Personal representatives are people who you have given permission to speak for you when you receive medical services or when you are talking to your health plan. This may be a family member such as your spouse, an adult child, a neighbor or a member of your church or synagogue.
We have all needed help from a family member or a friend at one time or another. This may be a one time event for some special information that someone else understands better than you do. It may be help you want all the time. Or it may be intermittent as in an active family who makes calls for each other and who assist younger and older members of the family with health care and health care information.
HIPAA Needs and Requirements
Under HIPAA you do not need to sign an authorization form for permission to family and friends who assist you with your medical care or payment related to this medical care. Often personal representation can be inferred if you are receiving services in a care setting because your spouse is with you at the doctor's office, or a colleague or friend has taken you to the emergency department.
What about when you are communicating with your health plan on the phone and you want your husband or daughter to do this task? Without a signed authorization form that grants your permission for FEP to talk to your personal representative your husband or daughter when they call will be asked a series of verification questions that you would be asked if you had initiated the call. These verification questions will most likely include your name, your date of birth, your address, your health card number, and possibly several more demographic pieces of information. Do they know your social security number, or your mother's maiden name?
If you are going to ask your personal representative to make calls for you often to FEP you would be better off having a signed authorization form on file with FEP.
You may ask for FEP for their form or you may have a more formal legal document in place. The FEP form permits a family or friend to make enquiries about the payments for your medical case.
Formal Documents
There are several legal documents that you may consider if you need to use a personal representative often or always. These include a health care proxy and a power of attorney. If you have either of these documents already in place you should have copies that you can give to both your doctor and FEP.
Power of Attorney
A power of attorney is a grant of power from you to another person. This is a decision to give up control of certain aspects of your life to another person. This may be permission to help you with your business and financial needs. It may also be permission to make medical decisions for you.The control within a power of attorney may take affect when the document was signed or only upon your disability or incapacity. This is your decision.
A power of attorney is deemed a fiduciary trust at law. This means that your family member or friend must take care of your assets and resources. They have a moral, ethical and legal responsibility to act in your very best interest.
Healthcare Proxy
A health care proxy is also your permission for another person to act on your behalf to make health and medical care decisions for you. A health care proxy can be very specific written instructions to doctors, your family or institutions about your care.You may revoke or re-write a power of attorney or a health proxy at any time.
Remember a personal representative is a family member or a friend who assist you with medical care and payment for that medical care whether it is an informal one-time event or written into formal document.