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hippa and medical bills


school17777
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Since our insurance is no longer co-pays for the appointment up front and that is it, we now don't pay anything until we receive a bill months later. However, the bills are often coming in the kids names and we may not get the bill. For example, ds gave us a bill from March the other day. Luckily, we had already paid it (must have gotten another bill and paid it then).

 

The office said it was because he was 18 by March, but not at the time of service and doesn't explain the other bills that came in his name before he turned 18. And, I don't even get what his being 18 has to do with anything. He is not paying the bill, it should go to the person who is listed as financially responsible.

 

Is it truly a Hippa violation to mail a medical bill to the parent of a child? I am trying to find out for sure, but I am not finding this either way.

 

Makes no sense to me! It better not mess with our credit if the bills are not sent in our name.

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I just read an article about how some institutions and practitioners misuse Hipaa:

 

http://www.nytimes.com/2015/07/21/health/hipaas-use-as-code-of-silence-often-misinterprets-the-law.html?_r=0

 

I do not know what Hipaa says about medical bills, but regardless of whether the office can mail the bill to you without your son's consent  -- and based on this article, it certainly does not seem as though this should be a problem -- but it also looks like if your son specifically authorizes the disclosure of information to you, they have to agree.  I would have your son mail a letter to the office explicitly telling them to mail bills directly to you.

 

 

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I just read an article about how some institutions and practitioners misuse Hipaa:

 

http://www.nytimes.com/2015/07/21/health/hipaas-use-as-code-of-silence-often-misinterprets-the-law.html?_r=0

 

I do not know what Hipaa says about medical bills, but regardless of whether the office can mail the bill to you without your son's consent -- and based on this article, it certainly does not seem as though this should be a problem -- but it also looks like if your son specifically authorizes the disclosure of information to you, they have to agree. I would have your son mail a letter to the office explicitly telling them to mail bills directly to you.

My ds was a minor when the bill occured. A minor shouldn't have to send a letter to the office to tell them to bill his parent. He has been getting bills in his name for a couple of years now, so them saying it is because he is 18 is just a random statement from them. It is so frustrating. He just recently turned 18. I told the doctor's office today to go ahead and try to bill an 18 year old who has no job and no money (because his is a full time student). Ridiculous. We, the parents, signed the financial responsibility statement. How can we be responsible for it if we don't get the bill?

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Does your son not live with you? What address did he give them? I would simply have him give them your address for billing. It's not like they will be spying on who opens the envelope. My ds18's bills come addressed to him. I open them because I pay them. (I don't open his other mail.)

He does live with us. He and his twin sister were gettting like 10 letters a day from colleges and college stuff that the bills just got in those piles. The bill that he just brought down was from March. I don't go through all of his mail. We aren't expecting him to be getting our bills.

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He does live with us. He and his twin sister were gettting like 10 letters a day from colleges and college stuff that the bills just got in those piles. The bill that he just brought down was from March. I don't go through all of his mail. We aren't expecting him to be getting our bills.

I'm sorry but whoever collects the mail needs to sort the mail appropriately.  I don't see how the medical office could do things any differently.  I know you probably won't like me saying that but that is my opinion.  

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He does live with us. He and his twin sister were gettting like 10 letters a day from colleges and college stuff that the bills just got in those piles. The bill that he just brought down was from March. I don't go through all of his mail. We aren't expecting him to be getting our bills.

 

If he's been getting the bills in his name for 2 years, and you knew he went to the doctor, why didn't you expect him to be getting bills now?

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If he's been getting the bills in his name for 2 years, and you knew he went to the doctor, why didn't you expect him to be getting bills now?

He was going twice a week at the time. That is a lot of bills. This one got put in his room and we didn't get it. Plus, technicially, it is illegal for us to open his mail when it is in his name.

 

He just recently turned 18. Doesn't explain all the bills that they sent before he turned 18 in his name.

 

I guess we are the only ones frustrated by receiving doctor bills in our children's names. I still haven't been able to find anything saying that yes, hippa requires the bill to be in the child's name.

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I'm sorry but whoever collects the mail needs to sort the mail appropriately. I don't see how the medical office could do things any differently. I know you probably won't like me saying that but that is my opinion.

The letter was addressed to ds and given to ds. How is that inappropriate?

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I'm sorry but whoever collects the mail needs to sort the mail appropriately. I don't see how the medical office could do things any differently. I know you probably won't like me saying that but that is my opinion.

At our doctor offices, you fill out a form saying who is financially responsible for payment. The bill should go to that person. (And in the past did. Now, apparently, "hippa" has changed things according to the office.)

