Information Governance & Standards

Transgender Patients

  • 1.  Transgender Patients

    Posted 07-06-2015 11:40

    We have received a complaint from a patient who wants the facility to list her gender as female not male.  She identifies as female.  Has anyone addressed this situation before?  Did you encounter any issues with the payor when the bill was submitted?  If you have addressed this before, could you please share a policy with me?

    Thank you.
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    Kelly Morgan
    AVP of HIM and Coding
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  • 2.  RE: Transgender Patients

    Posted 07-06-2015 14:13
    Hi Morgan,
    No doubt your policies call for appropriate identification on admission or enrollment (driver's license, official state ID, or Passport. Whatever the ID indicates is what makes the most sense and what most payors adhere to.  
    Dixie Gleason, Consultant




    Sent from my iPhone





  • 3.  RE: Transgender Patients

    Posted 07-07-2015 13:04

    Hi Kelly,

    We had this same situation happen.  We created a policy stating that we go with what the patient's driver's license has as gender.  We then discovered the payor issue.  Our patient had Medicare as a payor source.  Medicare had not yet recognized the gender change.  We notified the patient that due to Medicare being the payor source, that we had to go with the gender they had on record or they may not pay the bill.  The patient wanted us to continue with the gender she identified with and that she would deal with Medicare.  So we had her sign forms relating to the possibility of her stay not being paid by Medicare and kept her as the gender she wanted-which was on her driver's license.

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    Teri Smith
    Health Information Administrator
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  • 4.  RE: Transgender Patients

    Posted 07-12-2015 07:14
    Kelly,

    I have been advised by legal in the past that we are to go by the gender on legal documents  given by the patient.

    Donna Coomes, MBA, RHIA, CHPS, CPHQ, CCS





  • 5.  RE: Transgender Patients

    Posted 07-13-2015 19:00

    Donna,

    I am just curious incase this comes up in the future, even though the patient was willing to sign the release forms they have to still go off of the gender on the legal documents?

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    Kari Weiss
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  • 6.  RE: Transgender Patients

    Posted 03-15-2017 17:19
    Good Afternoon,

    There was a recent article in the March 2017 that is very relevant to this discussion topic. Improved Patient Engagement for LGBT Populations: Addressing Factors Related to Sexual Orientation/Gender Identity for Effective Health Information Management. I encourage everyone who has posted in this discussion board to check out this topic. I applaud AHIMA for writing about a timely and relevant article about an important patient population.

    Warm Regards,

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    Sarah R. Keppen RHIA
    Applications Analyst
    Facilitator Certification Exam Prep Community
    2016 Chair Engage Advisory Committee
    skeppen@regionalhealth.com
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  • 7.  RE: Transgender Patients

    Posted 25 days ago
    ​​Good Afternoon,

    I wanted to provide an update on this topic. The small integrated healthcare system I work has Epic as our integrated EHR. In Epic 2018 there are different ways to identify the patient's preferred name vs. legal name and other aspects of gender identity. Due to the amount of workflows that will need to be identified, we are waiting until after the upgrade to address sexuality and gender identity (SOGI) items that aren't an automatic change. If you are an Epic shop I would look into the changes that were made to identify preferred gender vs. legal gender. To ensure the dignity of the patient, patient facing documents such as the after visit summary and clinician facing documentation should always list the preferred name and gender. Healthcare professionals have an obligation to ensure that all patients are treated with respect and dignity and this includes patients on the gender identity spectrum. Behind the scenes documentation such as billing forms can address the legal forms for business purposes.

    Regards,

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    Sarah R. Keppen RHIA
    Applications Analyst
    Facilitator Certification Exam Prep Community
    2016 Chair Engage Advisory Committee
    skeppen@regionalhealth.com
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