Hungry, Hungry, HIPAA

I do not generally like to boast nor do I consider myself much of an expert at really anything.  That being said, thanks to living with cancer for going on six years now, I am quite skilled at completing medical forms.  I dare say at this point that there has not been a form, question, interrogatory or superfluous blank that I have not encountered.  But for those out there with mercifully less expertise with such matters, I thought I should highlight a few of the more poignant items I have noticed and related observations. 

Let’s begin at the beginning.  The name.  This seems like a softball – an easy one to get you rolling but approach with caution (particularly if filling out with pen, which is always the only option).  Sometimes the form wants the name of the patient, which would seem rather logical.  Other times, however, the patient’s name is not really important – it is the name of the policy-holder they want, which would seem rather fiscally-focused.  To further confound the patient, other synonyms such as “Subscriber” might be employed so that one has no idea whose name to write down.  But figure it out one must as the next question will be either that person’s birthdate or social security number.  It’s not too bad to forget a loved one’s social, but if the “Subscriber” is your spouse and you cannot recall her or his birthdate the reason for your medical appointment may then be the least of your problems. 

While on the topic of birthdates, one of my favorite series of questions involves such dates.  On many forms, there are two blanks:  The first asks for the patient’s birthdate.  A reasonable question to be sure – age does quite often have some relevance to one’s medical situation.  But then the next blank asks for the same person’s age.  I realize math is not everyone’s strong suit, but if I just put down my birthdate, can’t the person reading the form do the math for herself?  And if that someone is a doctor, and she can’t do that most basic of math, do I really feel comfortable with her figuring out the proper dosing of any Rx based on multiple variables and other more advanced algebraic concepts? 

Before getting to any of the reasons for the visit – and thus the necessity for this battle of the forms in the first place – there are still more routine administrative questions to be addressed.  One such blank is for the patient’s (or “member’s”) insurance account number.  Yet this is despite the fact that the first thing done at every doctor’s office is to make a photocopy of the very card from which one must get this information.  Have these people ever heard of a stapler?  Swingline has several lovely models from which to choose. 

Assuming one can figure out the group number, plan number, whether it’s a PPO, HMO, or some other unintelligible set of random letters, the patient then can get down to some data that he might actually know:  address, phone number, etc.  Of course, a modern form must reflect modern means of contact so it is not adequate to merely provide a phone number – there are blanks to give home, work and mobile – as well as a space that is wholly inadequate for one’s email address.  I am not sure who designs these forms, but unless you were the first subscriber on AOL and have an email address of 1@aol.com, the blanks are impossibly small for all of the alphanumeric characters that need to be squeezed in there.  It’s probably just as well, however, as does anyone really need any more email?  Even if it is from the doctor, do you really want to find out from your Inbox that you contracted HPV?  It’s more of a phone conversation type of matter, I think. 

“Progressing” down the form we start to transition from the merely administrative to items that might actually be relevant to why you are at the doctor’s office in the first place.  But lest we should rush to specifics, we must first answer whether we have, have had or plan on having any medical condition ever known to humankind, many of which one must assume one does not have since this is the first time hearing of such a condition.  Granuloma annulare?  Guillain-Barré Syndrome?  Aarskog Syndrome?  They also want to know about every surgery one has ever had.  Of course, the older one gets the longer the forms should become because indubitably the more crap there is that has happened and thus must be memorialized.  And while I appreciate the urologist wanting to get a full sense of my surgical history, does the exact date on which my tonsils were removed circa 1976 really have much to do with my prostate?  Maybe – when he says “cough” it could impact my pitch. 

At long last, you reach the part of the form that corresponds to the reason for filling it out in the first place:  Your current malady.  I consider this portion of the form really to be just a draft however.  I say this because the doctor will most certainly ask you every single one of the questions – and more – that are listed on this portion of the form, as well she should.  I thus view this as an opportunity to get my story straight and if there are any particularly embarrassing aspects to it now is the chance to rehearse editing those out.   Finally, with hand-cramping as no one ever writes using a pen or pencil anymore much less for the full 15 minutes you have been sitting there (and you know it is 15 minutes because they tell you when you make the appointment to come that much early to fill out these forms) you triumphantly turn to the last page.  The HIPAA form.  No one knows what HIPAA actually stands for much less what it does because that would entail reading the form.  Or maybe not since I have never read it so maybe even then I would not know.  But I just do what we all do:  Sign it, return the clip board, tell the receptionist we did the best we could but we may have to retake the forms when they are offered again in the spring. 

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