Thursday, September 24, 2009

Identification theft a disease in health care

Providers now required to check patient ID

It's not unusual to be asked to show photo ID when buying cigarettes or alcohol, or going into a night club. But now there is a new reason that people are being asked to pull out their picture identification.

Identity theft is on the rise, and no one is immune. The Federal Trade Commission recently began enforcing Red Flag Rules requiring creditors to take additional steps to ensure that identity theft is not a problem. This includes doctor's offices and hospitals.


To prevent medical identity theft:

•Closely monitor Explanation of Benefits sent by a public or private health insurer.

•Proactively request a listing of benefits from your health insurers.

•Request a copy of current medical files from each health care provider.

If you are a victim of medical identity theft:

•File a police report.

•Correct any erroneous and false information in your file.

•Keep an eye on your credit report.

•Request an accounting of disclosures.

Where medical records are concerned, identity theft can take on a whole new meaning.

"If someone pretends to be me and uses my health insurance, my medical record will be clouded with someone else's medical information," said Pam Watkins, director of internal audit and corporate compliance at Pocono Medical Center. "It's important to keep clinical records tidy."

Medical identity theft causes problems for not only the patient but also the health insurance companies and hospital or doctor's office.

"Showing ID protects not only the patient but also the organization to some degree," said Watkins. "We provide services and extend credit. Any organization has had it happen where someone tries to use someone else's health insurance. Sometimes it is borrowed, and other times it is stolen."

Blue Cross and Blue Shield of Northeastern Pennsylvania has not seen any real cases of medical identity theft, but it has implemented a plan if the circumstance arises.

"We would run those types of cases through our fraud unit," said Trish Savitsky, vice president of audit and compliance. "We make sure that the member is made whole again."

The new Red Flag Rules will not create any significant change for the insurance company, and BCBS is on board with the new law.

"We think requiring photo ID is a great idea. It's a great process," Savitsky said. "We already educate our members on keeping things secure."

And while medical identity theft is nothing new, people are now more aware of the consequences. In fact, medical identity theft has been going on for years.

CBS News reported a story in October 2006 about a woman who had her medical identity stolen. She received a phone call that her baby just tested positive for illegal drugs. The catch here: She hadn't given birth in years.

"To make matters worse, authorities showed up at her door the next day, called her an unfit mother and threatened to take away her four kids," according to the CBS News story.

And while this may not be the typical story, it is a possibility if someone poses as you to obtain medical care with your insurance.

But is everyone happy with the new law, or are there some people that oppose showing a picture ID?

"Most people understand that this is good for them. But we do occasionally have people reluctant to show us ID. We have to try to explain why it is we are asking for it," Watkins said. "It's complying with the law, so most patients understand that it is for their own protection."

Pocono Record

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