[Legal aspects of health insurance claims and their potential use as a data source for epidemiological research].

Abstract

Health insurance claims are legal documents for the purpose of billing health care cost and not intended for medical certification. They contain valuable public health data as well as sensitive personal information which must be kept confidential. Conflicts arise between the public interest and the privacy protection when public health researchers attempt to perform studies using health insurance claims. This article examines the legal aspects of health insurance claims and proposes legitimate procedures and forms for using claims data in public health research: researchers should act as "contractors" to perform survey under the auspices of insurers instead of requesting the "disclosure" of the personal information.