Commission for Case Manager Certification (CCMC) Exam 2026 – 400 Free Practice Questions to Pass the Exam

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What can a patient do if they pay out of pocket for a service under HIPAA regulations?

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Instruct the provider not to share information with insurance

When a patient pays out of pocket for a service, they have specific rights under HIPAA regulations concerning their healthcare information. One of these rights includes the ability to instruct healthcare providers not to share any information related to the service with their insurance company. This is primarily because if a patient decides to pay for a service entirely out of pocket, they may wish to avoid having that information disclosed to the insurance provider for privacy reasons, such as keeping their treatment private or protecting their insurance premiums from potential increases.

By explicitly instructing the provider not to share this information, the patient is exercising their rights with regard to the confidentiality of their health information under HIPAA. This leads to a more controlled and private handling of their personal health data. The rationale behind allowing this action is to empower patients to manage their healthcare information more effectively, especially in cases where privacy is a priority.

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