In discussions elsewhere on the internet, I have seen a lot of comments about how HIPAA now makes it almost impossible for a spouse (or other) to talk with a doctor about the patient. There is a little information here, if this is the correct section of those rules -- http://www.hhs.gov/hipaafaq/personal/224.html
My question is, how have so many of you "talked with the doctor" and so easily? It seems like it would be impossible.
Also, as a piece of irony -- on the one hand, things are somewhat better here so I don't feel as urgent about all of this. But on the other hand, DH's doctor (who wouldn't have talked to me anyway, I'm sure) QUIT his practice quite suddenly. Put a little ad in the paper, and poof, gone like smoke on a windy day.
Dee,s doc is a gal GP who;s father died of AD and I believe has a soft spot in her heart for Dee,, therefore she talks with me about anything I want to discuss.. thankfully her common sense overrides her fear of big brother
Can anyone tell us in plain terms what the HIPAA rules allow and don't allow? And what we need to do to continue getting info from the Doctor? So far my wife's doctor has been very cooperative in talking to me about her condition. I think my she signs something once a year allowing me to access her medical records. This appears to be something that the clinic uses to cover themselves.
Her daughter has Health Care POA, so does that mean I could be shut out of any decisions or discussions?
I haven't had any problems, but it is early in our AD experience and I don't want to find out too late that I can't participate.
I walk into the room when he has a doctor's appointment. Reason for being there? I have questions. If you are in the room with the patient, they will talk to you.
I also have a Living Will/Medical Advocacy document, although I haven't given copies to his doctors yet. I need to do that.
I went to the lawyer in January. I didn't know about elder care lawyer's so I went to a family practice lawyer then. I got two sets of all the basic paperwork. One set for me and one for him. Wills, Living Wills and DPOA. I'm his advocate. My daughter is my advocate and the backup on him. I made my son-in-law the backup on mine just in case.
I presented it as something BOTH of us had to do because at that point he was capable of signing paperwork. I'm not sure that is still true now about 6 months later. Go get your paperwork done and do it now. And in the meantime, just walk into all of her appointments with her so the doctors get used to talking to you.
Ever since we found out my DH has Az I have gone into the doctor's office with him. Before he was DX'd i knew his memory was failing so I went in even with our Family doctor. I knew DH would either forget or get things confused. Sometimes on the way home he would come up with something that the doctor never said and I would have to explain it him. Of course now if I explain it he would say I got it wrong!!!!!
Doctors are not supposed to talk with you about your spouse without your spouse's permission. If you are there with your spouse, then obviously that permission has been given. As the others said, just walk right in with your spouse.
While it is a REALLY good idea to get the paperwork in place -- you never know what might happen -- I think that once you've been to a doctor a couple of times, they typically understand the situation and will continue talking with you, even if your spouse isn't around. Permission clearly has already been given.
But if you want to talk with an insurance company, or Medicare, each of them has their own HIPAA waiver -- be sure to get those filled out and turned in while your spouse is able to sign.
i go into all dr appt with DH as well from the beginning. and our dr are all under one roof at a local hospital so the paper he signed back then to allow me access to his info is there. plus i have poa for his healthcar if i need it appointing me as his decisionmaker but havent had to show that yet. i have never had any problems after they know he has AD and i guess going with him even to new doctors hasnt been a problem. even the pharmacy calls and i tell them i fill his rx and they talk to me now-i said i can put him on the phone but you wont get any info from him:) now talking to an agency be it life insur or medicare or such is another story. i had to cancel a life insur policy as he took a loan out many yrs ago and then never paid on it and the policy was running out so it was a big fiasco. any big agency will want proof you can speak forhim. divvi
Perhaps it's because we are established patients I find the doctors would rather deal with me if they expect a rational answer. I let DH see his psychiatrist alone and after the visit the doc wanted to speak with me alone. He did ask DH if this was OK.
