Privacy Contacting Patients and Verification

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2. Introduction • We contact patients for many purposes. This module will provide guidelines for contacting patients about: • Appointment reminders • Scheduling appointments or procedures • Providing patient instructions prior to or after a procedure • Relaying test results • Follow up after visit to Emergency Department or other department • Billing and Collections

3. Guidelines for Contacting Patients • Patient rights must be respected in all conversations with or about patients, including telephone contact, voice mail and answering machine messages.

4. Guidelines for Contacting Patients • Before contacting a patient, make sure the patient does not have an approved request for an alternative method or location for communications, or a restriction on particular disclosures (which should be documented in the medical record).

5. Guidelines for Contacting Patients • You should NOT leave protected health information (PHI) on answering machines, voice mails or with anyone answering other than the patient or their authorized representative.

6. Guidelines for Contacting Patients • Appointment reminders made by telephone must be limited to: • Patient’s Name • Caller’s Name • Location “UNC Health Care” • Date and Time of appointment • A call back number for further questions • Do NOT leave the name of the specific procedure or reason for the visit!

7. Guidelines for Contacting Patients • More information is available in the UNC Health Care Privacy Guidelines, which is located on the UNC Health Care HIPAA Web site.

8. For Example: • Tori is responsible for contacting patients to remind them about their appointments in the Infectious Disease Clinic. She leaves this message on the patient’s answering machine: “Hi, this is Tori calling for John Peterson to remind you about your appointment tomorrow at noon. If you have any questions, please return my call at 966-xxxx.” • Is this message appropriate? Why or why not?

9. For Example: • Yes, this is an appropriate message. Tori did not identify the clinic because of its sensitive nature, but did identify herself, the patient, the appointment time and a callback number.

10. Guidelines for Contacting Patients • For any reason other than appointment reminders, make every effort to speak directly to the patient or leave only call back information. • Test results may NOT be left withanyone other than the patient or their authorized representative. Do NOT leave results on voice mail or an answering machine.

11. Verification of Identity of Requester Prior to the Release of Patient Information • Information will not be released to anyone unless they have a right to the information. Prior to the release of information, reasonable efforts must be made to verify the identity of the person making the request and the person’s right to receive the information. Once verification has been made, follow the appropriate procedures for release of information.

12. Verification of Identity of Requester Prior to the Release of Patient Information • No information should be released if the person making the request does not reference the patient by name. • If the requester is a member of the press, please contact the UNC Health Care Public Affairs and Marketing Department.

13. For Example: • Sam, who works at the information desk, has heard through the grapevine that there is a celebrity currently undergoing cancer treatment here at the hospital. A member of the news media approaches him for information about this person’s condition and treatment. When Sam looks at the patient list, he sees that this person has “opted out” and is not listed. Sam tells the reporter, “yes, that person is here and is currently undergoing treatment for cancer but that’s all I can tell you.” • Did Sam say too much? 

14. For Example: • Yes, Sam said WAY too much! • When he looked at the Patient List and did not see the patient’s name listed, his response should have been, “I’m sorry, but I have no information on that person.” • Knowing that the person inquiring was from the Media, Sam should have referred the person to the Public Affairs and Marketing Department. • The fact that Sam knew that this person was in the hospital is also a problem. If others in the Hospital were not talking about this patient, how would Sam have even known he or she was there? Remember: It is up to each of us to keep patient information confidential.

15. Identification Procedure • In order to identify the person making the request: • obtain the persons name and relationship to the patient. • obtain purpose of request and basis for providing information. • If passwords are not used for identity verification the following methods are suggested: • Obtain the requester’s address, phone number and a photo id/number. • If the employee has any question about the identity of the requester, Hospitals Police may be contacted to run a search on the individual using their drivers’ license. If necessary, the employee can verify with the patient the requester’s right to information, and the employee may call the requester back. • If available, obtain a copy of the document granting authority of the individual as the patient’s representative.

16. Identification Procedure • UNC Health Care has a policy called Verbal Release of Protected Health Information. The policy provides verification procedures for specific types of inquiries, including inquiries from family members, personal representatives, police officers and other officials. Further, the policy describes procedures for setting passwords for family members and friends to obtain PHI.

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