Q: Can a car insurance company such as AAA call a hospital to request billing info without you signing anything/release?
I got into a car accident, the party who hit me insurance (AAA) accepted liability after sending them my dash cam footage. I had to go to the ER, I was hesitant because I lost my job 5 months ago and I thought I didn't have health insurance. Three days later I get a notification email saying my bill is ready, $35,000. Nowhere on the bill show my insurance info. I forward the bill to the AAA adjuster, she calls me back 6 days later informing me the hospital has my health insurance on file and it's the the Obamacare or Covered California county health insurance. I applied maybe a month or two after I was laid off but I had no idea I was given it. Was there any Hipaa law broken if the hospital gave them my billing info. How did the AAA adjuster find out before me?
A:
Based on the information you've provided, it doesn't appear that any HIPAA (Health Insurance Portability and Accountability Act) laws were violated. Here's why:
1. HIPAA allows healthcare providers to share a patient's protected health information (PHI) with third-party payers, such as insurance companies, for billing and payment purposes without the patient's authorization.
2. In the context of a car accident, the hospital likely provided AAA with your billing information because AAA is potentially responsible for covering your medical expenses as the at-fault party's insurance company.
3. The hospital sharing your health insurance information with AAA is also permitted under HIPAA for billing and payment purposes.
It's possible that the hospital verified your insurance coverage before AAA contacted them, which is why the adjuster found out about your Covered California insurance before you did. The hospital may have searched for your insurance information to ensure they could get reimbursed for your medical expenses.
However, if you believe that the hospital disclosed more information than necessary for billing purposes or that AAA obtained your personal health information improperly, you can contact the hospital's privacy officer or file a complaint with the Department of Health and Human Services (HHS) Office for Civil Rights (OCR).
In any case, it's essential to communicate with AAA and your health insurance provider to ensure that your medical bills are properly processed and paid. You may also want to consult with a personal injury attorney to help you navigate the claims process and protect your rights.
A: There might be a violation, but there is no private lawsuit for a HIPAA violation. You might be able to pursue an invaion of privacy lawsuit, but since you gave AAA the hospital bill, it doesn't really seem like your privacy has been violated. You should probably focus on a personal injury claim against the other party or parties. Have you identifed all the insurance polices? All the potential defendants?
A: In these settings, hospital staff sometimes picks up insurance information off the police reports. One might need to see additional details to figure out exactly what happened. Good luck
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