How does the medical assistant handle sending collection to the next of kin for a deceased patient

Does the HIPAA Privacy Rule permit a doctor to discuss a patient’s health status, treatment, or payment arrangements with the patient’s family and friends?

Answer:

Yes. The HIPAA Privacy Rule at 45 CFR 164.510(b) specifically permits covered entities to share information that is directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient’s care or payment for health care. If the patient is present, or is otherwise available prior to the disclosure, and has the capacity to make health care decisions, the covered entity may discuss this information with the family and these other persons if the patient agrees or, when given the opportunity, does not object. The covered entity may also share relevant information with the family and these other persons if it can reasonably infer, based on professional judgment, that the patient does not object. Under these circumstances, for example:

Inhaltsverzeichnis Show

Does the HIPAA Privacy Rule permit a doctor to discuss a patient’s health status, treatment, or payment arrangements with the patient’s family and friends?
What happens first?
Registering the death
Who to inform?
Who Else Should I Inform?
Checking your Benefits
Arranging the Funeral
Other Useful Information
What are the exceptions to the usual billing and collections procedures?
When it is necessary to collect a bill owed by a deceased patient the statement is sent to?
What must be considered when referring an account to a collection agency?
What is the account to which the patient owes money to the office?

A doctor may give information about a patient’s mobility limitations to a friend driving the patient home from the hospital.
A hospital may discuss a patient’s payment options with her adult daughter.
A doctor may instruct a patient’s roommate about proper medicine dosage when she comes to pick up her friend from the hospital.
A physician may discuss a patient’s treatment with the patient in the presence of a friend when the patient brings the friend to a medical appointment and asks if the friend can come into the treatment room.

Even when the patient is not present or it is impracticable because of emergency circumstances or the patient’s incapacity for the covered entity to ask the patient about discussing her care or payment with a family member or other person, a covered entity may share this information with the person when, in exercising professional judgment, it determines that doing so would be in the best interest of the patient. See 45 CFR 164.510(b). Thus, for example:

A surgeon may, if consistent with such professional judgment, inform a patient’s spouse, who accompanied her husband to the emergency room, that the patient has suffered a heart attack and provide periodic updates on the patient’s progress and prognosis.
A doctor may, if consistent with such professional judgment, discuss an incapacitated patient’s condition with a family member over the phone.

In addition, the Privacy Rule expressly permits a covered entity to use professional judgment and experience with common practice to make reasonable inferences about the patient’s best interests in allowing another person to act on behalf of the patient to pick up a filled prescription, medical supplies, X-rays, or other similar forms of protected health information. For example, when a person comes to a pharmacy requesting to pick up a prescription on behalf of an individual he identifies by name, a pharmacist, based on professional judgment and experience with common practice, may allow the person to do so.

Created 11/3/03

Content created by Office for Civil Rights (OCR)
Content last reviewed July 26, 2013

When someone dies there are many practical issues that need to be sorted out.

If you were the person who was closest to the deceased, a lot of the responsibility may fall to you. This can be overwhelming, especially when you are dealing with grief and shock at the same time.

Some people appreciate having lots of practical tasks to do when they’re bereaved, while others find that they just can’t cope in the immediate period after losing a loved one. Ask family and friends for help and don’t try to cope with everything on your own.

This section explains the steps to take following a bereavement.

What happens first?
If the death occurred in hospital or a care home
If the death occurred at home
If the death occurred abroad
Registering the death
Who to Inform?
Who else should I inform?
Checking your Benefits
Arranging the Funeral

Other Useful Information

What happens first?

If the death occurred in hospital or a care home

If the death occurs in hospital, the hospital or care staff will contact the person named by the deceased as the next of kin. They will also arrange for the nearest relative to collect the deceased person’s belongings.

The hospital mortuary will keep the body until the executor (a personal representative of the deceased) makes arrangements for it to be taken away. You may also want to inform the deceased’s minister of religion or see the hospital chaplain.

Before a death can be registered, a doctor will need to issue a medical certificate giving the cause of death.

In hospital, the hospital doctor will give you:

the certificate in a sealed envelope addressed to the Registrar of Births, Deaths and Marriages
a notice explaining how to register the death

If the cause of death is not clear, the coroner will carry out an investigation before issuing a death certificate.

