HIPAA Compliance
HIPAA Compliance

Is It a HIPAA Violation to Send to Collections?

May 28, 2025

Sending a patient's account to collections is a tricky subject, especially when you're dealing with HIPAA compliance. You might be wondering if this action could lead to a violation of patient privacy rights. This is a common concern for healthcare providers, as safeguarding patient information is a top priority. Let's break down what you need to know about handling collections while staying on the right side of HIPAA.

What Is HIPAA All About?

Before we get into the nitty-gritty of collections, it's important to have a basic understanding of HIPAA. The Health Insurance Portability and Accountability Act, commonly known as HIPAA, is a federal law that sets the standard for protecting sensitive patient information. It requires that healthcare providers, insurers, and their business associates ensure the confidentiality, integrity, and security of protected health information (PHI).

PHI includes any information that can be used to identify a patient, such as medical records, insurance information, and even names and addresses. The goal of HIPAA is to prevent unauthorized access to this information, which could lead to privacy breaches and potential harm to patients.

Can You Send Patient Accounts to Collections?

It's understandable that healthcare providers sometimes need to rely on collections to recover unpaid bills. Running a medical practice is a business, after all, and unpaid accounts can impact your bottom line. However, when it comes to sending accounts to collections, HIPAA compliance must remain a top priority.

Here's the good news: Sending patient accounts to collections is not inherently a HIPAA violation. However, you must follow certain guidelines to ensure you're handling PHI appropriately. When you share information with a collections agency, that agency becomes your business associate under HIPAA. This means they must also comply with HIPAA regulations and ensure the protection of PHI.

The Importance of Business Associate Agreements

A Business Associate Agreement (BAA) is a crucial document that outlines the responsibilities of the collections agency regarding PHI. This agreement ensures that the agency understands its obligations to protect patient information and comply with HIPAA regulations.

When drafting a BAA with a collections agency, make sure it includes:

  • Details about how the agency will use and protect PHI.
  • Requirements for reporting any breaches of PHI.
  • The agency's obligation to return or destroy PHI when no longer needed.
  • Provisions for ensuring any subcontractors also comply with HIPAA.

Having a BAA in place not only helps protect patient information but also shields your practice from potential legal repercussions if the collections agency mishandles PHI.

Minimizing PHI Disclosure During Collections

Even with a BAA in place, it's important to minimize the amount of PHI you share with a collections agency. Only provide the information necessary for the agency to do its job. Typically, this includes:

  • The patient's name and contact information.
  • The amount owed and the date of service.
  • Account numbers or billing identifiers.

Avoid sharing detailed medical information or anything not directly related to billing. By limiting the PHI you disclose, you reduce the risk of a privacy breach.

Communicating with Patients About Collections

Transparency is key when it comes to patient accounts going to collections. Patients should be informed about the potential for their account to be sent to collections if payment is not received. This communication is not only a courtesy but can also prevent misunderstandings and disputes down the line.

Here are some tips for communicating with patients about collections:

  • Include information about your collections policy in the patient intake paperwork.
  • Send reminder notices before the account is sent to collections.
  • Provide clear instructions on how to resolve outstanding balances.
  • Offer payment plans or financial counseling to help patients manage their bills.

Effective communication can go a long way in maintaining a positive relationship with your patients, even when financial issues arise.

Balancing Patient Care and Financial Responsibilities

As healthcare providers, we all want to prioritize patient care above everything else. However, financial sustainability is also important to keep your practice running smoothly. Balancing these responsibilities can be challenging, but it’s not impossible.

One way to alleviate some of this burden is to use tools like Feather, which helps automate administrative tasks, including billing processes. By streamlining these tasks, you can focus more on patient care and less on the financial aspects of running a practice.

Understanding Patients' Rights in the Collections Process

Patients have rights when it comes to how their debts are handled. The Fair Debt Collection Practices Act (FDCPA) is a federal law that governs the practices of debt collectors. It’s important to be aware of these rights to ensure that both you and the collections agency are acting ethically and legally.

Some key points of the FDCPA include:

  • Debt collectors cannot use abusive or deceptive practices.
  • They must respect patients' privacy and cannot disclose debt information to unauthorized parties.
  • Patients have the right to dispute the debt and request verification.

Understanding these rights can help you choose a reputable collections agency and ensure that your patients are treated fairly throughout the process.

Addressing Concerns About Privacy Breaches

Privacy breaches are a serious concern in the healthcare industry, and sending accounts to collections can increase the risk of unauthorized access to PHI. While having a BAA and limiting PHI disclosure are important steps, it’s also essential to have a plan in place for responding to potential breaches.

Here are some steps to consider:

  • Conduct regular audits of your collections process to identify potential vulnerabilities.
  • Train staff on HIPAA compliance and the importance of protecting PHI.
  • Establish a clear protocol for responding to breaches, including notifying affected patients and reporting to the appropriate authorities.

By being proactive and prepared, you can minimize the impact of a privacy breach and maintain your patients' trust.

Using Technology to Enhance Collections and Compliance

Technology can be a powerful ally in managing collections while ensuring HIPAA compliance. Tools like Feather offer AI-driven solutions that automate billing processes, reducing the risk of human error and increasing efficiency.

With Feather, you can:

  • Automate the generation of billing summaries and prior authorization letters.
  • Securely store and manage sensitive documents in a HIPAA-compliant environment.
  • Use AI to extract and summarize key information from documents.

These features not only help you stay compliant but also free up time to focus on what truly matters: providing quality care to your patients.

Final Thoughts

Sending patient accounts to collections doesn't have to mean a HIPAA violation. By understanding patient rights, using technology like Feather, and ensuring thorough compliance with HIPAA through business associate agreements, you can manage collections efficiently and securely. Feather’s HIPAA-compliant AI can help you eliminate busywork and be more productive, all while safeguarding patient data.

Feather is a team of healthcare professionals, engineers, and AI researchers with over a decade of experience building secure, privacy-first products. With deep knowledge of HIPAA, data compliance, and clinical workflows, the team is focused on helping healthcare providers use AI safely and effectively to reduce admin burden and improve patient outcomes.

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