Ownership of Medical Data

by Kathy
(South Carolina)

I have been doing medical billing for a client for about 4 years now and she has recently decided to incorporate with a family practice who is requiring her to shift her billing to their office. They happen to use the same software I own and she is requesting I give them my electronic data. Needless to say we don't have a formal contract, which is bad I know, and I am torn about doing this - for free anyway.


When I first took on her business I spent many hours cleaning up the previous persons mess without additional compensation. Also, a lot of the data I would have to give to them I spent many hours setting up and this data has nothing to do with patient records. I don't think they should be able to use what I created. I have looked at the following web-site:

http://www.hbma.org/uploads/content_files/HBMAFINALwhitepaper(3).pdf

and it sounds as if you can charge for expenses regarding the transfer of electronic data. I would be glad to give them paper copies of patient data, but she already has all those in her files and I would print the A/R reports at no cost. Please let me know what you think. Thank you.

Kathy,

Great question.

Don’t beat yourself up about not having a formal contract.

I’ve been frustrated many times because a provider doesn’t understand the time and effort we put into cleaning up these messes in the patient database and maintaining it so they can get paid.

I think the provider is certainly entitled to the patient data - but I’m not aware of anything that defines what form that data has to be in - paper or electronic - or the enhanced info you added to it.

Like you I wouldn’t hesitate to provide paper copies, but would be hesitant to hand over the electronic files unless you feel you have recouped the investment in time and effort over the course of 4 years - and obviously you don’t feel that way.

Just like a provider expects to be paid for their time and effort, I don’t think it’s wrong to expect payment for your efforts. I would suggest estimating the time you put into cleaning up the mess as well as the enhanced work you did - and multiplying by what you think is a fair hourly rate for your time. I would then suggest using this to propose a fee for providing the electronic data along with the justification (just like you gave above) as to why you would like to be paid.

I think you certainly have a strong case. The challenge I’ve run into is that doctors don’t always appreciate what we do behind the scenes as part of the billing process and don’t necessarily value the effort - or they think the billing service is trying to take advantage of them. Hopefully you still have a good relationship with this doctor and can reach an amicable solution - or at least negotiate.

Since there’s no written agreement to define the hand over of electronic information, it may require some back-and-forth negotiation to get it resolved.

I hope this works out well for you.

Thanks,

Gina

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Mar 30, 2013
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Data ownership
by: Anonymous

I too have a medical billing business and have been billing for the past 12 years. Since you don't have a contract it is not specified who owns the data, but who maintains it? Where is the data stored? Who is responsible for the safety of that data? While the provider owns the patient list, they do NOT own your work product, which is all the hours you put into loading that data into YOUR software. If they supplied you paperwork, your job was to get the claim to insurance company and get it paid, not to "house" their data. (Unless that was pre-agreed). You could have easily have just mailed each and every claim on paper instead of choosing to load them onto a data based software. So I disagree with the prior person who said the physician owns your work product. They charge patients for copies of their charts, you should charge them for copies they request from you. You are entitled to be compensated for your manual labor of entering that data and maintaining it's correctness as well as it's proper storage. The typical cost is 1.00 - 2.00 per name depending on the demographic information they are seeking. Depending on if you got paid per claim or via percentage, the fees they paid you were to get the claims sent to insurance companies and guarantee their processing and follow up, and maybe some reports as well. In the future you may want to clarify this in your contract.

Nov 16, 2011
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Comment from a Billing Company
by: Anonymous

Cathy and Gina--I see your comments and have some of my own. We run a very professional billing company, and have experienced many times, the task of cleaning up a mess when we began. This is just part of the job, and any responsible biller should not complain about this. If this is a problem for you, then don't do medical billing.
About the data. It is so much easier to give the provider the data in electronic form than on paper. Ultimately you have the responsibility to give to the provider all of his/her data, in whatever form you choose. However if it were me, I would do a backup of my billing software for the particular provider, and then give this data backup to the provider. This is faster, more complete, easier, and cheaper than providing the data on paper. Do you really want to print hundreds of pages of information when you can simply provide the data to the provider on a CD or jump drive?
The provider will need to have the same billing software as you do to read the data, but at least the provider has all of the data.

The data belongs to the provider, and there should be no charge for providing this information. If you do not do this, you are running the risk of creating serious legal problems for yourself. You own the software, but the provider owns his/her data, and no billing company has the right to with hold this data, as long as you are paid up for your services, and this does not include a charge for the providing the data. I also agree with Gina when she says, just get it done and move on. Getting into a hassle with the provider is a situation on which you will lose, and the repercussions for you are just not worth it. CT

Nov 10, 2011
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Comment from a Billing Company
by: CT

Cathy and Gina--I see your comments and have some of my own. We run a very professional billing company, and have experienced many times, the task of cleaning up a mess when we began. This is just part of the job, and any responsible biller should not complain about this. If this is a problem for you, then don't do medical billing.
About the data. It is so much easier to give the provider the data in electronic form than on paper. Ultimately you have the responsibility to give to the provider all of his/her data, in whatever form you choose. However if it were me, I would do a backup of my billing software for the particular provider, and then give this data backup to the provider. This is faster, more complete, easier, and cheaper than providing the data on paper. Do you really want to print hundreds of pages of information when you can simply provide the data to the provider on a CD or jump drive?
The provider will need to have the same billing software as you do to read the data, but at least the provider has all of the data.

The data belongs to the provider, and there should be no charge for providing this information. If you do not do this, you are running the risk of creating serious legal problems for yourself. You own the software, but the provider owns his/her data, and no billing company has the right to with hold this data, as long as you are paid up for your services, and this does not include a charge for the providing the data. I also agree with Gina when she says, just get it done and move on. Getting into a hassle with the provider is a situation on which you will lose, and the repercussions for you are just not worth it. CT

Great comments CT - Thanks!

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