Subscription 790/year or 190/quarter

Doctors sell patient records

Insurance companies pay between NOK 30-40 million annually to doctors to obtain medical records and health information.




(THIS ARTICLE IS MACHINE TRANSLATED by Google from Norwegian)

- We demand that there will be a legal ban on the distribution of patient records. As the situation is today, the doctor is forced to provide health information to the insurance companies because the customers have given the companies a power of attorney, often without knowing exactly what they signed, says president Hans Petter Aarseth of the Norwegian Medical Association.

Both before the insurance contract is entered into and when paying out insurance, the insurance companies actively use health information that they receive from doctors for a fee. Ny Tid has received help from Deputy Chief Stein Kjennvold from Gjensidige NOR Forsikring to quantify the doctors' income in this context to a minimum of between NOK 30 and 40 million annually.

There is not very little insurance companies will know about you if you want to take out personal insurance, whether it is life insurance, surgical insurance or critical illness insurance. Before you can become a customer, you must complete a health declaration in the form of a detailed and comprehensive form, regardless of which company you are applying to.

The moment of truth

If we start with Gjensidige Insurance's form, you will be asked about virtually every imaginable and unthinkable disorder you may have had in the last 10 years, whether they are mental or physical. You will be required to know what institutions and treatment places you have been to, what alcohol habits and drug problems you have had, whether you have been on social security, and even if your parents or siblings have had illnesses.

- We also believe that the insurance companies should not have the opportunity to request family members' health information, Hans Petter Aarseth states.

But if you do not answer the questions in the health declaration forms honestly: If the insurance company takes you into "betrayal", you can lose the entire insurance you have paid premiums on for years.

- The moment of truth comes to light when the customer wants the insurance paid out. Everything is written down in the patient record, says deputy manager Stein Kjennvold in Gjensidige NOR Forsikring.

170 crowns

Two years ago, the Medical Association and the Norwegian Insurance Association entered into an agreement on guidelines for the delivery of patient records to insurance companies during the settlement hour. The agreement also figures out how much the doctor of the potential insurance customer will receive in fees.

Although the requirement for a copy of a complete, unedited patient record is to be limited to the greatest extent possible, the insurance companies' need for such information is acknowledged. In this case, the companies must present specific reasons and specified consent from the patient. The doctor can then send the patient record to the insurance company doctor, who in turn will edit out sensitive and irrelevant information before it is forwarded to the case officer.

- We have a very restrictive view on this. But we know that medical records are sometimes sent unedited, and we think that is reprehensible, says the president of the Norwegian Medical Association.

Regardless, according to the agreement, the patient's, or the potential insurance customer's doctor, receives NOK 170 in fees for the job of sending unedited patient records.

510 crowns

Even more payment awaits if the patient's doctor is the one who edits the medical record. According to the agreement, the main rule is that the insurance companies ask the treating physician to evaluate the contents and relevance of the journal themselves.

If the doctor finds that the record does not contain sensitive information, the journal transcript can be sent directly to the company's case officer. Otherwise, the doctor must edit the patient record before sending it to the insurer's physician.

Regardless of editing or not; The doctor's job is obviously considered more comprehensive in these cases. The agreement between the Norwegian Medical Association and the Norwegian Insurance Association states that the doctor must have paid NOK 510 for this job.

- There are no statistics on how much our industry pays annually to doctors for these services. But in addition to information from the doctors, we also collect around 10.000 specialist statements annually. The specialists receive a high hourly wage, so the fees are significant, Kjennvold believes.

NOK 285-400

However, Gjensidige NOR's deputy chief says that the industry also collects health information before taking out insurance.

When you sign the health declaration form, you have authorized Gjensidige or other companies to obtain additional confidential information from your doctor, from practitioners and institutions you have been in contact with, and from the Social Security Office.

This authorization, or declaration of consent, is at the bottom of Gjensidige's form.

- If, for example, a potential customer has checked in the health declaration form that the person in question was admitted to Ullevål a few years ago due to hepatitis, we can contact the hospital and ask them to tell us why the person got hepatitis, Kjennvold explains.

The fee for this type of information is NOK 285. If the insurance company wants more detailed information about the patient's current illness, the fee increases to NOK 400. Both fees are listed on the Medical Association's website on the Internet.

large Consumer

- I also do not have exact figures on how many inquiries the insurance industry makes to doctors during the processing of the customer's insurance application. But annually the number is between 40-50.000 inquiries, of which around 80 percent is paid at the fee rate of 285 kroner, says Kjennvold.

It should indicate that the insurance industry pays over NOK 15 million annually to doctors as a thank you for health information before the insurance contracts are signed. According to Kjennvold, the fees of doctors and specialists for patient records and declarations in connection with the payment of insurance constitute even more in kroner and ears.

The total amount that doctors receive annually to serve the insurance companies' information needs is thus at least somewhere between NOK 30 and 40 million.

- Our industry is a large consumer of health information, says the deputy head of Gjensidige NOR Forsikring straight out.

The weak party

Because the patient has abrogated the doctor's duty of confidentiality by signing a declaration of consent, the doctors cannot refuse to provide relevant health information, parishes the Medical Association president.

Aarseth is very critical of whether potential insurance customers know what they are signing.

- I often think people are "unconscious" when they sign the health declaration. The insurance applicant is the weak party in this context, they are trapped in the companies' power, he says, and adds that there is also a need for increased awareness of these issues among the members of the Norwegian Medical Association.

- It is impossible for us to know what is going on in every doctor's office. The association's regulations for ethics are good, but we cannot rule out that there are doctors who have a different ethics, says Aarseth.

The President is now very pleased that there is a bill amending the issue of medical records.

- According to the bill, access to medical records will only be granted in very special cases, and then only after approval by a special commission, says Aarseth, and refers to the Ministry of Social Affairs and Health's NOU report number 23 from last year, which is out to hearing now.

- I think there is a growing understanding among politicians that we must protect patients in our information technology age, the Medical Association's president concludes.

Contrary to the Act on Play?

In connection with a traffic accident, a general practitioner was asked by an insurance company to send the medical record and other health information to his patient.

However, the doctor refused because he considered it a breach of the duty of confidentiality. At the same time he asked for a new request from the company's chief physician.

The company admitted that they had no permanent doctor. But they continued to leverage the handing over of the patient record, possibly in an edited version, citing the recently signed agreement between the Medical Association and the Norwegian Insurance Association.

In the fourth request to the doctor, the insurance company asked the doctor on what basis he withheld the record, and indicated that his patient had given the company authority to obtain this type of information at the time he took out insurance.

At this time, the physician raised the matter in the Medical Association's Council on Medical Ethics for a principled assessment. The council responded to the doctor by referring to the agreement signed with the Norwegian Insurance Association, which provides guidelines for when and how doctors can submit complete or edited records.

The doctor was still not happy. One last time he returned to the case with the following issue: Is it not in violation of the provisions of the Medical Act when it is assumed that edited journal transcripts should be sent directly to the company's caseworker and not to the company's consultant physician?

The Council on Medical Ethics closed the case with a statement beginning with the following:

“The insurance companies' need for documentation of medical information in certain types of cases is obvious. Some insurance agreements between a company and a policyholder will also not be able to be entered into without the policyholder agreeing that relevant medical information can be obtained from the company for assessment of a possible insurance case. ”

The council concluded that it could not see that there was anything in the way of the company's caseworker being able to handle the policyholder's medical information, but finally gave a pat on the doctor's shoulder because he "in this case has tried to safeguard the policyholder's (patient) interest interesse" .

You may also like