Jim, The entity status (CE or BA) of the organization to which you disclose is not the issue here. Your organization, as a CE is allowed to disclose PHI for the purposes of payment (among others) without client authorization (or consent as a health plan).
The definition of payment at 164.501 includes "determinations of eligibility or coverage (including coordination of benefits or the determination of cost sharing amounts) and adjudication or subrogation of health benefit claims." The comments related to payment are also helpful. Note that the minimum necessary rule does apply, so only the amount of information that your org. needs to release to find out an subrogation issues should be released. Leah Hole-Curry Fox Systems, Inc. 602-708-1045 >>> "Jim Moores" <[EMAIL PROTECTED]> 03/27/02 08:42 AM >>> Hi All, Have any of the payers on the list confronted the problem of how health plans getting Disclosure Authorization to subrogate claims with auto/property/casualty/hazard insurance companies... For example, because the auto insurer is not a CE nor a BA how can the Health Plan share PHI with the auto insurer when it is looking for them to subrogate the claim. Getting authorization from the member is going to be hard because they have no motivation to provide it and may actually have a disincentive to do so because they do not want their auto insurance rates to go up. The auto co won't subrogate without the information. Tips on where to go to get guidance or thoughts on the matter would be much appreciated.... Jim Moores - HIPAA Team Leader - Privacy Antares Management Solutions 23700 Commerce Park Road Beachwood, Ohio 44122-5832 [EMAIL PROTECTED] Phone: (216)292-1605 Fax: (216)292-1619 ------------------------------------------------------------------------------ CONFIDENTIALITY NOTICE: This message is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential or exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that you are strictly prohibited from printing, storing, disseminating, distributing or copying this communication. If you have received this communication in error, please notify us immediately by replying to the message and deleting it from your computer. Thank You, Antares Management Solutions. ============================================================================== ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address. ********************************************************************** To be removed from this list, go to: http://snip.wedi.org/unsubscribe.cfm?list=privacy and enter your email address.