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Anything for ds is in his name, but he lives here so I just put it on my pile to deal with. And no, I really don't care whose name is on it.......... if I know it's for me to deal with, I open it.

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I am an employee benefits attorney in my spare time and have done more than my share of HIPAA work.  HIPAA starts with a presumption that the health information is not to be disclosed except to the person it is about--your son, in this case.  There has, then, to be an exception for his health information (and the mere fact that he has sought treatment constitutes protected health information) to be given to someone other than your son.  For instance, HIPAA expressly permits the disclosure of PHI for treatment, e.g., doctor-to-hospital; payment,  e.g., doctor to insurance company; and healthcare operations, e.g., well, let's skip that one.  In this case, I would argue that, if you are shown on his records as the financially responsible party, sending bills to you falls within the "payment" exception to nondisclosure.  And if your provider's office were willing to think about it for five minutes, they would probably come to this same conclusion.  But they are not because, as you've learned, some over-zealous HIPAA consultant came in, put the fear of God and HHS in them and magically took away their ability to think rationally about how the rules apply in this situation.  They've gotten to the "presumption of nondisclosure" and stopped, not venturing into whether any of the exceptions might apply.  You'll be better off spending your time training your son to go through his mail in a timely manner than you will arguing with the billing department.  But, I agree with you that HIPAA does not prohibit the provider from mailing bills to you.  On the other hand, nothing prohibits the provider from mailing them to him, either.

 

 

 

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The bill is supposed to be mailed in care of the parent/guardian until the child turns 18.  If the patient is 18 or over, the bill is mailed to the patient, not to another person (even if the other person is the policyholder).

 

If the patient wants the bill to be sent in care of another person, he/she needs to call the doctor's billing office to request that. 

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HIPAA has been around for years, and I don't think anything has changed significantly in the past year. The health care privacy of minors is also complicated by state law. Billing is a known issue in privacy for minors, (especially if the child is being treated for anything sexual health related because there are additional protections there). Once the child is an adult, the bill goes to that person. An adult can't assign liability for his bills to another person. You may agree to have him on your insurance and pay them, but the bills will still come to him in his name. The doctor's office can't foresee when he will get a job, get married, get booted off your insurance for whatever reason... He will have to give consent to your insurance company and his doctors for them to discuss billing issues with you if you're going to handle that instead of him. I had to do that for DH to fix the screwed up mess of billing after our last baby was born.

 

It's not illegal to open someone's mail with his permission. If he consents for you to deal with the medical bills, sort anything from the doctor/hospital into your pile.

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Anything for ds is in his name, but he lives here so I just put it on my pile to deal with. And no, I really don't care whose name is on it.......... if I know it's for me to deal with, I open it.

In a month, ds won't have the same address. Some envelopes don't have any identifying information on them. Ds got two today. He is away for a week, so they will sit unopened because I know he would be upset if we opened them for him.

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I know not from HIPPA, but it seems a little silly that he would get mail, not open it, let it sit in his room for five months, and then blame the doctor's office for the oversight.  He's 18, he knows when he goes to the doctor, and he knows there's going to be a bill, right?  Even if he doesn't have to pay it.

 

If he'd be upset at you opening his mail, and you all know this is an ongoing issue with this doctor's office, then he needs to be on top of things that get sent to him and pass bills on to you or give you permission to open stuff that you think might be a medical bill.  I mean, maybe you can get things sorted with the doctor's office, maybe not, but any medical bill I've ever gotten has not come unmarked.

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HIPAA has been around for years, and I don't think anything has changed significantly in the past year. The health care privacy of minors is also complicated by state law. Billing is a known issue in privacy for minors, (especially if the child is being treated for anything sexual health related because there are additional protections there). Once the child is an adult, the bill goes to that person. An adult can't assign liability for his bills to another person. You may agree to have him on your insurance and pay them, but the bills will still come to him in his name. The doctor's office can't foresee when he will get a job, get married, get booted off your insurance for whatever reason... He will have to give consent to your insurance company and his doctors for them to discuss billing issues with you if you're going to handle that instead of him. I had to do that for DH to fix the screwed up mess of billing after our last baby was born.

 

It's not illegal to open someone's mail with his permission. If he consents for you to deal with the medical bills, sort anything from the doctor/hospital into your pile.

I just read the billing procedures for our local hospital (not where the current bill is from). The bill is sent to the guarantor. A patient over 18 is automatically the guarantor, EXCEPT if they are a full time student (and other exceptions). Other offices have similar policies regarding bills and minors - where it goes to the guarantor, not the patient. I haven't found any law that says the bill must go to the minor patient.

