[Nolunl]

I work in a chiropractic office. While treating a patient for a workers comp injury, the insurance adjuster for the patient came and "pretended" to get treatment for an injury. She would make appts around the same time as the patient being treated under the workers comp company she worked for. All the while, the adjuster kept asking all of the office and medical staff pointed questions about the patient, such as whether we thought the patient was truly injured or just "faking". When no one would give her any information, she would state things like "I think she's a big liar". We all would just shrug our shoulders, roll our eyes and not say anything. The insurance adjuster never received any medical or personal information from our office about the patient, however, she called and told the patient that she talked to several people in our office (which she named to the patient) and that we had said she was "faking" her injuries. Now the patient says she wants to sue our office for violation of HIPAA rules. I don't know how I can prove that nothing was ever said to the insurance adjuster from anyone in our office. Is there somewhere to report this insurance adjuster? Isn't there some law to protect our office from someone like her saying that we stated things about patients when we really didn't? HELP!

[nanajo1]

You can report the adjuter to the head office of the particular insurance co. #1. No 2 you can notify the insurance regulation board about the illegal behavior. I am sure that if your chiropractuer were to give the patient written proof that they were not faking and that the adjuster had falsified the information, their case would be reexamined. Yes there are laws in place to protect your office from someone stating that you gave away confidential info or made false statements. Your office and the patient can both sue the insurance co, the adjuster personally and also have them slapped with slander and defamation charges

[Fr_Chuck]

First you can't "prove" you did not do something,

This person will have to prove you did. Merely tell this person, that nothing was done, and to see if the adjuster will put these statements in writing that this information was received.

Also as noted, report the adjuster to the insurance company and to the state insurance commissioner. ( it may not have been an adjuster but a investigator hired by them)

Also explain that she and the doctors office needs to file a law suit against the investigator and insurance company.