Do you ever wonder about the forms you sign when you visit your doctor in the new year or while visiting a new practice? I want to provide a quick reference overview of the forms you sign and what they mean.
What is the patient registration form?
- Purpose – gathers information to identify you as their patient.It is used for processing claims with your health insurance company. This form may also include the policies of the practice for submitting to your insurance company and collection for non-covered services.
What is the assignment of benefits?
- Purpose – an authorization form that allows your insurance carrier to pay the health care provider directly for the services provided to you.
What is the confirmation of Receipt of Privacy Notice? (HIPAA)
- Purpose – provides a clear explanation of the health care provider’s privacy practices and how your Personal Health Care Information (PHI) will be used.
What is the release of information form?
- Purpose – To allow for the release of medical records. You will find a section where you will be allowed to designate who the medical information may be released to.
What is the informed consent form?
- Purpose – this is usually signed when a procedure is to be performed.The form consists of your diagnosis (if known), the purpose of the treatment/procedure, alternative treatments/procedures, and the associated risks and benefits as well as the risk and benefits of not receiving the treatment/procedure. As the patient, you have the option to withdraw the consent form for the procedure at any time.
There may be other forms you are asked to sign, depending on the specialty or choice of the provider group. These may include:
- Non-discrimination notice – states that the group complies with applicable Federal civil rights laws and does not discriminate based on race, color, national origin, age, disability, or gender.
- Prescription History Consent – gives access to the use of prescription medication history from other health care providers or third-party pharmacy for treatment purposes.
- Patient communication – allows for your care to be discussed with additional providers or caregivers. This also covers the way that the practice may communicate with you, such as email, voicemail, and text appointment reminders as a few examples.
- Record release or request to disclose health information – used to obtain medical records from another provider group often used when transferring to a new provider group.
- Financial policy agreement – an overview of how the provider group, collects patient cost share, services not covered, and no-show costs. This may also be included in the patient registration form.
What if I don’t sign a document?
It depends on the form. Let’s say you refuse to sign the financial policy. The policy serves as a notice to you about how payments are processed and possible liability for say uncovered services or co-insurance. Its purpose is to make sure all parties are informed of the polices. Should you refuse to sign, it is at the discretion of the provider group to determine the next steps on the refusal to sign the form.
If you refuse to sign the HIPAA notice, this is acceptable as it is not required by law. The provider group will need to have a record of your refusal to sign. For more details reference: HHS.Gov: HIPAA Notice of Privacy Practices
Forms are usually provided in the following ways:
- Downloadable so you can print, review and sign ahead of time.
- You may be asked to access the patient portal on the provider’s website, where you may view electronic versions and e-sign prior to your appointment. The signature is on a secure site, and the data is captured and easily accessible by office staff.
- You may be given a tablet and asked to view and e-sign the forms while in the patient waiting area. These are also secure, and the provider’s office will sync the documents up, so the forms are easily accessible by staff.
This is a general overview of forms that I hope to provide a level of knowledge and comfort. Please keep in mind practices may have additional forms, or they may be combined or formatted differently. Don’t be afraid to ask questions or consult your attorney for review if you have concerns.