7 Steps to Take When You Have a HIPAA Complaint

We’ve gotten a few calls about this issue. This is a continuation of our blog from 2 weeks ago. What do you do when a client/patient contacts you about improper use of their PHI and thinks they have a HIPAA Complaint?

The 7 Steps

1. Communication is key. You need to listen closely to what the client/patient is saying, what the issue is, and what kind of resolution they are looking for. Many times, listening can solve most of your problems, and will keep this client from filing a formal complaint with HHS.
2. Document this issue. Regardless of whether the person files a complaint with HHS, it’s important that you document what the issue was, when it occurred, and what information the client felt was released or used improperly. If you determine there was a breach, this information needs to be filed with HHS within 60 days of the end of the calendar year.
3. Remember: Breaches of over 500 clients information needs to be reported to HHS within 30 days of discovery, or from when you should have known there was a breach. They also need to be reported to prominent local media outlets, and posted on your website.
4. Fix the problem. This is easier said than done sometimes. Once information has been released, it’s hard, if not impossible to have it unreleased. One example we’ve seen lately is bills being sent to the wrong family member. Update your records to reflect that you’ve identified the problem and made the necessary changes. In this case, you have a breach since the wrong person has seen PHI. You would need to document this, notate how you’ve mitigated the problem, and file with HHS at the end of the year.
5. Many providers choose to give clients who have had their information breached free credit monitoring for a year to help mitigate any issues they might come up against.
6. If you do find there was an issue, you should audit the rest of your records to make sure this is a one-time incident and not the proverbial canary in the coal mine.
7. This client/patient may still use your services after the report. By law, you are NOT allowed to retaliate in any way. This may be uncomfortable for you and people in your agency/practice, but the reality is they might be doing you a favor by pointing out an error! You should be professional, and courteous with these people, and put any personal feelings behind you. If this does become a major issue, you can suggest that the client/patient might be more comfortable with another provider, but you cannot force them to make this change.

Let us know if you have any questions or comments on how to respond.

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