 

eta: from local hospital: "Who is the "guarantor"?

 

The guarantor is the person legally responsible for all charges incurred by the patient. If the patient is over the age of 18, then they are listed as their own guarantor. Exceptions would include:

 

Full-time high school/college students covered under their parents' insurance. If parents are divorced or separated, the custodial parent is the guarantor. If the custody is equally shared, the parent who has the insurance coverage on the patient is the guarantor." Previously, the hospital stated that the bill goes to the guarantor.

 

(They previously state that the bill goes to the guarantor, not the patient.)

 

At least in all this, I have found that we need to get some type of HIPPA form or medical poa filled out for the kids before they leave for college.

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I know not from HIPPA, but it seems a little silly that he would get mail, not open it, let it sit in his room for five months, and then blame the doctor's office for the oversight. He's 18, he knows when he goes to the doctor, and he knows there's going to be a bill, right? Even if he doesn't have to pay it.

 

If he'd be upset at you opening his mail, and you all know this is an ongoing issue with this doctor's office, then he needs to be on top of things that get sent to him and pass bills on to you or give you permission to open stuff that you think might be a medical bill. I mean, maybe you can get things sorted with the doctor's office, maybe not, but any medical bill I've ever gotten has not come unmarked.

He wasn't 18 when he went to the dr. And, I have no idea if the kids realize how payment works for doctors. It has totally changed. We used to pay a co-pay at the time of the appointment and that was it. Now, we don't pay anything, unless the office tries to guess how much we will be charged and we pay that. I am guessing that my kids don't realize how doctor billing works. Also, we get bills months after the appt. We just got a bill last week from his appt in Apr at a different dr's.

 

We obviously got another bill and paid since that March bill because when I called today, they said that it was already paid. Somehow that one bill got mixed in a pile of ds' things that didn't get to us. If it had been in our name intially, at least it would have been on our pile to begin with.

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Does your son not live with you? What address did he give them? I would simply have him give them your address for billing. It's not like they will be spying on who opens the envelope. My ds18's bills come addressed to him. I open them because I pay them. (I don't open his other mail.)

What happens when he has a different address and I cannot go through his mail?

 

Our NAME and address was given to them for billing.

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I still don't understand, can he not just open his mail and pass the bill to you or ask you to pay it? Are they not marked to indicate who they are from? Mail doesn't seem like it should be that big of an issue if it's at least getting to him, even it's supposed to be paid by you.

 

I get it's an inconvenience and I hope you can get them to send the bills to you, but in the meantime it doesn't seem like a huge issue for him to just handle his own mail responsibly (to include letting you know if he gets a bill...If he doesn't know how it all works, can't he just ask you if you need to pay it?).

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I still don't understand, can he not just open his mail and pass the bill to you or ask you to pay it? Are they not marked to indicate who they are from? Mail doesn't seem like it should be that big of an issue if it's at least getting to him, even it's supposed to be paid by you.

 

I get it's an inconvenience and I hope you can get them to send the bills to you, but in the meantime it doesn't seem like a huge issue for him to just handle his own mail responsibly (to include letting you know if he gets a bill...If he doesn't know how it all works, can't he just ask you if you need to pay it?).

 

This ONE bill didn't get to us. But, I would prefer that bills that we are responsible for, come to us in our name, not someone else's whether or child or not. It seems that I am the only one who feels this way.

 

From reading a lot on tonight about this to see if the lady was stating the truth that Hippa requires this (which doesn't appear to be true), there are a lot of cases when not getting the bill mailed to the guarantor is a problem, especially when the patient doesn't live at the same address as the guarantor.

 

It does bother me that my credit can be affected by not getting a bill that I am meant to pay, but is technicially mailed to someone else (even if it is in the same house).

 

I wish I hadn't put any personal details about why I was asking if hippa really says that bills must be mailed to the child. That's what I am trying to figure out. Not whether or not my ds is responsible enough to pass bills onto me.

 

I dislike being told the reason for something when it isn't true.

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If I were in this situation, it would not matter to me how HIPPA works. What would be important to me is that I am being responsible in getting my bills paid. In this situation, that would include telling my son that if he doesn't go through his mail and give me the bills I need to pay, I will do it. If it involves my credit being dinged because he is not bothering to open his mail, I am going to open the envelopes that are potentially doctor bills. I'm guessing that if you have been receiving many of these, you would start to know what they look like.

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In a month, ds won't have the same address. Some envelopes don't have any identifying information on them. Ds got two today. He is away for a week, so they will sit unopened because I know he would be upset if we opened them for him.

