Thursday Troubleshooter: How to legally handle 18-year-old dental patients

QUESTION: Is it legal to have 18-year-old patients update their medical history, HIPAA, and insurance information, even though their parents have signed to be financially responsible?

ANSWER FROM LINDA HARVEY, RDH, MS, LHRM, Compliance/Risk Management Specialist:
Turning 18 is one of life’s milestones. It marks the age in which one can legally vote, as well as join the military, without parental consent. It also marks the legal age of majority in almost all 50 states.

With that in mind, how does that impact the consent process in your practice? First, it’s important to know whether 18 is the legal age of majority in your state. Our research yielded only two states in which the legal age was 19: Alabama and Nebraska. Be sure to check the legal age in your state for accuracy.

If you practice in a state where 18 is the legal age, it’s a good risk management practice to have patients update their medical history, HIPAA forms, and insurance information when they reach the age of majority. If a parent has accompanied the patient to the appointment, the patient may choose to have the parent help complete the information.

Incidentally, it’s also a good risk management practice to have all patients, not just young adults, indicate who you can speak to about their care and finances. Consider scenarios when a young patient may be away at college and the parent needs to call to make appointment or handle the finances. Also consider the fact that not all patients want their spouses to know about their dental care. This can easily be captured on the HIPAA Acknowledgement of Notice of Privacy Practices form. Doing so may prevent future headaches.

And again, be sure to check the legal the age of majority for your state or province.

ANSWER FROM LESLIE CANHAM, Leslie Canham and Associates:
Yes, the 18-year-old can update his or her own medical health, health form, insurance, and more. Keep in mind that even if the parents are the responsible party for payment, you must still get permission from the 18-year-old before discussing treatment information with the parents.

ANSWER FROM MARY GOVONI,Mary Govoni and Associates:
Eighteen-year-olds are considered to be adults as they have reached what is referred to as the “age of majority.” This means that they can marry, join the military, obtain credit cards, and sign contracts. If a new patient is 18 or older, or when an existing patient turns 18, they need to complete their own HIPAA acknowledgement form, and information regarding their health care is restricted unless they give a health-care provider written permission to discuss their treatment and financial arrangements with their parent(s) or guardian(s). They can now legally complete their own registration forms, including health history and financial information.

ANSWER FROM DEBI CARR,DK Carr and Associates:
It would be appropriate to ask an 18-year-old to complete a HIPAA form as well as update his or her health history etc., even though the parents are still the responsible party. This is the same as asking a wife to complete the forms even though her husband is the responsible party.

As a legal adult, the 18-year-old now has the right to authorize or prohibit information from being given to his or her parents. I encourage dental practices to implement a policy that requires that patients reaching the age of maturity be required to complete all practice forms.

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Do YOU have a tough issue in your dental office that you would like addressed?


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