I just received a call from a young woman who could barely form a sentence. I wasn't even able to understand what she had said for her name and had to go off of the demographic information that popped up in my system, which was one of the accounts I service. I asked her what was wrong and I was able to make out "I'm on some drugs and I cannot urinate". I asked if they were prescribed medications she reaponded "no".

I work on a dedicated team specific to one employer group, so I did at least know that she was in the right place and saw her plan was active. I tried to verify her DOB but she was all over the place and honestly I was caught off guard. I told her she needed to call 911 but she just mumbled okay and then hung up.

I've lost family to OD's and I wasn't confident she'd actually call (or was able to call) 911. So I did. My phone system wouldn't allow me to dial it so I auxed out of ready and called from my cell. I gave them her information and asked them to do a welfare check. They took my info down and said they'd send an ambulance. As soon as they hung up I went back and listened to the call. I realized that it was the DAUGHTER on the plan and I'd given them mom's info since that's what populated when the call came in (I know, I'm a dumbass). It took 10 minutes for 911 to even transfer me to the right department, so I wasn't confident that I'd reached them in time to correct that information anyway. This is where I'm a little worried I might have stepped over the line. I didn't know what else to do so I called mom using the phone number we had on file for her. Thankfully, the daughter was still living at home so I did send the ambulance to the right place. I quoted her ER benefit which includes ambulance but she declined that and chose to drive her to the ER herself. She thanked me profusely so she's not tripping about it.

See also  CIGNA out-of-network claim negotiation, Data iSight?

Other industry reps, do you think I'll get in trouble for this legally/with my job? I have already emailed my supervisor (I'm an honest guy) but now I'm really worried I'll be fucked because to be honest I was more focused on getting that kid to the ER than verifying and adhering to HIPAA. I'd do it again in a heartbeat anyway, but what do y'all think?

submitted by /u/mrpickle123
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