My college kids use our home address for medical things, with their cell phone number as the contact (for reminder calls etc). Just have him do that going forward.

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I think the bills should be sent to him.  Might be annoying if you are ultimately the one paying for them, but he is an adult and it could potentially be an invasion of his privacy.

 

I've had my bills sent to my husband.  I was not amused.  I've got nothing to hide, but it is an invasion of my privacy.

 

 

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Slight spin off, but asking here.

 

I am thinking of my under 18 children. We had a hospital visit. I had to sign form after form acknowledging that I am the guarantor. No problem. Bills come to me. I check to make sure they are accurate, also no problem.

 

But if my kid were over 18 and went to the ER for a head cold, or got a $$ prescription that was not on the formulary, when a generic would do, I would be pretty ticked off. Or if he got the bills, didn't check them and didn't show them to me? Would I have to pay? If parents pay insurance premiums, are they then responsible for every medical bill?

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Billing issues can be frustrating. If I'm reading the OP correctly, there are a few concerns. The first is that the parents are listed as being responsible for payment, and she wants to make sure the bills are paid so that their credit is not negatively affected. The second is that the bills are not coming to them but to a child who will soon be leaving the family home.

 

I am not an expert on HIPPA (disclaimer here), but in your situation, I'd do two things. First, if your DS isn't giving you the bills promptly and/or does not want you opening mail that looked like bills, I'd take him to each doctor's office and have your name removed as the guarantor. Your son is a legal adult. If he's receiving the bills, make sure he is listed as the responsible party. That doesn't mean you can't still pay them. It would just help protect you against being blindsided. It might also impress upon your son the importance of getting those bills to you since it's now his credit rating that is on the line. At that point, I'd try to do what someone else suggested: have him list your home address as his even if he's on his own and give you permission to open bills that come. (He could have all his personal mail sent to his new address.)

 

ETA: I'd also give a call to the insurance company and/or doctor's office to see what they suggest. You can't be the first family to have run into this situation.

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Slight spin off, but asking here.

 

I am thinking of my under 18 children. We had a hospital visit. I had to sign form after form acknowledging that I am the guarantor. No problem. Bills come to me. I check to make sure they are accurate, also no problem.

 

But if my kid were over 18 and went to the ER for a head cold, or got a $$ prescription that was not on the formulary, when a generic would do, I would be pretty ticked off. Or if he got the bills, didn't check them and didn't show them to me? Would I have to pay? If parents pay insurance premiums, are they then responsible for every medical bill?

 

I don't know the exact answer to that, but it seems to me that you would not be responsible.  Would the insurance company come after my husband for my medical bill even though he holds the insurance?  I'd think ultimately not. 

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My guess is that the doctor's office was wrong, in sending the bill to a patient under 18, or at least it wasn't their only choice.  That's water under the bridge though.

 

Once a young person turns 18, though, HIPPA does kick in.  I know more about HIPPA from a mental health standpoint, but I do know that unless a young person signs very particular paperwork on or after their 18th birthday, parents can not get any information from the mental health providers who see their child.  This includes information such as whether the young person showed up at an appointment, or reviewing dosages if the young person forgets what they were supposed to take. Or whether they were checked out of a hospital AMA. One of the things that parents worry about when they have kids with mental illness, is whether they'll be in a good place on and right after their 18th birthday, and thus willing to sign.  Oh, and the doctor can't tell you if they didn't sign, so you might think "Oh, I bet he signed." When in reality the patient didn't sign and hasn't been to therapy since, but the therapist can't tell you. Since medical bills include information such as diagnoses, and appointment dates, I assume they'd be covered by HIPPA unless the patient signed something specific granting permission to share that information.

 

So, my guess is that there is paperwork that the doctor office can get signed that would allow the parent to be billed.  However, if he hasn't been to the doctor since before his birthday, he hasn't signed it.  My guess is also that the paper is a pain in the neck for the office, and they'd prefer not to have to deal with it, and they certainly aren't going to track down their patients on their 18th birthday to get it signed.

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Slight spin off, but asking here.

 

I am thinking of my under 18 children. We had a hospital visit. I had to sign form after form acknowledging that I am the guarantor. No problem. Bills come to me. I check to make sure they are accurate, also no problem.

 

But if my kid were over 18 and went to the ER for a head cold, or got a $$ prescription that was not on the formulary, when a generic would do, I would be pretty ticked off. Or if he got the bills, didn't check them and didn't show them to me? Would I have to pay? If parents pay insurance premiums, are they then responsible for every medical bill?

 

Bill for 18+ patient is sent to the patient at the address the patient writes down when filling out the registration form.

