The information in your medical record is used to monitor your
health, coordinate the care you receive, and ensure that quality
healthcare is being delivered—but that’s just the beginning. It also
travels to many different places both inside and outside the healthcare
system. Your information may be used for research, as a legal document
in cases where evidence of care is needed, and to pay for the care you
receive.
By healthcare providers:
Most healthcare organizations have quality assurance departments.
People in these departments review patient information in order to
monitor and improve the quality of care you receive. Your information
may also be used for research and as a legal document in cases where
evidence of care is needed. For the most part, anyone who wants to use
it for any other purpose needs your permission first.
Hospitals can share information with family members without your
authorization if you are unable to consent and a family member (such as
spouse, parent, or child) is involved in providing your care. For
example, your spouse or child may be involved in caring for you
following a hospital stay (by helping you in and out of bed, to bathe,
changing bandages, and similar activities). You can simplify things at
the time you are admitted to the hospital (or nursing home) by
specifying which family member you want to receive information about
you.
By insurance companies:
After your health information is collected, it is used to bill for the services you received.
Your patient data for billing purposes is usually transmitted
electronically to those paying your bills, such as your insurance
company, although the company may request paper documents in support of
the bill. Your information is often identified by your name, patient
identification number, address, phone number, and social security
number.
Your health insurance company receives your health information
through the claims provided by the patient accounts/billing department
at your healthcare facility. The coded data is then evaluated
automatically to identify appropriate payment for the services you
received. Your insurance company may ask your provider for more
information to validate payment if the claims submitted were not
complete enough to support what was being billed.
