For what reasons might a hospital send a certified letter?

December 7, 2015 4:16 PM

A friend is freaking out because she got a notification in her mailbox that she has a certified letter from the hospital at the post office. She was there six months ago for a procedure.

The post office is closed now, and friend suffers from severe health anxiety. She is worried that the hospital might have "found something" in her results that was overlooked before. She had a colposcopy there to check for cancer after a pap smear came back abnormal.

How likely is this? And if this letter is not about overlooked results, what else might they be sending her a certified letter for?

posted by Serene Empress Dork to Health & Fitness (23 answers total)

Did they have her phone number? A hospital would not have sent a letter with cancer results if they could contact her otherwise.
posted by roomthreeseventeen at 4:19 PM on December 7, 2015 [3 favorites]

My immediate guess would be some kind of data breach requiring notification under HIPPA, rather than anything directly health-related.
posted by Itaxpica at 4:19 PM on December 7, 2015 [22 favorites]

Is it possible she was enrolled in any kind of study related to her procedure? It could be a follow up survey.
posted by telegraph at 4:20 PM on December 7, 2015

Yeah, this seems much more likely to be an administrative thing, like a money thing, or "there's a lawsuit against a doctor and we're required to inform you" or "we're sending out a required survey and our quality control/licensing protocols require it to be sent certified mail".
posted by LobsterMitten at 4:21 PM on December 7, 2015 [4 favorites]

Every time I've ever received bad medical news it's been in the form of a phone call and follow up appointment. This could be hospital records, some kind of billing, or as Itaxpica suggests some kind of legal notice.

I wouldn't personally expect there to be any new personal health information in there.
posted by phunniemee at 4:22 PM on December 7, 2015 [3 favorites]

Yes, ask her re: the possibility of an overdue bill. I usually associate certified mail with something financial or legal, rather than test results.
(P.S., I'm the health-anxious type too, so I empathize. And I hate coming home to any annoying letter I can't call about til next day.)
posted by NorthernLite at 4:24 PM on December 7, 2015 [5 favorites]

I'd guess it's about a bill that somehow never reached her, and now is being re-sent more securely.

(Let us know later how this turns out, if you can.)
posted by JimN2TAW at 4:25 PM on December 7, 2015

This is almost certainly something like "you owe us money" or "we've had a data breach." This is almost certainly not anything clinical.

If she's in crisis over the uncertainty, she could call the physician who performed the procedure (or that person's coverage).
posted by mattbcoset at 4:27 PM on December 7, 2015 [2 favorites]

When I had bad medical test results once, I had a doctor track me down at work, despite me only giving my place of employment, and not my office number. He just called my employer's switchboard, and got transferred to me. (It later turned out to be nothing)

I think this is, like others said above, either legal or administrative. Maybe financial, but in my experience with that, they just shunt off the bulls to Collections if they're not paid/arrangements made in a few months time.
posted by spinifex23 at 4:28 PM on December 7, 2015 [1 favorite]

This exact thing happened to me and it was just notification of my normal pap smear. For god's sake. It's clear they do it that way just because they want proof that they've informed you of it, but it's so, so infuriating and scary.
posted by BlahLaLa at 4:28 PM on December 7, 2015 [3 favorites]

Response by poster: Hmmm, hadn't thought about it being HIPPA related. Hopefully that's it. She said she hasn't received any bills from them.
posted by Serene Empress Dork at 4:36 PM on December 7, 2015

I had to go to the post office to pick up a certified letter that turned out to be a nag to get a test done. It's a cover-their-ass thing.
posted by sageleaf at 4:53 PM on December 7, 2015

My boyfriend received a certified letter from a hospital saying that, because he hadn't a paid a bill, he was no longer allowed to be a patient in the practice. It turned out to be a misunderstanding that was eventually resolved.
posted by girlmightlive at 4:56 PM on December 7, 2015

