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To: codercpc
But, why is it that the insurer is permitted this kind of free access to medical information? The reality is that the insurer has no reason to peruse patient records.
128 posted on 08/10/2002 12:04:36 PM PDT by bonesmccoy
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To: bonesmccoy
You are right, they have no right to "peruse" your records, unless you want them to pay for your care.

Let me put it this way, if your plan doesn't pay for certain care (ie smoking cessation), how do they know that what you are seen for is a covered service unless the doctor tells them what you were seen for.

No insurance that I know covers everything. They all have their provisions, so it is up to the doctors billing department to tell them what you were seen for.

As I said, you can opt out by paying cash. Or by asking your doctor to let you submit the claim on your own, and then only submitting the ones that you think ok for them to see.

This is my job to submit these claims, so I am up to date on all of the HIPPA rules and regulations, and I will tell you that this particular rule we are talking about would have made it extremely difficult for your physician to get payment for your treatment, and I could have forseen many, many more physicians refusing to submit to any insurance and telling the patient that would be their responsibility.

169 posted on 08/11/2002 4:59:57 AM PDT by codercpc
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