This level of scrutiny is vastly more stringent than it was even one or two years ago. Here are a couple important tips to remember:
If you require billing records from a particular organization, you must (1) determine where the billing is done and (2) include the specific billing department’s name and location on the stipulation/authorization. Many hospital billing departments are now off-site and/or outsourced. This is true for hospitals such as University of Washington and Harborview Medical Center. In the past, it was sufficient to state on the stipulation that you require medical records and billing records from University of Washington Medical Center, or Harborview Medical Center. Now, if you require billings in addition to the medical records, you must list the billing departments separately from the medical records departments. So for Harborview, you must indicate “Association of University Physicians” billings (and include the address), as well as “Hospital Collections” billings. Furthermore, you must indicate whether you seek billings generated by a UWMC Doctor or department, or a Harborview Doctor. Yes, this is much more detailed than it was a year ago. But it is useful to be aware of these nuances in advance as requests will be processed more quickly and achieve a higher level of success if copious information is provided at the outset. If you have any questions about this, please contact MEDRECS. If you are unsure of the exact wording or address for a billing facility, please contact MEDRECS. Note – citing incorrect address, name, or facility information on a stipulation may result in a rejection from the facility. Therefore, it is advisable to cross-check all information with MEDRECS before proceeding.