 

Patient doesn't pay = patient's account sent to collections.

 

No matter who the policyholder is, 18+ patient is responsible to pay the bill.  Of course, another person can make payment for the patient.  But ultimately, the bill is the patient's responsibility.

 

If you are concerned about your 18+ child on your policy going to the ER for a head cold, IMO it's time for a discussion about how to determine where to seek treatment for different types of illnesses.  And how to talk to doctors about prescriptions.

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Slight spin off, but asking here.

 

I am thinking of my under 18 children. We had a hospital visit. I had to sign form after form acknowledging that I am the guarantor. No problem. Bills come to me. I check to make sure they are accurate, also no problem.

 

But if my kid were over 18 and went to the ER for a head cold, or got a $$ prescription that was not on the formulary, when a generic would do, I would be pretty ticked off. Or if he got the bills, didn't check them and didn't show them to me? Would I have to pay? If parents pay insurance premiums, are they then responsible for every medical bill?

 

For you and others who are worried about collections coming after you on account of your 18+ child's medical expenses, what you need to look for is whether paperwork you signed before he turned 18, in which you no doubt declared yourself the guarantor, survives past his 18th birthday.  It MIGHT, and it MIGHT NOT, depending on the language of the paperwork.  Most hospital paperwork applies only to that visit, that admission, so if he takes himself to the ER for a hangnail on his eighteenth birthday, you are probably off the hook.  Most doctor's office paperwork is, on the other hand, theoretically, forever.  Neither provider, however, would automatically come after you as the guarantor just because the adult is on your insurance.  Their bill collector might, because bill collectors are mostly stupid, but they would be legally wrong (like that's never happened before), and you could fight it and have your credit restored with a challenge to the credit reporting agency.  Not ideal, of course, but still doable.

 

Your adult child cannot effectively designate you as his guarantor any more than he can sign you up for any other kind of legal obligation without your consent.  If you are helping out with the paperwork in an emergency, however, you need to be very careful what you sign so that you don't end up in that position just because you blindly signed everything that was shoved at you in the heat of the moment.

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My 13 yo spent a week in the hospital after getting his appendix out. All of the bills came with his name on them. Never thought it should be different? He was the patient. The bill is for services rendered to him. A bill comes in I open it. Even an unmarked envelope is pretty easy to tell its a bill.

 

Maybe it's not an issue because he's only 13 and doesn't get a lot of mail?

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What happens when he has a different address and I cannot go through his mail?

 

Our NAME and address was given to them for billing.

He should leave his doctor's office address as home, not his temporary school address. If he chooses to list another address, it will be up to him to arrange payment by getting them to you or getting reimbursed by you or whatever y'all decide.

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Bill for 18+ patient is sent to the patient at the address the patient writes down when filling out the registration form.

 

Patient doesn't pay = patient's account sent to collections.

 

No matter who the policyholder is, 18+ patient is responsible to pay the bill. Of course, another person can make payment for the patient. But ultimately, the bill is the patient's responsibility.

 

If you are concerned about your 18+ child on your policy going to the ER for a head cold, IMO it's time for a discussion about how to determine where to seek treatment for different types of illnesses. And how to talk to doctors about prescriptions.

My question was hypothetical. When ds was hospitalized recently, I had to reassure him that meals were included. He was afraid the we would be charged extra, lol. Btw, the food was excellent -- since you could order off a big menu, it looked like a restaurant.

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For you and others who are worried about collections coming after you on account of your 18+ child's medical expenses, what you need to look for is whether paperwork you signed before he turned 18, in which you no doubt declared yourself the guarantor, survives past his 18th birthday. It MIGHT, and it MIGHT NOT, depending on the language of the paperwork. Most hospital paperwork applies only to that visit, that admission, so if he takes himself to the ER for a hangnail on his eighteenth birthday, you are probably off the hook. Most doctor's office paperwork is, on the other hand, theoretically, forever. Neither provider, however, would automatically come after you as the guarantor just because the adult is on your insurance. Their bill collector might, because bill collectors are mostly stupid, but they would be legally wrong (like that's never happened before), and you could fight it and have your credit restored with a challenge to the credit reporting agency. Not ideal, of course, but still doable.

 

Your adult child cannot effectively designate you as his guarantor any more than he can sign you up for any other kind of legal obligation without your consent. If you are helping out with the paperwork in an emergency, however, you need to be very careful what you sign so that you don't end up in that position just because you blindly signed everything that was shoved at you in the heat of the moment.

Thank you, that is very helpful. I would plan on paying for dc, but I don't like being responsible for something that I have no control over or information about.

