Radiologist Revises Process for Workers Compensation Disclosures
Covered Entity: Health Care Provider
Issue: Impermissible Uses and Disclosures

A radiology practice that interpreted a hospital patient’s imaging tests submitted a worker’s compensation claim to the patient’s employer. The claim included the patient’s test results.  However, the patient was not covered by worker’s compensation and had not identified worker’s compensation as responsible for payment. OCR’s investigation revealed that the radiology practice had relied upon incorrect billing information from the treating hospital in submitting the claim.  Among other corrective actions to resolve the specific issues in the case, the practice apologized to the patient and sanctioned the employee responsible for the incident; trained all billing and coding staff on appropriate insurance claims submission; and revised its policies and procedures to require a specific request from worker’s compensation carriers before submitting test results to them.