There is no charge to register a death or for the death certificate.

If the person has not been seen by a hospital doctor, their GP may be able to issue a death certificate instead. Where a cremation is planned, a second doctor will be needed to sign a certificate to say that the body has been examined. There will be a charge for this.

If you are aware that the person wished to donate their organs or to donate their body to science following their death it is best inform staff as soon as possible.

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If the death occurred at home

When someone dies at home, the first step is to call the GP. The GP will normally visit the house and if the death was expected, issue a certificate giving the cause of death.

If the person did not have a GP or you do not know the name of the GP, you should call an ambulance instead.

A doctor is not allowed to issue a certificate if they are unsure about the cause of death. The death must instead be reported to a coroner and the body will be taken to a hospital mortuary, where a post mortem may need to take place.

If you are aware that the person wished to donate their organs or to donate their body to science following their death it is best to inform staff as soon as possible.

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If the death occurred abroad

If a death takes place abroad it must be registered according to the law of that country. The death should also be reported to the British Consul, who may be able to arrange for the death to be registered in the UK as well.

Returning a body to the UK is expensive, but the cost may be covered by any travel insurance taken out by the person. If the death was on a package holiday, the tour operator should be able to help with arrangements.

When a body is returned to the UK, the Registrar of Births, Deaths and Marriages for the district where the funeral will take place must be told and will need to issue a certificate before burial can take place. If cremation is planned, the Home Office also needs to give permission.

If you are aware that the person wished to donate their organs or to donate their body to science it is best to inform staff as soon as possible.

Funeral Services Guide offers advice and information on official procedures for dealing with a death.

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Registering the death

The registration of the death is the formal record of the death. It is done by the Registrar of Births, Deaths and Marriages at the Register Office.

See Newcastle City Council Register Office. You will need to contact them first to make an appointment.

When someone dies at home, the death should be registered at the register office in the district where they lived.

If the death took place in hospital or in a care home it must be registered at the register office for the district in which the hospital or care home is situated. The hospital administrator can do this if there are no relatives.

A death should be registered within five days, but the deadline can be extended for another nine days if the registrar is told that a medical certificate has been issued. If a post mortem is being carried out, you can’t register the death until the coroner’s investigations are finished.

It is a criminal offence not to register a death.

The death should be registered in person by one of the following (in order of priority):

a relative who was present at the death
a relative present during the person’s last illness
a relative living in the district where the death took place
anyone else present at the death
an owner or occupier of the building where the death took place and who was aware of the death
the person arranging the funeral (but not the funeral director)

If none of these options are possible, contact the Register Office for advice.

You must take the medical death certificate with you because the death can’t be registered until the registrar has seen this. If possible, you should also take the person’s NHS medical card and birth and marriage certificates.

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The registrar will ask you for the following information:

the date and place of death
the full name of the person and their last address
the person’s date and place of birth
the person’s occupation and, in the case of a woman who was married or widowed, the full name and occupation of her husband
if the person was still married, the date of birth of their husband or wife
whether the person was receiving a pension or other social security benefits

When you have registered the death, the registrar will give you a certificate for you to give to the funeral director or whoever is arranging the funeral. This allows the burial or cremation to go ahead.

The registrar will also give you a form to send to the Department for Work and Pensions (DWP) to allow them to deal with the person’s pension and benefits.

The death certificate is a copy of the entry made by the registrar in the death register. You may need several copies of the certificate as it is needed to deal with money or property left by the person, including dealing with the Will.

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Who to inform?

Following a Bereavement it is important that the affairs of the deceased are all settled. If left unchecked, outstanding bills, benefits and credit cards can add unwelcome pressure and stress during a difficult time.

Tell us Once Service

In the past, a grieving relative may have had to spend hours on the phone, often having to repeat the same information to different departments and organisations. The Tell Us Once service means you only need to tell the government once of the bereavement and you won’t have to send a copy of the death certificate in the post. The service will notify local and central government services of the death on your behalf, including:

HM Revenue and Customs (HMRC) to deal with tax and cancel benefits
Department for Work and Pensions (DWP) to cancel benefits, eg income support
Passport Office to cancel a passport
the local council to cancel housing benefit, council tax benefit, a Blue Badge, inform council housing services and remove the person from the electoral register
the Driver and Vehicle Licensing Agency (DVLA) to cancel the deceased’s driving licence.

