Handling Requests via Healthcare Proxy or Power of Attorney: Not Difficult – but Pay Attention

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Nilda Tamburello RHIA, Vice President of Release Of Information

Nilda Tamburello RHIA, Vice President of Release Of Information

Both methodologies are the assignment of authority in healthcare decision making to another individual, in the event that the patient becomes incapacitated. Note that in both cases, for these instruments to go into effect, the patient must be incapacitated.

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Tip: Incapacitated patient proof must come from the physician and must be in writing.

In both cases, once the patient is deceased, they are no longer valid. Also, the person making the decisions must be at least 18 years old, and provide an ID to verify that they are in fact the person with the decision making authority. Usually there is a copy of an ID (license) with a picture, attached to the documentation.

Health Care Proxy

A proxy can obtain a patient’s PHI if they have the documentation, signed and witnessed by two adults. Health care proxies are permitted in 49 states and the District of Columbia. The document should include:

  • Name and address of agent / and of an alternative agent
  • Duration of proxy
  • Any special instructions
  • Two adult witnesses
  • Name, date and signature of the “patient” / person
  • The agent and primary proxy cannot act as witnesses. It requires two additional adults.

Power of Attorney

A power of attorney (POA) is written authorization to represent or act on behalf of another individual in some type of financial or legal matter. Be careful, as POA’s are no longer valid if a person becomes incapacitated UNLESS – it is a durable power of attorney. So, check to be sure it is a durable POA.

Tip: Read the express language of the documentation for scope and then follow what is authorized.

If it says “authorized to make healthcare decisions”, that implies the right to access health records, so that decisions made can be informed decisions.

State Rules

Lastly, be aware of state specific rules regarding both of these instruments. POA in some states requires a notary public to endorse the document. Some states require two witnesses or a single notary. Having a notary involved is considered a best practice in that, if a third party challenges the POA it has an increased likelihood to withstand that challenge if it is notarized.

Tip: If you should have any doubt on how to handle HCP or POA’s please consult the Hospital’s HIM Director or Legal Counsel.

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