Private health insurers access patients' full medical records in 'aggressive' audits
Australian private health insurers are facing criticism for 'aggressive' audit practices that involve requesting full clinical histories from patients. Hospitals and providers argue this oversteps privacy boundaries, while insurers maintain it is necessary to verify legitimate claims.
Why it matters
The conflict highlights the tension between data-driven cost control in healthcare and patient privacy rights.
Private health insurers can access clinical records during audits. ( ABC News: Maren Preuss )
Health insurers are entitled to ask a medical practitioner for a patient's notes to ensure the correct procedure item numbers have been billed.
However, hospitals and allied health providers are raising concerns about insurers asking providers for their patients' full clinical history.
The private health insurance industry says it has a responsibility to ensure claims are legitimate, and payment audits ae part of that.
Link copied Share Share article Private health insurers are accessing patients' confidential medical information, with some coming under fire for what has been described by the Australian Private Hospitals Association as "aggressive" audit practices.
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