STD Toolkit

Patient Confidentiality Fof Medical Providers

Confidentiality concerns can be significant barriers to patients seeking STD-related care. This is particularly true for teens & young adults seeking care without the knowledge of a parent or guardian.

A minor can receive certain services related to STD prevention and control, including STD testing and treatment, or birth control services without parental consent.

For more specific information, see the Michigan laws related to minor consent for care summarized here.

For information on HIPAA, click here

QUICK TIPS

  • Make it policy to have patients fill out a preferred method to be reached for follow-up on lab results.
  • If allowing others to be in the room with the patient, make it policy to have partners/spouses/parents leave the room for part of every exam. Post the Confidentiality Policy Poster in waiting areas and/or provide and discuss the policy handout with adolescent patients and parents.
  • Discuss patient confidentiality during every visit to develop and foster trust.

Billing concerns can be significant barriers for patients seeking STD-related care, especially for teens seeking care without the knowledge of a parent or guardian. The concern may be due to an inability to pay for care, or that insurance notification may be sent home verifying that services were rendered.

Federal HIPAA regulations allow health care providers, including health plans and laboratory providers, to disclose protected health information when they seek payment or make a referral for treatment. The onus is on the patient to request confidentiality and/or notices to be sent to an alternate address. This places an undue burden on teens and other patients who may already be feeling intimidated by the fact that they are seeking treatment or being screened for an STD.

Billing for confidential services is a complex problem, and adolescents seeking services under parental insurance policies are not guaranteed that the nature of the services sought will not be disclosed to parents. In many commercial health plans, an explanation of benefit (EOB) is sent home to the primary insured or the primary beneficiary listing services rendered by the provider and reimbursed by the health plan. An EOB received by the parent documenting that reproductive health services were rendered to their adolescent dependent may disclose confidential services.

BILLING TIPS

  • Make sure staff are familiar with laboratory and third party payer policies and procedures, and which labs and insurers routinely send bills, EOBs, and appointment notices.

    • Call the 3rd party payer and inquire ahead of time or at the time of service regarding policies and procedures (i.e. what is contained within the EOBs).
    • Provide information regarding outsourcing of any lab procedures regarding billing and payment policies.
  • Make optional billing and payment methods available and ensure that patients are offered an opportunity to pay privately if they wish to avoid parental or spousal/partner involvement.

    • Make sure billing statements sent out by the clinic do not document the diagnosis or diagnosis code; use CPT codes instead of text descriptions
    • Make it policy to have patients fill out a preferred method for billing.
  • Make it policy to provide a handout to patients that explains billing options and ask them to choose a preferred approach.

Develop a policy and procedure to refer patients who are afraid to use their insurance and cannot afford private pay to Kalamazoo County HCS STD clinic or a local family planning clinic that could provide State/Title X-funded services confidentially.

By law, healthcare providers and laboratories are required to report specific communicable diseases to the local health department, including some sexually transmitted infections. This is not a violation of HIPAA. See "

For state law, see Michigan law on communicable disease reporting.

The pregnancy of a child less than 12 years of age or the presence of a venereal disease in a child who is over 1 month of age but less than 12 years of age is reasonable cause to suspect child abuse and neglect have occurred, and must be reported as such to the Department of Health and Human Services Child Protective Services.

Suspected abuse or neglect should be reported immediately by calling: 855-444-3911

Michigan Child Protection Law

Michigan Mandated Reporter's Resource Guide