 

I generally get copies of what I sign or scan docs in an my phone. I have not had problems so far, but I remember trying to fix my parents Medicare bills for things they never got. Nightmare!

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My 13 yo spent a week in the hospital after getting his appendix out. All of the bills came with his name on them. Never thought it should be different? He was the patient. The bill is for services rendered to him. A bill comes in I open it. Even an unmarked envelope is pretty easy to tell its a bill.

 

Maybe it's not an issue because he's only 13 and doesn't get a lot of mail?

Similar situation here with 15 year olds. They know never to touch any mail. Never. I check the mail and give them their stuff, but I open and pay all the bills and have not heard any objections.

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I have not had any problems with my 18 year old son.  Yes, his bills come with his name on it.  So do the bills for his 13 year old sister.  The bills say "XYZ Medical Office" on it so it isn't hard to sort them out.  I pay them.  We've gotten college mail for a couple of years now.  It is very easy to see what is college and what isn't.  If he tried some kind of a "Micky Mouse game" where he had a hissy fit over me opening a bill then he would be paying for that bill no matter how much of his paycheck went towards it or how much yard work he had to do to make up the difference.  (I don't see this happening though.  Even my Aspie who can play pedantic word games at times still understands that medical bills are expensive and that he is blessed to have us footing the bill.)  BTW - unless a bill goes to collections, it has never ever affected my credit score and I have a stellar score.  I often pay the medical bills on the second invoice.  

 

How much information I have or even if I'm included in the office visit is totally up to my 18 year old.  I'm responsible for trying to keep the lines of communication open between us.  He does ask for me to come in most of the time because he recognizes that my presence there is valuable.  Since he is giving clear permission for me to be there, there is no problem at all with HIPPA.  I do let him handle 90% of doctor interactions but am there primarily as a resource or to ask some salient questions that he doesn't have the experience to ask.  (His doctor visits do not tend to be for very private or embarrassing conditions).  If he asked me not to come in, I would have absolutely no problem with that.  Again - totally up to him.  

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 But, I would prefer that bills that we are responsible for, come to us in our name, not someone else's whether or child or not. It seems that I am the only one who feels this way.

 

 

 

Nope, I feel the same way. Ds and dd are still on our insurance, at ages 21 and 23. We pay their medical bills because they're students and haven't yet launched.   When they are seen locally through our health care network their bills come to us in dh's and the kid's name. When either go to a doc when they're away at school, their bills are sent to them...sometimes here, sometimes at school.   So they can come to our house in dh's name, as that's what our network does.  I'm guessing that when they see a doc out of network that they have listed themselves as responsible for payment. 

 

At some point, kids on our insurance will need to be responsible for their own bills. I'm good with that- we're transitioning dd to that this year.  But it can be a little sticky when adult kids are on parents' insurance.  They want privacy, we want the bills paid...

 

Sometimes we don't know the kids have gone to a doctor until we get the insurance statement. Well, that tells us when and where they were seen, and usually some other info like what lab work was done. So right there we're getting personal info.  

 

When our older girls were adults in college, their bills came just in dh's name because he was the guarantor. Times have changed.  

 

I get that they are adults, I really do.  

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  I'm guessing that when they see a doc out of network that they have listed themselves as responsible for payment. 

 

 

I see this as a kid problem not the doctor's office problem.  If they are not actually going to be responsible for payment then they need to fill out the forms correctly.  I would coach them on that.  

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As for the slight spin-off, the patient is responsible which ultimately means you are probably responsible.  Educate your child on filling out medical forms and knowing what their insurance covers.  It'll serve them well for the rest of their life to make sure they know these things.

 

Medical and dental bills have been addressed to our children for years.  None of our kids are over 18.  I simply look at the return address and it becomes clear what is inside.  Sometimes the kids get ads in the mail.  I don't just give those to them either.  Again, I look at the return address when sorting mail to know what it is.

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My question was hypothetical. When ds was hospitalized recently, I had to reassure him that meals were included. He was afraid the we would be charged extra, lol. Btw, the food was excellent -- since you could order off a big menu, it looked like a restaurant.

 

I should have gone to your hospital for my surgery. :tongue_smilie: Even the coffee was bad.  They claimed it was Starbucks.  Must have been the special hospital blend.

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I see this as a kid problem not the doctor's office problem.  If they are not actually going to be responsible for payment then they need to fill out the forms correctly.  I would coach them on that.  

 

Agreed!  But at this age their coaching is more geared toward taking on more responsibility so we're focusing on that instead of encouraging them to let dh be responsible. 

