Kimberly in IN Posted February 11, 2009 Share Posted February 11, 2009 Oh, hive mind, we need your wisdom and experience. Has anyone else run into this situation - New insurance, new rules, etc. Ds, 12, went to new dr. Appears insurance wasn't billed correctly as we received a letter from drs office stating that insurance co said he wasn't covered. Dh does have insurance, ds is on the insurance and this dr is a participating dr. Okay, so we contact insurance company to see if they have actually received the bill, etc. We want to find out what is going on. We have not received an EOB for this service. Insurance response threw us for quite a loop. We were told that since ds is 12, we cannot receive any information from them. Ds, 12, is not considered a minor under HIPAA. Say what???? Is this true? And then the best part, since ds is just 12 and not a legal adult he cannot request this info either. Only his legal representative can request that info - insurance co must receive the correct legal documents before releasing any info. So (according to insurance co and yes, we asked many people at co) I must hire a lawyer, go to court to have dh and me (full custodial parents) named his legal reps, have such documents sent to insurance company in order to find out if the dr office did indeed even bill the visit correctly. And to see the EOB. This can't be right, can it? And why would it only apply on the insurance side of things? The dr office said I can have a copy of med record, etc. - ds is under 18. (and no, visit had nothing to do w/ reproduction, STDs or such - I was actually in the room during the visit) Just want to scream!!!!!!! Has anyone else run into this? Previous insurance company had no such rule. Ds has been 12 for a few months and has been to the dr since turning 12. All I want to do is see the EOB, if there is one. I actually think the dr office made a mistake w/ the billing. (we seem to be the poster family for billing errors w/ dr offices :lol:) We live in IN and dr office is in IN, if that matters. Any experience w/ this is greatly appreciated. I am at such a loss. Thank you, especially if you read this long post. :D Quote Link to comment Share on other sites More sharing options...
MommyX8 Posted February 11, 2009 Share Posted February 11, 2009 . Quote Link to comment Share on other sites More sharing options...
MommyX8 Posted February 11, 2009 Share Posted February 11, 2009 We have BCBS and I have to set up online accounts with pins for my 12+ older children. And I sign paperwork for my olders which allows the doctors to discuss their care with myself, my husband and grandparents. See if you need to bring him in to do this. Typically, though, I only need to do that with my 18+ older children. Quote Link to comment Share on other sites More sharing options...
Hillary in KS Posted February 11, 2009 Share Posted February 11, 2009 Wow! No, I've never heard of this. Yikes! Quote Link to comment Share on other sites More sharing options...
plansrme Posted February 11, 2009 Share Posted February 11, 2009 I'm an employee benefits attorney. This is what I do for a living, and assuming you're the legal parents (not a step-parent or foster parent), they're dead wrong about HIPAA. There could be something under state law that is stricter than HIPAA, but I would be shocked to find that is the case. I have three suggestions: 1. Contact your state insurance commissioner and ask them to run interference for you. I haven't dealt with IN specifically, but most will actually answer their phones and take complaints very seriously. 2. If you don't want to fix it, have the doctor's office contact the insurance company on your behalf. 3. Put your experience in writing and try to get it to the insurance company's legal department. Perhaps address it to their general counsel. He won't personally read it, but he may assign it to someone in the legal department. If you need specific cites to HIPAA, PM me. Terri Quote Link to comment Share on other sites More sharing options...
JoyfulMama Posted February 11, 2009 Share Posted February 11, 2009 (edited) According to Indiana State Medical Association: Patient ConsentCan minors consent to their own healthcare decisions? As a general rule, only competent adults (age 18) can consent to their own health care. Minors may only consent to their own health care if the minor: <LI class=TextInsidePages>Is emancipated; <LI class=TextInsidePages>Is ... at least 14 years of age; <LI class=TextInsidePages>not dependent on a parent for support; <LI class=TextInsidePages>living apart from the minor's parents or from an individual in loco parentis; and managing the minor's own affairs; <LI class=TextInsidePages>Is or has been married; <LI class=TextInsidePages>Is in the military service of the United States; or [*]Is authorized to consent to the health care by any other statute. The only known statutory exceptions (part 5) are donating blood (age 17) and treatment for an actual, suspected or potential (exposed) venereal disease (no age limit). IC 16-36-1-3. Pregnancy and contraception are not exceptions. Facilities that receive Title X Federal Family Planning Funds, e.g., Planned Parenthood, are allowed to treat minors age 14 and older pursuant to federal law. Private physician offices do not receive such funds and are not subject to such law. And I know of no such law with HIPAA either. Edited February 11, 2009 by JoyfulMama spelling mistake! Quote Link to comment Share on other sites More sharing options...
KidsHappen Posted February 11, 2009 Share Posted February 11, 2009 We have had some of these issues. We needed to submit receipts for prescriptions to our flexible benefit company. I had to requests copies of the receipts to send in. My dd was over 12 so I couldn't do it myself. She was allowed to sign the paperwork herself though. I have no idea why. A minor's signiture is not legally binding. We have mail-in prescription coverage and my children have maintanence drugs. I can not call in about these medications because they are older than 12. I do have computer accounts and manage them that way. I have no idea what I would do if I actually needed to talk to someone about the prescription though. I guess have my child that needs medication call? My drs. have to get permission for me to be in the room with them if they are seeing one of the kids older than 12. I can imagine it would be a nightmare if I needed to talk to the dr. about something without the child present. These laws are absolutely ridiculous and I think they were written by the village idiot. I have no suggestions just sympathy. Quote Link to comment Share on other sites More sharing options...
