Patient confidentiality is a cornerstone of health care. But, how do insurance companies protect patient confidentiality in communications with policy holders and members, particularly when it comes to sensitive health care services?
Insurance companies often use an Explanation of Benefits (EOB) to communicate with policy holders to explain payments for health care services. But, what what if the person receiving services is not the primary policy holder? The EOB will go to the primary policy holder, who might be a spouse or parent. As a result, those who are not primary policy holders may forgo much needed and confidential services out of fear that this information might get back to their parent or spouse. For example, young adults still covered under a parent’s insurance policy may forgo reproductive or sexual health services in order to avoid disclosure of these services to their parents.
The potential for EOBs to compromise confidentiality is not new. However, now is an opportune time to make sure peole feel safe using their coverage. More New Yorkers than ever are gaining coverage through the new options under the Affordable Care Act. And, sensitive services, like behavioral health services, are increasingly becoming part of benefit packages, including managed care.
Explore this issue further with a new issue brief from HCFANY steering committee members Schuyler Center for Analysis and Advocacy. Schuyler Center is currently working with Raising Women’s Voices (also a HCFANY steering committee member), Family Planning Advocates of NY, New York Civil Liberties Union, Department of Financial Services, and other stakeholders to identify solutions to assure patient-doctor confidentiality is protected beyond the doctor’s office.
Read SCAA’s New Issue Brief – Confidentiality and Insurance: Making Sure People Feel Safe Using Their Insurance