 

I'm not too critical of young adults who don't know all the ins and outs of this kind of thing.  When they were 16 and going to the doc on their own, dh was responsible. When they turned 18, nothing suddenly changed to them, so they didn't know that a doc would even ask who is responsible (and our local docs didn't).  It's a weird place to be- technically an adult but still mostly being supported by parents.  

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I should have gone to your hospital for my surgery. :tongue_smilie: Even the coffee was bad. They claimed it was Starbucks. Must have been the special hospital blend.

Our hospital has a menu and you can order from about 6 am to 8 pm. Ds was not that hungry, but I enjoyed the Atlantic broiled salmon and the the Koren beef bulgogi. No wonder ds thought we would be charged extra!

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I have not had any problems with my 18 year old son. Yes, his bills come with his name on it. So do the bills for his 13 year old sister. The bills say "XYZ Medical Office" on it so it isn't hard to sort them out. I pay them. We've gotten college mail for a couple of years now. It is very easy to see what is college and what isn't. If he tried some kind of a "Micky Mouse game" where he had a hissy fit over me opening a bill then he would be paying for that bill no matter how much of his paycheck went towards it or how much yard work he had to do to make up the difference. (I don't see this happening though. Even my Aspie who can play pedantic word games at times still understands that medical bills are expensive and that he is blessed to have us footing the bill.) BTW - unless a bill goes to collections, it has never ever affected my credit score and I have a stellar score. I often pay the medical bills on the second invoice.

 

How much information I have or even if I'm included in the office visit is totally up to my 18 year old. I'm responsible for trying to keep the lines of communication open between us. He does ask for me to come in most of the time because he recognizes that my presence there is valuable. Since he is giving clear permission for me to be there, there is no problem at all with HIPPA. I do let him handle 90% of doctor interactions but am there primarily as a resource or to ask some salient questions that he doesn't have the experience to ask. (His doctor visits do not tend to be for very private or embarrassing conditions). If he asked me not to come in, I would have absolutely no problem with that. Again - totally up to him.

Good advice!

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  • 1 month later...

For you and others who are worried about collections coming after you on account of your 18+ child's medical expenses, what you need to look for is whether paperwork you signed before he turned 18, in which you no doubt declared yourself the guarantor, survives past his 18th birthday.  It MIGHT, and it MIGHT NOT, depending on the language of the paperwork.  Most hospital paperwork applies only to that visit, that admission, so if he takes himself to the ER for a hangnail on his eighteenth birthday, you are probably off the hook.  Most doctor's office paperwork is, on the other hand, theoretically, forever.  Neither provider, however, would automatically come after you as the guarantor just because the adult is on your insurance.  Their bill collector might, because bill collectors are mostly stupid, but they would be legally wrong (like that's never happened before), and you could fight it and have your credit restored with a challenge to the credit reporting agency.  Not ideal, of course, but still doable.

 

Your adult child cannot effectively designate you as his guarantor any more than he can sign you up for any other kind of legal obligation without your consent.  If you are helping out with the paperwork in an emergency, however, you need to be very careful what you sign so that you don't end up in that position just because you blindly signed everything that was shoved at you in the heat of the moment.

 

 

I just remembered this thread as I'm trying to deal this issue out right now. My son was hospitalized as an adult with a major medical emergency and required significant treatment over the next months. The first few bills came in my son's name, but eventually started coming in my husband's name. My husband carries the insurance on him, but I am 100% certain that my husband didn't sign any of the business or insurance forms because he wasn't there for intake or any subsequent appointments requiring paperwork.

 

At present there is no outstanding bill, but knowing there will be future visits, I called billing to try and sort it out. The person I spoke to insisted there must have been some agreement between my son and husband that resulted in my husband agreeing to be financially responsible. Most curious of all, she said that my son was the only one that could change that status, to which I replied that made no sense because that would give my husband no control of his financial responsibilities.

 

This isn't a small town hospital--it's a major university hospital. Do we need to add a letter to his file stating that although he remains on our insurance, neither my husband or I are guarantors?  Or should we wait and deal with it at my son's next appointment, and visit the billing office first?

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It sounds like it is either a problem with your mail sorting or, if you actually think you will go to jail because you opened a letter addressed to your son, a problem with your son's mail sorting.  It got send to the correct address and to the adult who is to deal with it. After that, it is up to him to make sure the right thing happens to it.

 

My kids have been getting mail addressed directly to them or 'to the parents of...' from our insurers and doctors since they were babies. I just look at all the return addresses and sort accordingly.  But, if I didn't sort and handed them off to my kids, I would expect them to open it in a timely fashion and bring it to my attention. Now that ds1 is in public high school I get lots of mail from the school district that is addressed to him that in fact I need to deal with. Again, I just break the law and open it, lol.  Actually, I am not sure it is against the law if the person is under 18.....