ps- how does it work with medicare ifyou need to talk to them about spouses benefits etc? if we have DPOA someone said soc sec doesnt recognise that? since DH couldnt sign a hipaa paper how would you proceed? i guess you could go in PERSON to soc sec office and they can see for themself he has AD and take DPOA??? just in case, some may need to know as well! divvi
divvi, you're talking about the Government ... do not expect rational behavior. No, they don't accept DPOA to release personal information, Medicare only accepts its own HIPAA waiver form. You can download the form from the internet. Follow the instructions to fill it out, naming yourself as the person to whom information can be released. If your LO isn't able to sign the waiver, then it says that you can sign it for your LO if you have authorization to act as his/her personal representative. You have to provide a copy of the DPOA or conservatorship papers when you send in the HIPAA waiver.
When I went to the Veteran's Administration, I had to bring home a paper for my DH to sign saying that he was incompetent and wanted me to act on his behalf so that I could talk to them for him. Now, if he is incompetent, how can he say anything believable? It's a Catch 22! However, he signed it in front of two witnesses like they wanted, and they filed it! :)
As to HIPAA, Sunshyne is right. The patient has to sign a Waiver to Release Information to you. Most of our spouses can still sign their name. Most places will accept copies. My husband's doctors accepted his DPOA which had the HIPAA medical statement in it and have it in their records. One of my daughters is the alternate agent, so if anything happens to me, she can deal with his doctors and get the information needed. Doctors, hospitals, Medicare and insurance companie are not allowed to talk to the spouse without the waiver, so if your doctor is doing so, it is because they have had what they consider a verbal waiver from your spouse and have noted it in their records.
On a related topic, I got credit cards in my own name, and regarding the two long term credit cards we had, he told them over the phone to deal with me (he said "yes" after I explained to them that I would be dealing with them, and they asked him the question - Do you give your permission?). I don't think that I will be able to use those two cards after his death, so I wanted credit estabished in my own name. I also added one of my daughters to our lock box, and made her beneficiary of our bank accounts. I didn't want her to have to wait for the will to be probated. Just thought I would throw this in for those who are spouses of newly diagnosed AD.
that just goes to show. having an 'incompetent' person sign admitting they are incompetent, , and they think thats ok. whats the legal status on that move??ha, amazing.
thanks, sunshyne, for the input, i dont need to tackle medicare at this moment but will file this Hipaa form info just in case for future use.
i did have to tackle american express with questions once, and they wouldnt talk to me either, even though i am a 'signer' on DH acct with myown card number from his acct as primary holder. i got my own cards in my name as well. of course if the primary holder should 'die' then they WILL be talking to the one next in line to pay the balance due:) without any objections of course. divvi
I drove myself nuts trying to change something on our Visa card. DH was the card holder and I was an approved user. They would accept no explanations. I just tucked the card in a drawer and took out a new Visa card. I went through the same with utility bills which were set up with my husbands SS#. I wanted to change bill paying for my convenience and they wouldn't let me. Does this disease have no end to causing misery.
Warning to anyone who might be getting into financial difficulties ... American Express SUCKS (pardon my language.) I had an employee who had to file bankruptcy. AmEx will do anything, legal or not, to hound you into paying them off. They don't hesitate to call you at work, and harrass your fellow workers, even your neighbors if they can locate them, whether or not you demand that they stop. (You would not believe some of the things their reps said to me when they called my company looking for my employee, and I answered the phones!) They hire the worst collection agencies in the business, the ones that have been fined repeatedly for violating the regulations. Even if you pay them off, they still harrass you.
I finally had to talk with his bankruptcy attorney about how to get them off his back. The attorney says AmEx is well known for behaving this way.
If you want to establish your own credit, do it with another credit card company!!!
bluedaze -- maybe she had the kind that has to be paid off in full every month. My employee had the kind that works like a "regular" credit card, and he owed sixteen thousand on it. (I know to the penny what he owed, because they told me!)
Sunshyne, I'm surprised because when a person files for bankruptcy, the creditors can NOT collect from the individual - they are legally prevented from doing so! I'm surprised the bankruptcy attorney didn't file a cease and desist order on the collectors!
