Adolescent Confidentiality and Impact of Billing for Services Provided

Teens are entitled to obtain certain services without the permission of, or any disclosure to, their parents or guardians, specifically in the case of reproductive health; outpatient mental health care; and outpatient chemical dependency services. Most adolescents are covered under a parent/guardian’s insurance plans, which typically generate a detailed “Explanation of Benefits” (EOB) for services provided. An EOB often discloses services provided, which can violate a teen’s confidentiality.

Some providers address this issue through approaches including but not limited to masking codes and/or simply not billing insurance incurring a financial loss. This can create a financial and or administrative hardship for providers. The Office of Insurance Commissioner has proposed rules to suppress generating EOBs for confidential services, but insurers have objected, arguing instead that teens can simply call the insurer on a case-by-case basis. This has not been seen as a viable solution. The Washington Chapter of the American Academy of Pediatrics would like to hear your voice on this issue. Can you please add your voice to this issue by completing this brief survey?