How is Your Health Information Used

The information in your medical record is used to monitor your health, coordinate the care you receive, and ensure that quality healthcare is being delivered—but that’s just the beginning. It also travels to many different places both inside and outside the healthcare system. Your information may be used for research, as a legal document in cases where evidence of care is needed, and to pay for the care you receive.

By healthcare providers:
Most healthcare organizations have quality assurance departments. People in these departments review patient information in order to monitor and improve the quality of care you receive. Your information may also be used for research and as a legal document in cases where evidence of care is needed. For the most part, anyone who wants to use it for any other purpose needs your permission first.
Hospitals can share information with family members without your authorization if you are unable to consent and a family member (such as spouse, parent, or child) is involved in providing your care. For example, your spouse or child may be involved in caring for you following a hospital stay (by helping you in and out of bed, to bathe, changing bandages, and similar activities). You can simplify things at the time you are admitted to the hospital (or nursing home) by specifying which family member you want to receive information about you.
By insurance companies:
After your health information is collected, it is used to bill for the services you received.
Your patient data for billing purposes is usually transmitted electronically to those paying your bills, such as your insurance company, although the company may request paper documents in support of the bill. Your information is often identified by your name, patient identification number, address, phone number, and social security number.
Your health insurance company receives your health information through the claims provided by the patient accounts/billing department at your healthcare facility. The coded data is then evaluated automatically to identify appropriate payment for the services you received. Your insurance company may ask your provider for more information to validate payment if the claims submitted were not complete enough to support what was being billed.