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Now let’s talk about patients' rights. Patients' rights include your rights when you go see the doctor. Covered entities, which are health plans, clearinghouses, and providers transmitting PHI electronically, must provide individuals a Notice of Privacy Practices upon request. This notice describes how medical information about you may be used and disclosed and the process for filing complaints. As shown on screen, patients have several key rights regarding their PHI, including the right to inspect their records within 30 days, request corrections, ask for communication restrictions, and request an accounting of disclosures outside of routine treatment, payment, and operations. Additionally, if a patient pays for a service in full out of pocket, they can require that the provider not share that information with their health plan. Now let’s talk about patient authorization. Patient authorization is necessary to disclose an individual’s personal health information outside of routine operations, but it is not required to treat the patient. We often get asked, “Can I see a patient without written authorization?” Yes, you can. It is a good idea to update their medical record and note that. In the event of a workers' compensation claim or valid public health reporting, you can disclose required patient information without authorization. You can also alert law enforcement of an imminent danger to self or others. Think of this like protecting a minor: if you suspect abuse, you are authorized to report it. It just may save a child’s or adult’s life. In another example: The HIPAA Privacy Rule allows covered health care providers to disclose PHI about students to school nurses, physicians, or other health care providers for treatment purposes, without written authorization from the student or student's parent. For example, a student's primary care physician may discuss medication and health needs directly with a school nurse who will administer that care while the student is at school.
In this lesson, we'll go over patients' rights under HIPAA, what information requires authorization, when patient authorization is not required, and real-world examples you may encounter in practice.
All covered entities (health plans, healthcare clearinghouses, and healthcare providers transmitting PHI electronically) are required to provide individuals a Notice of Privacy Practices upon request. This notice describes how medical information may be used and disclosed, as well as the process for filing complaints.
Patients have several key rights regarding their Protected Health Information (PHI), including:
Pro Tip #1: Out-of-Pocket Payment Exception: If a patient pays for a healthcare service in full out of pocket, they have the right to require that the provider not share information about that specific service with their health plan.
Patient authorization is necessary to disclose an individual's personal health information outside of routine healthcare operations, but written authorization is not required in order to treat the patient.
Pro Tip #2: Treating Without Written Authorization: Healthcare providers often ask if they can see a patient without obtaining written authorization. The answer is yes. However, it is always best practice to update the patient's medical record and note the circumstance.
There are specific legal exceptions where covered entities may disclose PHI without prior written authorization from the patient or parent: