Hipaa Form For Durable Medical: Fill & Download for Free

The short answer is; People lie, cheat and steal.The government has spent a tremendous amount of money pursuing fraud, waste and abuse in the medical industry and a disturbing amount of that money is spent on pursuing false/inaccurate claims.Like the physician who billed for services that were provided to dead people. Or the physician who billed for an extraordinary amount of high dollar laser eye treatments when all he had was a lamp with a light bulb in his office. True stories. You have probably heard of some of the high dollar prosecutions of drug companies and companies that provide durable medical equipment as well.So the rules for submission of claims have become extremely complex in an effort to limit or identify false claims or claims that just don’t make sense.In addition to the complex billing and claim submission rules, HIPAA rules on privacy have added another layer of complexity to every service in healthcare in addition to requiring the use of specific coding systems to submit claims.A claim is only numbers and letters. The format is CPT codes, diagnosis codes, modifiers and ICD-10 hospital procedures codes. These short strings of numbers and letters carry all the information about the medical services received by the patient. These extremely abbreviated codes on a complex claim form can go through over 10,000 edits before a claim is paid. It takes a professional coder and a stack of books (or a good encoding program) to translate this information into human speak. So, it is complex and obscure system. On the other hand, it has kept me employed for about 30 years.

Yes. Some health insurance companies want proof that durable medical equipment (DME) was provided to the patient before paying the claim. This is the payment part of “TPO” which is part of HIPAA. Patient authorization is not required for treatment, payment, or operations under HIPAA.

It is a violation if you were capable of making the decisions at the time but not of HIPAA. The HIPAA violation would be discussing your condition with your husband for him to make an informed decision about your care. He might have made an uninformed decision or stated I don’t want…In my understanding it is allowed for the consent to be given orally especially when it is a spouse.I am not certain I have ever shown doctors my durable Medical Power of Attorney for my dad before they discussed his condition and treatment plans with me. I go with him to his visits and he very much wants me to make the decisions but just not sure if the proper protocol was followed in his case.We have come a long ways from the time that a husband got to choose IF his wife could take birth control (he had to consent in the past).