Yes, Mary, after I talked with his bankruptcy attorney, she started sending pleasant little reminders that such activities are strictly forbidden. One or two of those, and they stopped. (Well, a couple took more than two reminders to get the message.)
Actually, the regs state that creditors cannot hound you if you tell them to stop, whether or not you've filed for bankruptcy. There are very strict rules about when and how they can contact you. Basically, they can only do it in writing, and they have to clearly outline exactly which LEGAL steps they intend to take (take you to court, for example, or repossess a car on which you still owe money.) They can't call at weird hours, they absolutely can NOT call you at work, they are forbidden to talk to neighbors or coworkers.
Once a person has filed for bankruptcy, ALL collection efforts, including repossessing a car or foreclosing on a house, have to stop until the court sorts out what is to be done.
Unfortunately, many creditors will see how much they can get away with until somebody slaps them upside the head.
I finally found the Medicare HIPAA file and I've downloaded it and saved it to my own computer. One more form to get filled out and signed and copied a zillion times. Thank you for mentioning the need to get this. At this point, he can still sign things.
I've already gotten my own Visa card and will be starting what I need to do to get all the automatic payments changed to the new card.
The telephone company had the phone in my father's name even though he had been dead for several years before they put the phone in back in the Bronx. He was the person who applied for a phone in 1940. If my mother had tried to change it she would have been put at the bottom of the list and they had already waited 8 years to get the phone. Don't think any of the crazyness is new, because it isn't.
Let me add some information to all the above regarding the Authorization to disclose personal health information. Please do not file this away somewhere to be attended to at a later time. The time most likely will come when your loved one will no longer be able to speak, therefore unable to give permission by telephone, even if they do not loose their speech they will no longer remember the answers to the questions that Medicare will ask in order to allow you permission to obtain the information. The information you may need could even be in regard to a claim they have not paid. You will not be able to get this if your loved one cannot provide approval unless you have this AUTHORIZATION TO DISCLOSE PERSONAL HEALTH INFORMATION. Medicare will allow this information ONLY if they have you listed on file as the LEGAL REPRESENTATIVE AS DEFINED BY THE STATE. this does not mean a POA, it means that you have been appointed by Social Security as the PAYEE REPRESENTATIVE, or if they have your name listed as authorized by the Authorization form they provide. Social Security does their own appointing of representative they do not honor a POA. So, you either have to have the form on file or they will appoint you, when you have to be appointed without the use of the form then you have to start giving a yearly account of the expenditures of all the Social Security benefits that your loved one recieves.
Get the form and get it now. Make a copy or two or three after it is signed, and let me tell you this, do not be surprised if they loose it because that happend to us. Lucky I had a copy.
As for the Doctor offices, I made a copy from one of the Doctor forms we had signed, I just made it generic and it will cover anything that we may have come up with a Doctor or place that do not know us. We did this while my husband could still sign his name.
It really is a maze. My first thought was transferring a pdf file too.
Here it is:
http://www.medicare.gov/MedicareOnlineForms/ or http://www.medicare.gov/MedicareOnlineForms/PublicForms/CMS10106.pdf for the actual form. You can save a copy to your own computer.
And here is the list of all 209 forms http://www.cms.hhs.gov/CMSForms/CMSForms/list.asp
You can actually fill the form in online and then print it out so it can be signed. If you are using a POA to get permission to talk to them, you need to attach a copy of the POA to the form. The directions are pretty clear and they are in the pdf file.
You might want to check what they define as POA, I am not sure that they accept a regular POA, they assign their own.
I could be wrong and it could have changed. Would not hurt to check this out first. Maybe they now allow your own POA, did not use to though. It use to be POA as defined by their rules. Sure would be simpler if they did allow your own.
Just like disability defined by THEIR RULES. JUST LIKE SOME OF THE BROKERAGE REQUIRE THIER OWN POA.
I always said, why can't things like this all be uniform.
Thanks Starling and Jane. i found the file, -i will see if DH can sign it. if he cant do it then i may hold off as i dont want to have to be appointed yet and have to do all the paper info just yet. thanks!