HNS Policies 

Continued participation in the HNS Network requires the consistent compliance to all HNS Policies, and the policies of health care plans contracted with HNS. 

 

  1. With the exception of certain requests for restrictions of disclosure of health care information (see information below), HNS providers are contractually required to file claims through HNS for ALL covered services provided.

     

  2. HNS providers may not reduce or discount fees for any covered services provided, at any time, regardless of whether a patient has requested a restriction of disclosure of their health care information and/or signed an ENTF form. (Exception:  financial hardship provided evidence of it is consistent with HNS Policies regarding financial hardship)

     

    While the NC BOCE allows providers to discount fees for "CASH" patients by up to 30%, signing an ENTF form does not make the patient a "CASH" patient.

     

  3. Because fees for covered services may not be discounted or reduced, for non-PI patients, there is NO financial benefit to the patient for restricting disclosure of their health care information (i.e. requesting claims not be filed to health care plan), or for signing an ENTF form.

     

  4. HNS providers shall not provide any information, whether orally or written, which may (or does) suggest a financial benefit to a non-PI patient as a result of signing an ENTF form, and/or which otherwise results in the provider's failure to file claims to HNS for covered services provided.

     

    To provide any information, whether orally or written, which may (or does) suggest a financial benefit to a non-PI patient as a result of signing an ENTF form is providing false and misleading information to the patient, and is a misrepresentation of the facts.

     

    ENTF forms are ONLY to be discussed or used
    IF and WHEN
    a patient initiates a conversation
    regarding the restriction of disclosure of their
    health care information.

     

  5. If, pursuant to above, a patient initiates a conversation regarding restriction of disclosure of their health care information, and should choose to do so, providers must comply with this request. However, such requests may ONLY be honored if the patient has first signed the applicable HNS Election Not to File form. (The appropriate HNS ENTF form must always be used.)

     

  6. A copy of the signed ENTF form must be provided to the patient, and the original, fully executed form must be maintained as part of the patient's health care record.

     

  7. Because the HNS ENTF forms include facts the member needs in order to make an informed decision regarding whether to file claims to his/her health care plan, only the HNS Election Not to File forms may be used. No other form is acceptable, and with the exception of the provider's name/practice name, no alterations to the forms may be made. 

 

Failure to comply with these policies will result in the immediate termination of participation in the HNS Network, and "committing deception or misrepresentation" may result in action against your NC license by the NC Board of Chiropractic Examiners.

  • Violation - Terms of the HNS Participation Agreement
    To provide any information, whether orally or written, which may (or does) suggest a financial benefit to a non-PI patient as a result of signing an ENTF form, and which may impact a patient's decision regarding signing an ENTF form, and which results in the provider not filing claims to HNS, is a violation of HNS Policies and the terms of the HNS Participation Agreement, and will result in the termination of your participation in the HNS Network.

     

  • Violation of NC GS 90-154
    (Grounds for Professional Discipline by NC BOCE)
    Because you cannot discount or reduce fees for covered services, there is NO financial benefit to a non-PI patient as a result of signing the ENTF form. To suggest otherwise may be a violation of NC GS 90-154 (b) (9) ("Committing or attempting to commit fraud, deception, or misrepresentation").

 

ENTF Forms

The two HNS ENTF forms can be found under the tab "HNS Forms".

 

HITECH Act - History

The HITECH Act provides that, with few exceptions, a patient has the right to restrict disclosure of their health care information, including but not limited to, requests not to file claims to their insurance plan. Per the HITECH Act, provided the patient pays in full at the time of service, the provider must comply with such requests.

 

In response to the requirements of the HITECH Act, physicians from the NC BOCE, the NCCA, and members of HNS Management worked together to create the HNS ENTF forms. Anticipating that PI patients might want to restrict disclosure of their health care information, the initial ENTF form was created to provide a simple way for these patients to exercise their right not to file claims, while protecting the provider, relative to his/her contractual obligation to file claims for all covered services.

 

Subsequently, HNS realized that on those few occasions when a patient may want to restrict disclosure of their health care information (i.e. they don't want their employers, family members, etc. to be aware of their health care conditions), a 2nd ENTF form was needed, and the ENTF (Non-Personal Injury) form was created.

 

Both forms were reviewed and approved by HNS contracted health care plans as appropriate evidence that 1) the patient had requested the restriction of their health care information, and 2) the patient had been provided all necessary information to make an informed decision.