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Tried and true practices for identity verification

Credentialing Resource Center Connection, April 5, 2007

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Two weeks ago, the topic of my Credentialing and Privileging Advisor column focused on how to properly confirm the identity of an applicant during the credentialing process.

The Joint Commission is quite specific on the methods which are acceptable to verify the identification of the practitioner.  I asked for organizations to share what they may be doing to confirm an applicant's identity in addition to the requirements of The Joint Commission.  Today, I'm pleased to share those results with you.

Overall, many respondents indicated that they include a photo as part of their correspondence to reference and verification sources, lending validation to that process. One reader also provided us with sample language that presents verification questions in a simple and direct format.

Sample form:

___ I confirm that the photo shown above is the physician I know as ______ MD

___ I have not seen ________ MD in person and am unable to confirm that the photo shown is her.

____ Other (please explain):

Signed:_______________________   Date:____________________

Printed Name: __________________________

Title:  ________________________   Contact Phone ___________________

In addition, here are some of the anecdotal practices that readers shared:

• The medical staff office often does not get to meet the individual until after they are appointed to the staff.  If they arrive at our door for an application, we take the opportunity to witness the driver's license, photo-copy and annotate that it is a true copy, dated and signed.

•  [At our facility] we do a criminal background check that includes a social security trace (in addition to The Joint Commission requirements and sending the photo along with the release to references/verifications). If the provider had taken the identity of someone else, it would show up in that check with multiple names associated with the social security number (SSN). The background check would also tell us if the "true owner" of the SSN was deceased.  It is tough these days, and even a government issued ID isn't a safe way to identify someone.

• We have a monthly new-applicant orientation program, which all applicants are required to attend. As the applicants enter we view their driver's license (or other photo ID if no driver's license). Application packets are given out at that meeting, so we've verified ID before giving an application. Of course, they do get and have to return a pre-application in advance, with required documentation that we verify before inviting to orientation. We then document the ID verification on a check-off list in the credentials file.

• In addition to obtaining visual verification, at the Tuscaloosa VA Medical Center in Alabama the human resources department takes fingerprints and matches with the "security investigation" requirements.

I thank Wendy Crimp, BSN, MBA, CPHQ, a consultant for The Greeley Company in the credentialing and privileging practice, for giving us the following food for thought regarding sending the photo to past affiliations and references.

Wendy writes:

The organization may elect to exceed the standards and confirm the applicant's identity with an outside contact during the credentialing process. In this event the organization might forward a photo to an individual who might attest that the applicant is the person that they also know as Dr. "X."  I first implemented this practice with clients approximately five years ago. The practice can be very problematic and if you decide that you want to proceed along these lines I would offer the following advice based upon my previous experience.

1. Scan the photo and print it directly on a reference letter. This letter cannot be faxed (the photo becomes too distorted) but may be e-mailed or printed on a high quality printer and "snail mailed." 

2. Send the photo query only to those peer references that have had contact with the applicant in the past two years. Prior to that I have found that there may be considerable follow-up required due to changes in appearance that cause the recipient to not recognize the applicant from their photo (fatter, skinnier, hair color, facial hair). I would not send the photo to hospital affiliation or training affiliation recipients, because often the person answering the letter is reviewing records and is not acquainted with the applicant.  I would also require the applicant to submit a passport-quality photo taken in the past year.

3. Things seem to run most smoothly when you ask the recipient of the query to select a response.  Something along the lines of.

• Option 1: The face in the photo matches the individual that I know to be Dr. "X."
• Option 2: The face in the photo is not the individual that I know to be Dr. "X."
• Option 3: I am unable to answer this question because I am unable to sufficiently recall the appearance of Dr. "X."

I'd like to thank the following individuals for sharing their practices and contributing to this article:

Velinda Russo, CPMSM, CPCS, manager, medical staff services, Fletcher Allen Health Care, Burlington, VT

Julie Miller, medical staff credentialer, medical staff office, Mercy Medical Center, Roseburg, OR

Lisa Scheetz, CPCS, manager, medical staff services, Goshen General Hospital, IN

Peggy Hickey, CPMSM, CPCS, credentialing coordinator, Bon Secours Cottage Health Services, Grosse Pointe, MI

Mary E. Wallace, CPCS, credentialing and privileging coordinator, Tuscaloosa NPI Facilitator, Tuscaloosa VA Medical Center, Tuscaloosa, AL

Remember, credentialing has no other master than the patient.

That's all for this week.

All the best,
Sally J. Pelletier, CPMSM, CPCS

http://www.greeley.com/consulting.cfm

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