BM accessing DH's dental insurance (that covers our whole family)?

[bloom6372]

Can BM legally access DH's dental insurance? She is NOT an authorized user. Only DH and I are supposed to have access to it. DH has not filled out any paperwork allowing BM access. Our entire family's information is filed under the insurance. Our address was changed to BM's address in the system. I checked our online account, and saw an EOB for SD for a recent appointment (that DH didn't know anything about), so I opened it. It was addressed to DH at BM's address. So, I checked, and DH's address was listed as BM's address for the insurance. ALL paperwork for our family would have been sent there (hopefully they didn't send anything! The last mailing WE got was in February, and it was insurance cards). She does not have access to the online account (it's password protected), but, she could contact them via telephone, email, or USPS. All she'd need is DH's full name, DOB, and his SSN (which is the policy number) to access the account.

DH has contacted the dentist and orthodontist to verify his contact information in SD's file (to prove that they have DH's address as a different address than what the EOB listed, in case BM tries to claim somehow the dentist or orthodontist changed it), and we have the EOB showing her address in case we need to prove it.

We will be password protecting the account for telephone, email, and USPS requests. We will be doing the same for the medical insurance. (There's no reason BM needs to access the insurance. She has all the information needed to use it to file claims, and DH is COed to provide the insurance, and pay any co-pays and uncovered expenses).

Can she legally access HIS account if she's not an authorized user and there's no way to access JUST SD's information (again, the account shows EVERYONE)? If not, what can we do about it?

[Simplydad]

Not unless the court order allows it.  She has rights to information pertaining to the child but must request it if I am not mistake.

I have my kids on my insurance and I have turned off all paper mail. Anything directly related to my insurance is all done on line and I am the only one authorized to make any changes.  My ex has an insurance card in her posession and can use it for the children.  Other than that I do not grant her any access to anything unless she has an absolute need. 

[bloom6372]

Not unless the court order allows it.  She has rights to information pertaining to the child but must request it if I am not mistake.

I have my kids on my insurance and I have turned off all paper mail. Anything directly related to my insurance is all done on line and I am the only one authorized to make any changes.  My ex has an insurance card in her posession and can use it for the children.  Other than that I do not grant her any access to anything unless she has an absolute need. 

I set everything to electronic today. Everything will now be emailed to us and stored online. I'm just worried she may have gotten our SSNs and DOBs for me and our 3 bios...

[Simplydad]

[I set everything to electronic today. Everything will now be emailed to us and stored online. I'm just worried she may have gotten our SSNs and DOBs for me and our 3 bios...

I don't think that information is available through your insurance website. I think HIPAA laws would prevent that. Your (or his) employer keeps that data but I don't recall every seeing my SSN visible on my insurance website. I think DOB may be there but not too sure.

[bloom6372]

So, I just got off the phone with the insurance company a few minutes ago...

They said someone could have called in and given DH's name, SSN, and DOB and then SD's information and could have accessed the account (I had to only give my first name and DH's SSN to talk to her and have her access the account for everyone--how hard would it have been for BM to say my first name and DH's SSN?... GREAT way to prevent someone from getting access....), OR the dentist used BM's address with DH's name. However, the dentist has had DH's address for 2 years, and BM has lived at her current address for 1.5 years. They always send correspondence to the correct address. They said they have no record of ANYONE (including the dentist) giving a different address than what we put in. *sigh* How does that happen?! How do they not have records of changes in information?!

Simplydad--she didn't get into the online account. That's password protected. But she had access to any paperwork mailed to her after the address was changed (and it will include full name, DOB, and sometimes part of the social).

[Kitty C.]

I think you have a case against the dental ins. carrier.  If the contact address the dental ins. has on file was changed to the ex's, ONLY the dental ins. would have done that.  I am assuming she contacted them somehow and convinced them that either she was you or passed herself off as your DH via letter (if it was through USPS).  Either way, the ins. carrier violated HIPAA laws by not verifying the identity of the person requesting the change.

You need to not just change electronic notification statuses, but contact them directly to inform them they've had a HIPAA breach of their own making because if their failure to verify the identity of the person requesting the address change.  You need to contact them immediately and not only find out how this happened, but make sure that no confidential info was sent to the BM.  The possibility of identity theft is high and the dental ins. carrier could be liable for any damages incurred if that were to happen.

[bloom6372]

I think you have a case against the dental ins. carrier.  If the contact address the dental ins. has on file was changed to the ex's, ONLY the dental ins. would have done that.  I am assuming she contacted them somehow and convinced them that either she was you or passed herself off as your DH via letter (if it was through USPS).  Either way, the ins. carrier violated HIPAA laws by not verifying the identity of the person requesting the change.

You need to not just change electronic notification statuses, but contact them directly to inform them they've had a HIPAA breach of their own making because if their failure to verify the identity of the person requesting the address change.  You need to contact them immediately and not only find out how this happened, but make sure that no confidential info was sent to the BM.  The possibility of identity theft is high and the dental ins. carrier could be liable for any damages incurred if that were to happen.

