Claire Dawson
Calling a hospital can be a daunting task, especially if you are unsure of the information you are allowed to obtain over the phone. Hospitals can disclose certain information over the phone, such as directory information, which includes the patient's name, location within the hospital, religious affiliation, and general condition. However, there are restrictions on what can be disclosed, especially regarding a patient's medical history. This introduction will explore the topic of calling a hospital for information, including privacy rules, authorization, and emergency situations, to provide a comprehensive understanding of the process and your rights.
| Characteristics | Values |
|---|---|
| When to call a hospital | When you are not comfortable with a medical situation |
| What to do when calling a hospital | Call 911, your local emergency number, or your family healthcare provider |
| What information hospitals can give over the phone | Directory information, including the patient's name, location, religious affiliation, and general condition. Treatment plans, drugs, and therapies can also be discussed with a caregiver. |
| Patient authorizations | Patients can authorize the disclosure of PHI to friends or family members, but they also have the right to revoke this authorization at any time. |
| Restrictions on information disclosure | Hospitals cannot provide information about a patient's past medical history if it is unrelated to the current medical condition. |
| Phone systems used by hospitals | Public Switched Telephone Network (PSTN) or Voice over Internet Protocol (VoIP) |
| Compliance with HIPAA | Hospitals must ensure they comply with HIPAA when providing information over the phone. |
| Patient privacy rights | Patients have the right to restrict disclosures and control who information is shared with. |
| Complaints about medical care | Contact the Joint Commission or Medicare.gov to file a complaint or compare hospital performance. |
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What You'll Learn
Patient privacy rights
Patients are often concerned about their privacy rights when calling a hospital for information. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) provides patients with certain privacy rights regarding their health information. The HIPAA Privacy Rule, a federal law, gives patients rights over their health information and sets rules and limits on who can access and receive this information.
Under the HIPAA Privacy Rule, patients have the right to decide whether to give permission for their health information to be used or shared for specific purposes, such as marketing. Patients can restrict some or all disclosures and control who their information is shared with. They also have the right to authorize disclosures beyond those permitted by the Privacy Rule to individuals who enquire about their health. For example, there is nothing in the Privacy Rule that prevents a patient from disclosing health information to friends or family members over the phone, although patients also have the right to revoke this authorization at any time.
Covered entities, such as health insurers and providers, must put in place safeguards to protect patient health information and ensure it is not used or disclosed improperly. They must reasonably limit the use and disclosure of information to the minimum necessary and have procedures in place to limit who can access it. Covered entities must also implement training programs for employees on how to protect patient health information.
In terms of what information hospitals can provide over the phone, this depends on various factors, including the purpose of the call, the recipient of the information, and any restrictions or authorizations in place. Hospitals can disclose directory information, such as the patient's name, location within the facility, religious affiliation, and general condition. They can also discuss treatment plans, drugs, and therapies with a caregiver over the phone. However, hospitals cannot provide information about a patient's past medical history if it is unrelated to their current medical condition. Additionally, hospitals must be mindful of the phone system they are using, as different requirements apply for Public Switched Telephone Networks (PSTN) and Voice over Internet Protocol (VoIP) systems.
If patients believe their privacy rights have been violated, they have the right to complain to the covered entity and the Department of Health and Human Services (HHS). Covered entities must provide a point of contact for further information and complaints regarding privacy practices.
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Directory information
When calling a hospital, it is important to be aware that the information you receive may vary depending on the purpose of your call, the recipient of the information, and any restrictions or authorizations in place. Here is some key directory information that hospitals can typically provide over the phone:
Patient Directory Information:
- Name of the Patient: Hospitals can typically disclose the name of a patient to individuals who enquire about them by name.
- Patient Location: The hospital staff should be able to provide information about the patient's location within the healthcare facility.
- Religious Affiliation: They may also share the patient's religious affiliation.
- Patient Condition: Hospitals can generally describe the patient's condition in broad terms without communicating specific medical details. They cannot provide information about a patient's past medical history unless it is directly related to their current condition.
Contact Information:
- Phone Numbers: Hospitals typically have multiple departments and extensions, so it is important to ask for the specific department or individual you wish to reach.
- Email and Website: Many hospitals also provide email addresses and websites for different departments, allowing for written enquiries and the sharing of non-urgent information.
Additional Information:
- Treatment Plans: Hospitals can usually discuss treatment plans, drugs, and therapies with authorised caregivers over the phone.
- Billing and Insurance: If you have questions about billing or insurance, you can contact the hospital's billing department or your insurance provider directly.
- Complaints and Feedback: Information about filing complaints or providing feedback on your experience can also be obtained. This includes details about the relevant departments and any official bodies that handle patient rights and safety.
It is important to note that hospitals must comply with privacy laws, such as HIPAA in the United States, and patients have the right to restrict disclosures of their information. Therefore, the amount of information shared may vary depending on the patient's preferences and authorizations.
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Restrictions and authorisations
When calling a hospital for information, it is important to be aware of the restrictions and authorisations that apply to the disclosure of patient information. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) governs the use and release of patient information, and hospitals must comply with its privacy standards.
