Let’s say that Eleanor Rigby struggles to make sense of all her doctor bills and explanation of benefits from the insurance company. Something about those bills is not making sense and since she has no friends or relatives nearby, she asks her priest, Father McKenzie, to call her insurance company to help her make sense of her insurance claims. Unfortunately, Father McKenzie is stymied as the insurance company refuses to give him any information due to HIPAA confidentiality provisions.
Whether it’s a claim or billing issue or any other problem, such scenarios occur on a daily basis. HIPAA regulations prohibit insurance companies from discussing any detail of your policy or claim with others—even a spouse will be denied the most basic information in trying to resolve a problem. Several solutions exist to remedy this problem.
Consent for Release of Protected Health Information (PHI): Request this form to authorize your insurance company to disclose your protected information to a relative or close friend. By signing this form you authorize the insurance carrier to release information to whomever you designate so they can support you with activities such as making insurance plan decisions, handling claim issues, or managing medications.
While this form (or one with a similar name depending on the carrier) allows someone else to communicate with your insurance carrier in order to obtain information, it generally, does not allow someone to make changes to your policy, or even to report a change of address.
Be aware that while some authorizations can last as long as your policy is in force, most carriers state that the authorization is only good for one to two years. That means you’ll need to remember to submit a new authorization every year or two. If you are having trouble obtaining this form, call our office if you don’t have your own agent to call and we’ll be happy to help you.
Want a permanent solution? A durable power of attorney may be the way to go.
Durable Power of Attorney: What if an accident, illness, or the effects of aging leave you unable to manage your medical and financial affairs? Your trusted representative will need at least two documents: A financial power of attorney (POA) allows a person to handle your financial affairs, while a medical POA allows your loved one to make medical decisions for you, such as what medical care is provided and what health insurance policy to purchase. It’s important to note that a “financial POA” will not work for purchasing a health insurance policy–you must have a “medical POA”.
Equally important is understanding that a regular POA becomes void upon one’s mental incapacity, whereas a “durable” POA stays in effect even in you become mentally incapacitated.
While it’s best for an attorney to draft the proper documents, you can save money by purchasing one online. Just make sure it’s a Colorado form as details are state specific.
While we like to plan and be self-sufficient and independent, at some point we’ll all need to get by with a little help from our friends.