Most likely is bill. Second most likely is administrative fuck up (HIPPA violation mentioned above). Probably least likely: anything directly related to medical procedure she received.
posted by latkes at 5:24 PM on December 7, 2015 [1 favorite]

Your friend was there for a colpo six months ago and hasn't been back since? This is vanishingly unlikely to be anything clinical. Absolutely no one at that hospital is going back through six-month-old tissue samples; in fact your friend's biopsy fragments were almost certainly disposed of many months ago. I also think this is probably a HIPAA-related information security thing.
posted by jesourie at 6:56 PM on December 7, 2015 [2 favorites]

from the hospital -- probably administrative crap.

if it came from her provider-- as a provider, and ironically, as a colposcopist, I do send a lot of certified letters. The most likely reason I'd send someone a certified letter a few months out would be notifying them of a need for routine follow-up, and their phone number we have on file doesn't work. This is more common than you might think. Those kind of follow-up and plan of care type of letters I always send certified. Occasionally I send "i will now explain in this absurdly long letter why you refusing this recommended treatment is really not good, and i'm sending this certified in case of legal problems from when your arm falls off", but most always it's "hey I've tried to call you like 12 times to remind you of your routine follow-up".
posted by circle_b at 8:28 PM on December 7, 2015 [5 favorites]

I don't think a hospital would randomly retest results after six months to find something they might have missed. This sounds like anxiety talking.
posted by sweetkid at 8:34 PM on December 7, 2015

In my experience it's straight-up difficult to convince a provider to actually mail you anything that might be useful in a medical sense - they want to give you that stuff in person or send it to another medical provider. The only mail I've gotten from a hospital is:

- You owe us money send us a check yesterday
- You have an upcoming appointment please actually show up
- Crap we let your data into the wild please don't sue us
- Your doctor doesn't work for us anymore please pick a new one
- Give us a donation, BTW here is a shiny cancer center we built check it out there's yoga

It has never been certified; the main reason to send something certified is so you have proof you really sent it. This is why certified letters often involve issues that relate to federal laws - debt collection, patient privacy, etc. Lawyers like evidence, especially if they might end up facing a federal agency trying to explain themselves.

BTW I've actually had my personal information released accidentally like eight times and no one sent me anything certified. Conversely, I've sent lots of HR letters certified at my job - "you have to come to a hearing," "come back to work or we're going to fire you," and "FYI we fired you at the hearing you never came to" are the typical messages. Using certified mail is a little bit of an "in your face" sort of move.
posted by SMPA at 8:55 PM on December 7, 2015 [3 favorites]

I received a certified letter recently informing me that I had missed a scheduled follow-up mammogram. Echoing the comment above -- my health care provider was creating a paper trail to cover themselves.
posted by Majorita at 9:43 PM on December 7, 2015

Didn't receive a bill? My hospital sent me to collections on something despite only billing me at my long out of date address (like 5 years old). It was super-infuriating because they acknowledge that I'd updated my address in their records; I just hadn't updated it with "billing services" or whatever department was billing me. ("How many departments do I have to individually notify of my new address?" "It's your responsibility to pay your bill." "I didn't know I *had* a bill!")

This all makes me think that if there's a chance this procedure resulted in a bill and she hasn't seen one yet, then this could well be someone finally figuring out how to bill her.
posted by salvia at 12:54 AM on December 8, 2015 [1 favorite]

My first thought was that it's probably a bill, though I agree that some kind of reminder or HIPAA related notification seems possible. Nthing that it is vanishingly unlikely to be news related to her medical condition.
posted by insectosaurus at 9:43 AM on December 8, 2015

I agree with those who say it's probably some kind of HIPAA (not HIPPA!) issue.
posted by Dolley at 1:17 PM on December 8, 2015

Response by poster: It turned out to be a reminder that she was supposed to schedule a follow-up colposcopy. But she and her doctor had already discussed it and he said she didn't need one at this point.

Thanks to all for helping me ease her mind.
posted by Serene Empress Dork at 3:11 PM on December 8, 2015