Revenue Cycle

Seven tips to minimize medical identity theft

Patient Access Weekly Advisor, June 25, 2008

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In the healthcare spectrum, two types of theft compromise the integrity of your bottom line and the customers who contribute to it:
· Medical identity theft-When an individual steals another person's identity (usually through his or her insurance card) to obtain healthcare services
· Theft of patient identity-When an individual steals personal health information (PHI)
Donna K. Gilley, CCS, CHC, director of revenue cycle and regulatory compliance for LBMC Healthcare Group, LLC, in Brentwood, TN, offered the following seven strategies to protect your organization:
1. Ask for identification
A student ID, a driver's license, or any photo identification will suffice. But make sure that you don't jump to conclusions if the name on the driver's license and the name on the insurance card don't match up, Gilley says.
2. Publicize your charity care program
Make everyone aware that they can receive services and pay on a sliding scale, or perhaps incur no costs at all if they qualify for charity care.
3. Publicize the criminal repercussions
Inform patients that stealing insurance or PHI is against the law. "In some cases, you could have family members, a large family, and a few or even one [person] [with] valid insurance. They share it," said Gilley. "Let them know that there are felony charges that can be brought against the thief or the [original subscriber]."
4. The rumor mill
Educating staff about potential issues surrounding theft should include posting names of repeat offenders. Just do it discreetly, Gilley said.
5. Share information with other divisions of your organization
You're not allowed to share information with providers outside of your network unless it's for continuity of care, but it's useful to communicate the identity theft problem throughout your organization, including your sister hospitals and outpatient facilities.
6. Develop a policy for cross-referencing records
"What do you call the identity thief? Is it 'John Doe,' or do you call [him or her] by the stolen name with a subtext or flag on the record? Having a policy that alerts the staff on how to go about separating the record and how to cross-reference them when either one of the patients return is very important," Gilley said.
7. Consider including notices at the bottom of the patient's bill
"Business offices are not always thrilled with this suggestion. That might create some telephone calls for someone who simply does not want to pay [his or her] bill," said Gilley. "But at the same time, every facility should have a method of accepting a patient complaint or a patient's indication that [he or she] did not receive the services that are listed on the statement."



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