The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules was established to protect the privacy of patients. The rule sets a standard set of security and privacy guidelines that all health providers and organizations are supposed to abide by when it comes to protecting your private information. When it comes to reporting medical-related items to the credit bureaus, however, there are some loopholes that allow medical information to appear on your credit report. In addition, some privacy protection rights still exist along the line connecting your medical needs to your credit report.
Many patients and consumers may believe that there is a line that divides medical procedure bills and your credit report. Unfortunately, this is not the case. An unpaid medical bill is treated as any other debt that goes unpaid would be treated. HIPPA protects how your personal medical information is handled, but it does not separate your medical expense responsibilities from your credit.
Medical Bill Reporting
While HIPPA does prohibit certain patient information from being released, it does not protect patients who do not pay their medical bills. If you have a past due or overdue medical bill, the doctor or hospital does have the right to report this to the credit bureaus. When the medical bill is reported to the credit bureaus, the claim can only include your name and address, date of birth, Social Security number, payment history, account number, and the name and address of the health care provider owed the money. The claim to the credit bureaus cannot contain any information as to what you were treated for or any other personal information.
Because an unpaid medical bill is considered a debt collection situation, under HIPPA health care providers can hire a debt collection agency to collect the debt on their behalf. When your medical expense is turned over to a collection agency, the health care provider is also allowed to supply the debt collection agency with some of your personal information. The information that can be disclosed is similar to that turned over to the credit bureaus, which is the minimum amount of information necessary for the debt collector to try to collect the debt.
The Fair Credit Billing Act allows consumers to dispute billing errors that show up on their credit reports with the credit bureaus. This act, however, does not apply to medical bills once the matter has reached the credit bureaus. The Fair Credit Billing Act only applies to credit card bills and other types of revolving credit lines. You can, however, dispute medical bills with the health care provider before it reaches the credit bureaus.
Credit Reports And Credit Scores
You may or may not be aware, but a creditor that is trying to collect a debt from you is allowed to access your credit report and credit score from the credit bureaus. A health care provider attempting to collect a date is not an exception to this rule, even under the HIPPA regulations. By pulling your credit, health care providers or the debt collectors they have hired may be able to glean information that reveals you have the ability to pay outstanding medical expenses. For example, if the credit report shows that you have a home equity line of credit with a zero balance, they can easily see that you have access to the amount of money required to pay them. If you are applying for free medical care or discounted medical rates, a health care provider also has the right to pull your credit report.
- PrivacyRights: Your Health Information and Your Credit Report
- Congressional Research Service. "Consumer Credit Reporting, Credit Bureaus, Credit Scoring, and Related Policy Issues," Page 14. Accessed Oct. 9, 2020.
- Board of the Governors of the Federal Reserve. "Credit Reports and Credit Scores," Page 4. Accessed Oct. 9, 2020.
- Medicaid.gov. "Eligibility: Effective Date of Coverage." Accessed Oct. 9, 2020.
- Consumer Financial Protection Bureau. "What Information Does a Debt Collector Have To Give Me About the Debt?" Accessed Oct. 9, 2020.
- Federal Trade Commission. "Fair Debt Collection Practices Act." Accessed Oct. 9, 2020.
- Federal Trade Commission Consumer Information. "Disputing Errors on Credit Reports." Accessed Oct. 9, 2020.
Kristie Lorette started writing professionally in 1996. She earned her Bachelor of Science degree in marketing and multinational business from Florida State University and a Master of Business Administration from Nova Southeastern University. Her work has appeared online at Bill Savings, Money Smart Life and Mortgage Loan.