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Q&A: Patient Identification and Fraud Prevention

Use of stolen or fraudulent information to obtain healthcare services is a growing problem throughout the United States, but Notaries working in healthcare are in a position to help prevent this problem. The Healthcare Professionals Sectionspoke with Lorraine Fernandes, IBM’s global healthcare information technology and identification management expert, to discuss possible fraud prevention solutions.

What are the common types of patient ID fraud healthcare facilities encounter?
Patients or their family members may present fraudulent insurance cards in order to financially qualify for healthcare services. They may provide secondary ID to try and support these fraudulent cards, or have no secondary ID at all. Patients may also seek to obtain services for free by simply present fraudulent data such incorrect birthdates, addresses, or Social Security numbers. Another form of fraud is where a person uses someone else’s data to change their identity.

What steps can Notaries or other healthcare professionals take to prevent this type of fraud?
Requesting supplementary photo ID is a key way to ensure accurate identification, such as a driver’s license, passport, or other government-issued documents.

In healthcare, before an elective procedure, patients typically present ID for pre-admission testing, insurance verification and other paperwork. This is the time where presenting photo identification and appearing before a Notary can serve as confirmation the patient is genuine and that the appropriate paperwork was signed in the presence of the Notary.

In the case of emergency room treatment, there is regulation for non-profit facilities to treat patients regardless of their ability to pay. Once treated, the patient or family may need to complete paperwork and have identify verified, and for this the above Notary process may prove useful.

Do you think healthcare facilities will try to switch from human identification methods to electronic methods, such as biometrics, in the near future?
Biometric identification in healthcare is still in its infancy, and many patients still aren’t comfortable with placing their eyes or hands on a device to be scanned. There have been a few pilot programs, but biometrics is also very expensive. Some industries, including healthcare, financial services, and government, use sophisticated master data management (MDM) software to analyze multiple data elements in order to facilitate better identification and detect fraud.

I think for the time being many facilities will stick with human interaction, such as the use of Notaries combined with software programs that can help check the authenticity of an identification document.

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