Pain Management Panel

Updated

I work in a hospital in the Medical Records dept., I release information for many reasons with our patients' signed consent. Please answer my question regarding a Lab test called "Pain Management Panel". It tests patients' blood or urine (not sure which but not important to this question) for many different drugs such as marijuana, cocaine or oxycodone. (It is different from a test called "Drug Screen") This test shows whether or not the patient is taking their prescribed medications. It is usually not accompanied by a signed consent/admission form (as it is just a Lab test), therefore, I do NOT have the signed permission from the patient (the sensitive information clause regarding drug abuse {HIPAA} is on the consent form and the patient normally signs it).
I need to release this Lab test for payment, but not until I can get that signed permission from the patient, so the hospital can be paid. I am told by my manager that it will be okay to release for reimbursement because it is for pain management, the patient is not abusing the medications. I have read that whether or not the patient is positive or negative it is still a sensitive record and needs a signed authorization before releasing it to the insurance company for reimbursement. What is the answer please? Which one of us is right? I think I am right, and I have not released the information without signed authorization from the patient regarding the "Pain Management Panel" drug tests.

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1

I have to be honest and say that I am really not sure. This website and most of the people that use it specialize in information on prescription drugs and medical conditions.

Most don't actually deal with the ins and outs of the paperwork, billing and HIPAA law, since no personal private information is ever gathered. Everything on here is anonymous.

I'd have to guess that your manager probably knows what they're talking about, since it is their job, but if you aren't certain, there should be some kind of procedure code that you can check.

Learn more HIPAA details here.

Were you given a training class in it? Did you receive any reference materials?

I'll try asking someone at my doctor's office and post back if I find out anything.

Does anyone else know?

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2

In response to your comment, I have listened to many live audio seminars, I have gone to many classes, and read books over my 15 year tenure in this position. I have manuals, but they are vague and do not speak to specific instances. I have not released records regarding the Lab test called "Drug Screen" without a patient's signed permission, therefore, I determine that this test called "Pain Management Panel" would be the same, since it tests for sensitive types of drugs in a patient's blood/urine as well. Regarding my manager, I do not think she has much experience regarding Release-of-Information, although she knows all the other parts of how our department and how it runs. It will keep our hospital safe if I just go ahead and ask the patient to sign a release, that way, nobody gets hurt. I will watch this website though in case anyone else may know the answer.

Thank you,
Cherie

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3

Don't know if this is still important to you but this is my job - the patient has signed a release for drug testing and any associated billing of services if he/she is in a pain management program. They have the release - if you are simply saying you have to submit it for billing purposes, you can do that and forward results to the ordering physician/practice under HIPAA guidelines.

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