 

I am guessing I will be dealing with this a lot when my kids are over 18....

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I just remembered this thread as I'm trying to deal this issue out right now. My son was hospitalized as an adult with a major medical emergency and required significant treatment over the next months. The first few bills came in my son's name, but eventually started coming in my husband's name. My husband carries the insurance on him, but I am 100% certain that my husband didn't sign any of the business or insurance forms because he wasn't there for intake or any subsequent appointments requiring paperwork.

 

At present there is no outstanding bill, but knowing there will be future visits, I called billing to try and sort it out. The person I spoke to insisted there must have been some agreement between my son and husband that resulted in my husband agreeing to be financially responsible. Most curious of all, she said that my son was the only one that could change that status, to which I replied that made no sense because that would give my husband no control of his financial responsibilities.

 

This isn't a small town hospital--it's a major university hospital. Do we need to add a letter to his file stating that although he remains on our insurance, neither my husband or I are guarantors?  Or should we wait and deal with it at my son's next appointment, and visit the billing office first?

Most medical forms that I've filled out ask who's name is primary on the insurance.  Your son would have put your husband's name.  They also ask who is financially responsible on the bill (usually in the portion under where you fill in the insurance.)  Your son might have put your husband's name there but perhaps not.  No matter what, it seems very easy to ask an adult son to pick up the phone and call the billing office to put his name as the one financially responsible.  

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I just remembered this thread as I'm trying to deal this issue out right now. My son was hospitalized as an adult with a major medical emergency and required significant treatment over the next months. The first few bills came in my son's name, but eventually started coming in my husband's name. My husband carries the insurance on him, but I am 100% certain that my husband didn't sign any of the business or insurance forms because he wasn't there for intake or any subsequent appointments requiring paperwork.

 

At present there is no outstanding bill, but knowing there will be future visits, I called billing to try and sort it out. The person I spoke to insisted there must have been some agreement between my son and husband that resulted in my husband agreeing to be financially responsible. Most curious of all, she said that my son was the only one that could change that status, to which I replied that made no sense because that would give my husband no control of his financial responsibilities.

 

This isn't a small town hospital--it's a major university hospital. Do we need to add a letter to his file stating that although he remains on our insurance, neither my husband or I are guarantors?  Or should we wait and deal with it at my son's next appointment, and visit the billing office first?

 

 

Our local hospital considers the parent the guarantor for a full-time student, even if they are over 18.    So, if his job status says student, maybe this could be why they assumed your dh is the guarantor.

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  • 1 year later...

Hello,

I realize this is an old post, but hoping to find some info. We have been having a similar problem to others but even stranger in that the hospital/billing office will not accept our payment for our 20yr old son's medical bills. My husband has tried repeatedly to pay but the medical office refuses to accept our payment on the basis of HIPAA violation. I guarantee you that my 20yr old does not have the money to pay the bill!!

Is this a correct enforcement of HIPAA?!

Thanks in advance.

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Hello,

I realize this is an old post, but hoping to find some info. We have been having a similar problem to others but even stranger in that the hospital/billing office will not accept our payment for our 20yr old son's medical bills. My husband has tried repeatedly to pay but the medical office refuses to accept our payment on the basis of HIPAA violation. I guarantee you that my 20yr old does not have the money to pay the bill!!

Is this a correct enforcement of HIPAA?!

Thanks in advance.

 

HIPPA should not have anything to do with who pays though it can have to do with who is invoiced (since medical codes and descriptions are on invoices).  Still there is an easy fix.  Ask your son how much the bill is (or look at the invoice yourself since it sounds like you know how much it is for).  Give your son a check for that amount.  Have him pay the bill. 

 

I pay for my 19 (almost 20) year old all the time.  Not one payment has been refused.  I just send them a check with the correct invoice and account number on the check. 

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Hello,

I realize this is an old post, but hoping to find some info. We have been having a similar problem to others but even stranger in that the hospital/billing office will not accept our payment for our 20yr old son's medical bills. My husband has tried repeatedly to pay but the medical office refuses to accept our payment on the basis of HIPAA violation. I guarantee you that my 20yr old does not have the money to pay the bill!!

Is this a correct enforcement of HIPAA?!

Thanks in advance.

 

We have not had a problem with a provider accepting our payment for our adult children.

 

To take care of this situation somit does not affect your ds, I would have him notify the office giving your dh permission to pay the bill.

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