Once you have registered the death, the Registrar will tell you about your options for using Tell Us Once. These are:

in person by making an appointment with your local authority bereavement adviser
by phone
online using a unique Tell Us Once log in number

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Who Else Should I Inform?

You should ensure that the following people and agencies are informed of the death, if relevant. If you use the Tell Us Once Service you do not need to inform the agencies marked with an asterisk*:

Relatives and friends
Employer
School
Solicitor/accountant
Landlord or Local Authority if the deceased rented their property
Any private organisation/agency providing home help
General insurance companies such as, contents, car, travel, medical
Pension providers/life insurance companies
Bank/building society
Mortgage provider
Hire purchase or loan companies
Credit card providers/store cards
Utility companies if accounts were in the deceased’s name
TV/Internet companies with which the deceased had subscriptions
Any other company with which the deceased may have had rental, hire purchase or loan agreements
Royal Mail, if mail needs re-directing
The Bereavement Register and
Deceased Preference Service to remove the deceased’s name from mailing lists and databases
Clubs, trade unions and associations with seasonal membership for cancellation and refunds
Church or regular place of worship
Social groups to which the deceased belonged
Dentist
Creditors or anyone to whom the deceased owed money
Debtors or anyone that owed the deceased money
*The deceased’s Tax Office
*National Insurance Contributions Office if they were self-employed to cancel payments
*Child Benefit Office
*UK Passport Agency, to return and cancel a passport
*DVLA, to return a driving licence, cancel car tax, return car registration documents and/or change ownership
*Local Authority if the deceased paid Council Tax, had a parking permit, was issued with a Blue Badge for disabled parking, received social services help, or attended day care

The following documents should be returned, with a note explaining the date of death:

Order books/benefits
Passport
Driving licence
Registration documents for the deceased’s car
Season ticket and membership cards of any clubs or associations as a refund may be due
Benefit/pension books and any unused cheques/vouchers should be returned to the benefits office
Library books and tickets
National Insurance papers

The Money Advice Service has information on how to deal with money matters after someone dies, including what to do with someone’s pension, tax, debts, insurance, benefits and estate.

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Checking your Benefits

The Bereavement Service is a telephone service that lets you:

End a benefit claim for someone who has died
Find out if you are eligible for benefits because your husband, wife or civil partner has died
Make a claim for bereavement benefits or a claim for help with funeral costs, known as a Funeral Payment

Bereavement benefits include the following benefits:

Bereavement Support Payment
Child Benefit if a child or parent dies
Get help with funeral costs (Funeral Expenses Payment)
Guardian’s Allowance
Support for child funeral costs (Children’s Funeral Fund for England)
Statutory Parental Bereavement Pay and Leave
Universal Credit
War Widow(er) Pension
Bereavement Allowance
Widowed Parent’s Allowance

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Arranging the Funeral

There are many different types of funerals to choose from and financial help may be available. You should always consider what the preferences of the deceased person may have been when arranging a funeral.

Arranging a funeral for detailed information on arranging a funeral, costs and memorials.

Funeral Services Guide offers advice and information on official procedures for dealing with a death.

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Other Useful Information

When someone dies: A step-by-step guide to what to do – Age UK guide
Money Advice service – provides information about dealing with money after a death in their ‘When Someone Dies’ advice.
Final Fling – a website dedicated to end of life decisions.
Patient Information Centre has a range of easy to read mental health self help guides available to download for free.

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Last updated: December 16, 2021

What are the exceptions to the usual billing and collections procedures?

There are a number of exceptions to the usual billing and collection procedures..

Use black or blue ink..

Enter the check number if it is not preprinted..

Enter the date..

Identify the payee..

Bring forward the balance from the previous stub..

List any deposits..

Enter the amount of the check being written..

Enter the new balance..

When it is necessary to collect a bill owed by a deceased patient the statement is sent to?

When it is necessary to collect a bill owed by a deceased patient, the statement is sent to the estate of the deceased in care of any known next of kin at the patient's last known address.

What must be considered when referring an account to a collection agency?

What must be considered when referring an account to a collection agency? Medical information must not be included. The patient must be notified. Diagnosis must not be included.