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Scenario 9c

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Submitted By babydracula
Words 554
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The situation described in Scenario 9C is one that I am sure it is very difficult to be in. Beth is in a terrible position because if her boss is starting to waver on whether or not he wants her to send the information to the MCO then she may start to feel like her job is in jeopardy if she doesn't do it. The thing that she has to do is find a way to make the MCO happy and still maintain patient privacy and not put herself as well as the hospital at risk. The big ethical issue in this scenario is that the MCO wants her to photocopy the entire medical record of the patient and do not have an authorization form. Legally, you are not supposed to send things to anyone that the patient does not authorize. I am actually a little shocked that the CEO is even entertaining the idea of having her send it anyway since it would put the entire hospital at risk if it became a problem with the patient should they ever find out. I agree with Beth's decision to refuse the request of the MCO. Putting her job and reputation at risk just because someone wants to get cranky and yell at her over the phone would be a bad idea. Not to mention that the entire hospital would suffer over this decision and not just herself. Also, insurance companies as well as hospital's and HIM professionals are required to follow HIPAA laws, so they should know better than to send a request like this without a signed authorization form from the patient. I think that the best way for Beth to protect patient privacy as well as protecting the hospital would be to send an authorization form to the MCO or maybe even directly to the patient. Have the patient sign the authorization form and then send the MCO what they are asking for. If I were Beth, I would discuss this problem with the Director of the HIM department in which I worked. Let them know what is going on and see if they have any advice

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