General Category > General Questions
Legal Basis for Claiming Ownership of Billing Data?
RichardP:
Over the years, we have lost clients and gained clients. Whether losing or gaining clients, there is always a transfer of data involved - from the old biller to the new biller. We have recently lost a couple of clients to a concierge medicine company. That freed us up to take on a couple of clients who have been wanting us to take them on for a while. So I have been importing data for the incoming clients and exporting data for the departing clients.
Which raised the following question in my mind: is there a legal requirement for the minimum data the old billing company must pass to the new billing company? And, if so, where would such a legal requirement be found in a particular state? I know the standard response can be "check with your local Healthcare Attorney". I'm just wondering if anybody here has had any experience with the legal requirments for the minimum requirement for data transfer.
[edit: Just to be clear, I'm talking about when the billing company is using their own billing software on their own servers. Obviously, if the billing company is dialing into the doctor's own server, this question is moot.]
We usually pass the patient demographics and insurance and work the old balances for four or five months and then pass a total balance owed for each patient to the new billing company. That is what we usually receive from a new client coming to us also - but sometimes we get nothing and the old billing company refuses to give us anything - including patient demographics. So we build our database from scratch as the patients are seen by the doctor. I've often wondered if that refusal to provide data is legal, and now I've remembered to ask about it.
I know that we've discussed here that some of the cloud companies flat out claim that they own all of the data on their servers and that they will not give it to the doctors if asked. I'm guessing that the legal authority for them to do that would be basically the same authority for a billing company to assert ownership of the doctor's data?? Any thoughts?
PMRNC:
As far as I know there is no legal requirement to provide any "data". Remember that the client provides a "copy" of their source documents for you to provide the data, therefore making it "yours" at that point of translation. Make sense? Now nothing says the doctor can't haul you into court and I've seen billing companies go to court with doctor owing them money, doctor says not paying till I get my data.. I've yet to see a billing company be forced to hand over their data (again, key thing to remember that if you are using your PM software you are preserving your source documents and translating that to YOUR data"
Another thing to remember is that your contract should be VERY specific about an exit plan. If you state exactly what the provider will get upon departure that should be that.
Richard, this was actually one of the MAIN reasons I went to a diff business model and use the clients PM system, even if they had none or wanted to switch, they purchase/subscribe and this makes that whole ugly mess of exit go away, they buy, they get to keep :)
RichardP:
Thanks for the response Linda.
--- Quote from: PMRNC on April 02, 2015, 11:27:24 AM ---... your contract should be VERY specific about an exit plan. ...
--- End quote ---
My question was specifically about folks who refuse to provide data to us. We look at billing as a business. Clients come and clients go. Data needs to be transferred in either situation. For the few who have transferred out (usually to a company that is off-shoring the billing), we provide them whatever data they request, assuming it is possible for us to give them what they ask for.
RichardP:
--- Quote from: PMRNC on April 02, 2015, 11:27:24 AM ---... Remember that the client provides a "copy" of their source documents for you to provide the data, therefore making it "yours" at that point of translation. Make sense? ...
--- End quote ---
That statement of yours provided the trigger for the thought that probably provides the answer. Under copyright and patent law, if you are employed and paid for your work, anything you create during that employment legally belongs to your employer. Makes me think that, if you are being paid to do billing, anything you create in that process would belong to the one who paid you.
Works Made for Hire
http://www.copyright.gov/circs/circ09.pdf
If a work is made for hire, an employer is considered the author even if an employee actually created the work. The employer can be a firm, an organization, or an individual. The concept of “work made for hire” can be complicated. This circular refers to its definition in copyright law and draws on the Supreme Court’s interpretation of it in Community for Creative Non-Violence v. Reid, decided in 1989.
If you know of actual cases where the court did not require the biller to turn over their data to their client, then perhaps your definition holds in this situation, rather than the copyright and patent law. Perhaps it can be argued that the biller is not creating something new when he types or scans data from paper into billing software. Not creating new data - just changing its form.
PMRNC:
Richard,
I have been updating our Getting started area and I was looking at this I had from AMA/HBMA from 2007, a bit outdated but MIGHT answer some questions for you.
http://www.hbma.org/uploads/content_files/HBMAFINALwhitepaper%283%29.pdf
Also I've always been curious too about this issue.. as we know in this country anyone can take anyone to court for anything.. so I reached out to an attorney practice I know will be able to shed some light on this. Let you know what I find out. If you read the above .. they both sort of state same thing about the CONTRACT being a vital part.
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