- Associated Press - Monday, June 30, 2014

SIOUX FALLS, S.D. (AP) - Every year, thousands of small claims and civil court cases are filed in South Dakota to collect medical debts.

Many of those cases contain an itemized list of the medical procedures for which a hospital, doctor or clinic is seeking payment, and that list is a public record.

That means that once confidential medical information becomes part of a lawsuit, that information no longer is strictly confidential. The type of procedure, date or dates performed and the treatment - which doctors would be legally liable for releasing to the public under other circumstances - all become public and available for scrutiny once a case goes to collections.

Now, with the advent of electronic filing, that information is available at public terminals in courthouses across the state. By the end of the year, you may access case records online, although the system won’t allow you to search by name only.

Electronic, online case records have made the always-thorny discussion of confidentiality more pressing for court administrators and collections agencies in the state, which have grappled for years with the question of how to protect the patients who haven’t paid.

“It’s a discussion we’ve been having for a long time,” said Karl Thoennes, administrator for the 2nd Judicial Circuit. “I don’t know that people realize how much information there is in these files.”

At least one collection agency in the state has moved to change that.

AAA Collections, a Sioux Falls-based agency that handles cases for Sanford Health, began asking more than a month ago that medical information be sealed in new case filings.

As the state moves nearer to mandatory e-filing of all civil and criminal cases, said AAA general counsel Sara Greff Dannen, the agency wanted to provide an additional layer of protection for private patient data.

“AAA Collections strives to be on the cutting edge of its industry,” Greff Dannen said. “Soon, South Dakota courts will transition to electronic filing. To respond to the electronic accessibility to court records, AAA Collections has updated its practices to add further protections for the benefit of its clients and their customers.”

Collections lawsuits still will have a cover sheet that is publicly accessible, she said, but the itemized list of medical information would be available only to AAA and the person being sued for a judgment.

The change, initiated by AAA but not by any other agency filing in the 2nd Circuit, was accepted willingly by Sanford, said Cindy Morrison, the health system’s vice president of marketing.

“It is our understanding that AAA Collections is changing its processes to meet its industry’s best practices; we are comfortable with those changes and view its efforts in that regard as an enhancement,” Morrison said.

In the Sioux Falls region alone, Sanford Health facilities see 4.2 million patient visits a year. About 189,000 of those go to collections, Morrison said, after a patient gets four billing statements and phone calls asking about a payment plan.

The average age of an account balance before it goes into collections is 150 days overdue.

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