The patient with human immunodeficiency virus (HIV) wishes his diagnosis to remain confidential. The patient’s insurance company calls to ask questions about the diagnosis prior to releasing payment for his medical treatment. Which response by the nurse is appropriate?

Provide the information needed to the insurance company for them to authorize payment. The Health Insurance Portability and Accountability Act (HIPAA) states that personal health information (PHI) may be disclosed for health payment purposes without the express written consent of the patient unless the patient has expressly requested restrictions in writing on how the hospital discloses his/her PHI. The nurse does not categorically refuse to give information to the insurance company nor does the nurse require that the insurance company obtain this information in person. Express written consent is not required to release the patient’s PHI to his insurance company for the purposes of payment.

The patient with human immunodeficiency virus (HIV) wishes his di...

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Management of Care
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Category: Management of Care
Difficulty: 3

Topics: Communication & Documentation Health Care Ethics, Law, and Policy Health Care Quality Infection

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