HIPAA's Privacy Rule sets out the restrictions and authorisations for disclosing protected health information (PHI). Hospitals can disclose PHI over the phone for treatment, payment, and healthcare operations (TPO). However, the amount of PHI disclosed depends on the purpose of the call. For example, there are no limitations on the information provided to a healthcare provider for patient treatment. However, if the call is to request authorisation for treatment from a health plan, only the minimum necessary information can be disclosed.
Patients have the right to restrict disclosures of their PHI and control who it is shared with. They can also authorise disclosures beyond those permitted by the Privacy Rule to individuals enquiring about their health. Hospitals must respect these patient rights and obtain consent before releasing PHI. In some cases, hospitals may require identity verification for individuals enquiring about a patient's condition, even though this is not required by HIPAA.
HIPAA permits hospitals to share information relevant to the involvement of a patient's family, friends, or caregivers in their care or payment for healthcare. This includes notifying them of the patient's location, general condition, or death. However, hospitals should ensure that the patient has not restricted the disclosure of this information and that they have the capacity to make healthcare decisions.
Additionally, hospitals must have a Business Associate Agreement in place with the software vendor when using a Voice over Internet Protocol (VoIP) system before disclosing PHI. This requirement does not apply to Public Switched Telephone Network (PSTN) phone services. Hospitals using VoIP without such an agreement are not allowed to disclose PHI over the phone.
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Complaints about poor care
When calling a hospital, the information you can receive depends on the purpose of the call, the recipient, and any restrictions or authorizations in place. Hospitals are generally allowed to disclose directory information, such as the patient's name, location in the facility, religious affiliation, and general condition. However, they must comply with patient privacy rights and any restrictions the patient has placed on information disclosure.
If you have a complaint about poor care, the first step is to bring your concerns to the relevant doctor or nurse as soon as possible. Be specific about your complaint and ask how it can be resolved. You can also request to speak with a hospital social worker, who can help address your issues and identify resources. If you have concerns about being discharged too early, the social worker can act as a discharge planner and take your concerns to the deciding doctor.
If you are not satisfied with the response from the care provider, you can contact the Parliamentary and Health Service Ombudsman for further guidance. Additionally, your state may have a Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) that handles complaints about the quality of care provided by Medicare providers. You can submit a complaint to your BFCC-QIO for issues such as incorrect medication, wrong treatment, or premature discharge. Their contact number is 1-800-MEDICARE (1-800-633-4227), and TTY users can call 1-877-468-2048.
You can also refer to Medicare.gov to find survey ratings and compare hospital performance against national averages for patient experiences, timely care, and more. Additionally, you can contact your state's medical society or licensing board for instructions on filing a complaint. Remember, as a consumer of medical services, you have the right to make your voice heard and ensure your concerns are addressed.
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Emergency situations
In an emergency situation, it is important to remain calm and act quickly. Here are some steps to follow if you need to call a hospital for urgent assistance:
- Assess the situation: Determine if the emergency requires immediate medical attention. If someone is experiencing symptoms such as chest pain, shortness of breath, a fast heartbeat, severe bleeding, broken bones, seizures, stroke symptoms, or any other life-threatening condition, immediate action is necessary.
- Call for help: Dial the emergency number for your country or region, such as 911 in the United States. Clearly explain the situation and provide as much detail as possible about the patient's symptoms, location, and any relevant medical history.
- Follow instructions: The emergency operator will provide instructions and guidance specific to your situation. They may dispatch an ambulance or provide you with instructions for immediate first aid or life-saving measures until professional help arrives.
- Provide emergency contact information: If you are calling on behalf of someone else, be prepared to provide their emergency contact information to the hospital. This can include the name and contact details of the patient's partner, family member, or next of kin. Having this information readily available can help the hospital reach out to the patient's emergency contacts if needed.
- Act promptly: Time is often critical in emergency situations. If you are instructed to go to the hospital, do so immediately. Drive safely but efficiently, and continue to monitor the patient's condition during transit. If the patient's condition worsens or changes significantly, update the hospital staff as soon as you arrive.
Remember, it is always better to err on the side of caution when it comes to health. Trust your instincts and don't hesitate to call for emergency assistance if you feel a situation is dangerous or life-threatening.
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Frequently asked questions
Hospitals can disclose directory information such as the patient's name, location in the healthcare facility, religious affiliation, and general condition. They can also discuss treatment plans, drugs, and therapies with a caregiver. However, they cannot provide information about a patient's past medical history if it is unrelated to the current medical condition. The amount of information disclosed also depends on the purpose of the call and any restrictions or authorizations in place.
Yes, patients can authorize the disclosure of PHI (Protected Health Information) to friends or family members over the phone. However, patients also have the right to revoke this authorization at any time.
First, ask your doctor or the hospital's billing department to explain the charges. Then, find out how the hospital handles complaints about billing and make your case. You may also have the right to dispute your bill or file an appeal, depending on your insurance provider.
You can file a complaint with the Joint Commission, which certifies the safety and security practices of many U.S. hospitals and investigates complaints about patients' rights. You can also visit Medicare.gov to find survey ratings and compare the hospital's performance against national averages.
If you're not comfortable with a medical situation, it's important to call for help right away. Call 911 or your local emergency number, go to your nearest emergency room, or call your family healthcare provider. Acting fast may prevent a serious emergency and could save a life.