LizzyBee Posted February 11, 2009 Share Posted February 11, 2009 I have kids ages 12 and 15, and I have not run into this problem in NC. When my 15 yo turned 14, she signed a release at the doctor's office to allow them to discuss her health with me or dh. I've had no problem at all with insurance. Quote Link to comment Share on other sites More sharing options...
Donovans4 Posted February 11, 2009 Share Posted February 11, 2009 we recently had a question about information on an EOB for our dd 14. My DH was told he could not get the info over the phone because of dd's age. DD had to get on the phone at the same time as DH and tell the rep that DH had permission to have access to the needed info. It took just a minute, but it was a hassle to coordinate schedules. LauraD in MN Quote Link to comment Share on other sites More sharing options...
farmgirlinwv Posted February 11, 2009 Share Posted February 11, 2009 This is insane! My dd is going to be 12 in June. I had NO idea. I wonder if the Amish are taking applicants? Quote Link to comment Share on other sites More sharing options...
Murphy101 Posted February 11, 2009 Share Posted February 11, 2009 We have had some of these issues. We needed to submit receipts for prescriptions to our flexible benefit company. I had to requests copies of the receipts to send in. My dd was over 12 so I couldn't do it myself. She was allowed to sign the paperwork herself though. I have no idea why. A minor's signiture is not legally binding. We have mail-in prescription coverage and my children have maintanence drugs. I can not call in about these medications because they are older than 12. I do have computer accounts and manage them that way. I have no idea what I would do if I actually needed to talk to someone about the prescription though. I guess have my child that needs medication call? My drs. have to get permission for me to be in the room with them if they are seeing one of the kids older than 12. I can imagine it would be a nightmare if I needed to talk to the dr. about something without the child present. These laws are absolutely ridiculous and I think they were written by the village idiot. I have no suggestions just sympathy. yeah. what she said. frankly, what needs to happen is someone needs to file a lawsuit to reverse this. the child isn't an adult and they have zero right to refuse to give parents medical information on their own child, esp if the parent is seeking the care and paying the bill. for that matter, I think all parents should refuse to pay the bill. what bill? sorry if you're not going to tell me what I'm paying for then I'm not going to pay for it. Quote Link to comment Share on other sites More sharing options...
MommyX8 Posted February 11, 2009 Share Posted February 11, 2009 yeah. what she said. frankly, what needs to happen is someone needs to file a lawsuit to reverse this. the child isn't an adult and they have zero right to refuse to give parents medical information on their own child, esp if the parent is seeking the care and paying the bill. for that matter, I think all parents should refuse to pay the bill. what bill? sorry if you're not going to tell me what I'm paying for then I'm not going to pay for it. You know, though, that libraries are the same way. One time I had a call from the library that my child's library book was overdue. I asked what book (as how can you find a book if you don't know what you are looking for.) She told me that she could not tell me as it was a US privacy issue. Apparently, children should feel free to investigate any type of reading material that they like without the knowledge of the parents. That is when my children lost their library cards. If they want a book, it goes on MY card. This is truly getting ridiculous. Quote Link to comment Share on other sites More sharing options...
Murphy101 Posted February 11, 2009 Share Posted February 11, 2009 You know, though, that libraries are the same way. One time I had a call from the library that my child's library book was overdue. I asked what book (as how can you find a book if you don't know what you are looking for.) She told me that she could not tell me as it was a US privacy issue. Apparently, children should feel free to investigate any type of reading material that they like without the knowledge of the parents. That is when my children lost their library cards. If they want a book, it goes on MY card. This is truly getting ridiculous. Oh geez. I'd have had the same response. It's all just so stupid.:glare: Quote Link to comment Share on other sites More sharing options...
Holly IN Posted February 11, 2009 Share Posted February 11, 2009 I am in Indiana. I never had this issue. My oldest is 14. So no problem there. I can even get information about my dh's EOB. Something is not right here. The insurance company is WRONG!!!! Call the state commissioner's office and discuss this situation with them. As long as your child is in your home you have every right to request an EOB or any medical information. I never ran into problems that you did. Holly Quote Link to comment Share on other sites More sharing options...
Carol in Cal. Posted February 11, 2009 Share Posted February 11, 2009 You know, though, that libraries are the same way. One time I had a call from the library that my child's library book was overdue. I asked what book (as how can you find a book if you don't know what you are looking for.) She told me that she could not tell me as it was a US privacy issue. Apparently, children should feel free to investigate any type of reading material that they like without the knowledge of the parents. That is when my children lost their library cards. If they want a book, it goes on MY card. This is truly getting ridiculous. I overheard a similar conversation in a library when DD was about 4. That is why she still doesn't have a library card, at 12. Nor will she, until she is about 18. Probably. Ironically enough, there was a big write up in the newspapers about 2 years ago about a public school that marched all of their classes over to the library to get library cards for the kids. K-5 grades. Must have been interesting trying to figure out who was really financially responsible for those books. Hmmmm. Quote Link to comment Share on other sites More sharing options...
KristenS Posted February 11, 2009 Share Posted February 11, 2009 Wow, that insurance thing is insane. I understand the library one, though. It's not about ages at all. It's truly a privacy law ... I was cited one instance where a husband was (incorrectly) given access to his wife's account to pay some fines, only to find out she'd been checking out books on filing divorce. (Yes, this actually happened at the system where I worked.) I think it's stupid when it applies to minor children, and around here, 14 and up qualifies for an adult library card. I'm glad to have the heads up about insurance ... my son is on maintenance asthma meds, and I guess we'll run into that one in a few years. Sigh. Quote Link to comment Share on other sites More sharing options...
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