Thank you for the advice! I will see who to contact about the HIPAA stuff. The lady on the phone said they had no record of our address ever being changed at all, which is odd, since DH has himself changed it three times over the last 6 years.

[MixedBag]

Bloom....I ran into this problem with Uncle Sam....and filed a HIPPA complaint and got told that Dad is custodial, so DAD has every right to receive EOBs that IMHO contained "too much information" because it included the family deductible -- which would clue him in on whether someone else in my family was sick -- which is none of his business.  I'd have to dig out the answer I got (boxed away), but I got told that there was no HIPPA violation when Tri-Care sent an EOB directly to the custodial parent (dad).

Delta Dental or United Concordia seemed to be a different animal from TriCare.

BUT.....and this happened all the time, depending WHO at the billing office of the different doctors were inputing the information, sometimes I got the EOB, sometimes it went to Dad.

It didn't matter how much I "corrected the records" at the doctor's and dentists' office.....they seemed to march to the beat of their own drummer.

So....what's important?  That's what you have to decide because you will feel like you're knocking your head against a brick wall.

1.  No access for mom to any ON-LINE stuff.  That's where she would be able to see "family" history beyond the child.  She's entitled to an EOB, but that's it.

2.  You (two) monitor on-line what's going on.  Log in once a month, and print file.

3.  When you see a claim filed, make sure that agency has dad's information on file.

4.  Notify Tri-Care and Delta Dental/United Concordia that the daughter's physical address is THE ONLY different address than yours.  Actually, your care and his care -- since you are overseas -- isn't it all taken care of by base doctor's and dentists?  (Forgot how that work since I was last overseas in 1991, but I didn't even learn about Tri-Care until I got stationed where there was NO military doctor and that was 10years into my career.)

5.  Take a deep breath.....I'm pretty sure that not ONE EOB that concerned me ever got sent to Dad over the years.  Our son?  both places, but nothing on me.

6.  And monitor your credit report -- If she gets your social, date of birth, etc.....that would be another area where she could be vindictive.  By monitoring the claims, you stop her from using "your identity" and getting services.  By monitoring your credit report, you know she didn't do anything there.    And monitor that annual social security statement you should get from them that says what your wages were last year....

[bloom6372]

Bloom....I ran into this problem with Uncle Sam....and filed a HIPPA complaint and got told that Dad is custodial, so DAD has every right to receive EOBs that IMHO contained "too much information" because it included the family deductible -- which would clue him in on whether someone else in my family was sick -- which is none of his business.  I'd have to dig out the answer I got (boxed away), but I got told that there was no HIPPA violation when Tri-Care sent an EOB directly to the custodial parent (dad).

Delta Dental or United Concordia seemed to be a different animal from TriCare.

BUT.....and this happened all the time, depending WHO at the billing office of the different doctors were inputing the information, sometimes I got the EOB, sometimes it went to Dad.

It didn't matter how much I "corrected the records" at the doctor's and dentists' office.....they seemed to march to the beat of their own drummer.

So....what's important?  That's what you have to decide because you will feel like you're knocking your head against a brick wall.

1.  No access for mom to any ON-LINE stuff.  That's where she would be able to see "family" history beyond the child.  She's entitled to an EOB, but that's it.

2.  You (two) monitor on-line what's going on.  Log in once a month, and print file.

3.  When you see a claim filed, make sure that agency has dad's information on file.

4.  Notify Tri-Care and Delta Dental/United Concordia that the daughter's physical address is THE ONLY different address than yours.  Actually, your care and his care -- since you are overseas -- isn't it all taken care of by base doctor's and dentists?  (Forgot how that work since I was last overseas in 1991, but I didn't even learn about Tri-Care until I got stationed where there was NO military doctor and that was 10years into my career.)

5.  Take a deep breath.....I'm pretty sure that not ONE EOB that concerned me ever got sent to Dad over the years.  Our son?  both places, but nothing on me.

6.  And monitor your credit report -- If she gets your social, date of birth, etc.....that would be another area where she could be vindictive.  By monitoring the claims, you stop her from using "your identity" and getting services.  By monitoring your credit report, you know she didn't do anything there.    And monitor that annual social security statement you should get from them that says what your wages were last year....

She doesn't have access to the online stuff--it all requires passwords, and have both DH and my email addresses, so if someone tried to reset it, it'd get sent to our emails. However, it was our entire family's address changed, not just SD's. No one has been seen in the last 2-3 months since I last checked (and this is EXACTLY why I keep an eye on it!), so she wouldn't have gotten any EOBs, but any other paperwork they mailed out (updates to accounts, the copies of all of our cards that I requested and didn't get, etc) would have been mailed to her. They told me that he can request a 3rd Party Flag, so that no matter what address is used, it will be sent to whatever address he requests. So, he will have to call in on Monday to get that set up (he has duty tonight and won't be home to use the Vonage to call). But unless DH can password protect it, it'd be easy for someone to call in using DH or my name and his SSN. The EOBs have his name, rank, and last 4 of his SSN, which is all that is required for me or DH to access anything under his name (insurance, medical records at the hospital, etc), and we'd rather that information not just be randomly about in BM's house (who knows who will have access to it?!).