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mailreba2 · 02-02-2010, 09:55 AM

i'll put this question out there for anyone that can answer it.
when calling to get auth on a surgery for a WC patient is it common for the wc customer service rep. to ask if you are related to the patient?

Bad Boy Bad Boy · (This post was last modified: 02-02-2010 10:21 AM by Bad Boy Bad Boy.)

Yes it is. If your not the doctor, or their attorney, they wont speak with you, unless your the injured worker. Unless you have power of attorney to speak in their behalf.
In other words, it's a Privacy matter. You would not someone calling a place for you if you were not aware of it, and have that information then talked about freely. This one issue where the HIPPA Laws comes in place.

mailreba2 · 02-02-2010, 12:36 PM

Bad Boy Bad Boy Wrote:Yes it is. If your not the doctor, or their attorney, they wont speak with you, unless your the injured worker. Unless you have power of attorney to speak in their behalf.
In other words, it's a Privacy matter. You would not someone calling a place for you if you were not aware of it, and have that information then talked about freely. This one issue where the HIPPA Laws comes in place.

mailreba2 · 02-02-2010, 12:39 PM

TO BAD BOY BAD BOY
EVEN IF YOU DO THE WC BILLING FOR THE DR. OR HOSPITAL AND HAVE A SIGN RELEASE FROM THE PATIENT INDICATING YOU (THE DR OR HOSP) WILL HAVE TO HAVE YOUR RECORDS AND CONTACT THE INSURANCE COMPANY, WHY WOULD THE WC PAYOR ASK IF YOU ARE RELATED? AND IS THIS COMMON PROCEDURE?

Bad Boy Bad Boy · 02-02-2010, 01:26 PM

Why not just tell us what your getting at?

~~Still in Limbo~~ · 02-02-2010, 01:29 PM

As Bad Boy has Mentioned, We need More of Info. to be able to Answer You to the Best of Our Ability! I'm Sure You can get Good Info. if You just give Us a bit More Info.!!! Wink

Bad Boy Bad Boy · 02-02-2010, 02:41 PM

Or if this is all the information, the IC can ask what ever they feel like asking.

mailreba2 · 02-02-2010, 03:47 PM

Still in Limbo Wrote:As Bad Boy has Mentioned, We need More of Info. to be able to Answer You to the Best of Our Ability! I'm Sure You can get Good Info. if You just give Us a bit More Info.!!!

mailreba2 · 02-02-2010, 03:52 PM

ok in a nut shell i work in a hospital and had to get auth for a surgery for my husband
(I had a signed auth from him) when i called i stated my name (first name only) and where i was calling from (name of hospital where i worked) the WC rep on the phone asked me if i was related to the patient! first of all i did not state my last name 2nd i have NEVER been asked by an insurance rep if i was related to the patient.
has anyone else ever have an insurance rep for WC or anyother insurance ask you if you are related to the patient when you are trying get an auth or a claim #?

1171 · (This post was last modified: 02-02-2010 04:08 PM by 1171.)

I don't believe all confidentiality/privacy laws are the same for every institution or in every state for such situations.

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